
















/ 


A V-ir 


HOME HAND-BOOK 


OF 


















































THE 


HOME HAND-BOOK 

OF 

Domestic Hygiene 

AND 

RATIONAL MEDICINE. 


y 

By J. H. KELLOGG, M. D., 



MEMBER OF THE AMERICAN ASSOCIATION FOR THE ADVANCEMENT OF SCIENCE, THE 
Cy AMERICAN PUBLIC HEALTH ASSOCIATION, THE AMERICAN SOCIETY OF MICROS- 
COPISTS, THE MICHIGAN STATE MEDICAL ASSOCIATION, STATE BOARD OF 
HEALTH OF MICHIGAN, EDITOR OF “GOOD HEALTH,” AUTHOR OF 
“PLAIN FACTS FOR OLD AND YOUNG,” “DIPHTHERIA,” “’J'HE 
HOUSEHOLD MANUAL,” “ALCOHOLIC FOISON,” AND VARIOUS 
OTHER WORKS ON HYGIENE AND TEMPERANCE. 


, « ; 

• 'Tv / 

BATTLE CREEK, MICH. 

GOOD HEALTH PUBLISHING COMPANY. 

1880. 




Entered according to Act of Congress, in the year 1880, 
By J. H. KELLOGG, M. D., 

In the office of the Librarian of Congress, at Washington. 


ALL RIGHTS RESERVED. 



PREFACE. 


It is unnecessary to argue the importance of a work of the character which 
this volume is intended to possess, since the demand for popular works 
relating to the preservation of health and the treatment of disease has in¬ 
creased so greatly, particularly within the last few years, that books of no 
other class are in such constant and general demand, if we except the in¬ 
dispensable family Bible. The common people as well as the higher classes 
in society are coming to think and investigate for themselves on all subjects 
of practical importance; and it is not surprising that there should be a 
general and increasing interest in subjects which involve the most vital of 
human interests,—life and health. There can be urged no reason of real 
weight why men and women of intelligence should not have an opportunity 
to acquire knowledge on ^11 useful subjects which can be brought within 
their reach. This fact has been well recognized in nearly every department 
of science, and at the pi'esent day, thanks to the labors of such eminent 
scientists as Prof. Proctor, Dr. Huxley, Prof. Tyndall, Rev. James G. Wood, 
and numerous other workers in various scientific fields, the great storehouse 
of knowledge into which the accumulated wealth of. the ages has been 
garnered, opens its doors almost as widely and freely to the wayfaring man, 
the laborer, or the most humble seeker after truth, as to the professor or the 
savant. New scientific facts are no longer held as secrets by their dis¬ 
coverers, to be imparted only to those who have the opportunity of sitting at 
the feet of learned professors in the temples of science, but are spread before 
the great masses of the common people in popular language, thus making 
each new acquisition to scientific knowledge the common property of the 
civilized portion of the race. The pioneers in this noble work of elevating 
the masses by sharing with them the golden treasures of scientific lore have 
not accomplished these grand results without opposition, oftentimes most 
bitter and unrelenting, from many men of equal rank with themselves as 
philosophers and scientists. It has been urged that science would lose some¬ 
what of its dignity if its truths were cheapened by popularization. The ex¬ 
periment has been tried, however, and the result is in the most eminent 
degree satisfactoiy. Science has lost some of its mystery, but has gained 

(i) 



11 


PREFACE. 


the confidence of thousands who before looked upon its choicest truths as the 
most monstrous vagaries. 

The science of medicine has been passing through this same ordeal. 
Medical scientists are of all classes of scientific workers the most conserva¬ 
tive. The wonderful revolutions which have overturned the fossil theories 
carefully hoarded in other departments of scientific research, and established 
new and better theories, have affected medicine much less than other branches, 
and hence we find many still clinging to notions which originated in an age 
when learning of all kinds was yet in a most primitive state; and one of 
these is the notion that the common people have no business with medical 
knowledge. We are glad to know that the adherents of this view are con¬ 
stantly decreasing. The more advanced and liberal class of thinkers in the 
profession are taking the same ground with reference to medicine that has 
already been very generally conceded for other departments of science ; viz., 
that every human being has a perfect right to acquire every atom of knowl¬ 
edge that he is capable of comprehending. It seems to us to be true be¬ 
yond all questioir that every human being has at least the right to know all 
about himself; and of all classes of knowledge none is so important as that 
which relates to the preservation of human life and the alleviation of human 
suffering. 

The people have ever manifested an eagerness to obtain information on 
subjects of the character treated of in this vojpme, which fact has been 
seized upon by charlatans and made a source of pecuniary profit through the 
sale of worse than worthless trash, on various medical topics, which has been 
sown broadcast over the country. Every newspaper teems with advertise¬ 
ments of medical pamphlets and books on special subjects for sale or to give 
away, which are simply adroit means of advertising the authors, whose igno¬ 
rance is only equaled by their impudence and mendacity. The evil results 
arising from the wide dissemination of this kind of popular medical liter¬ 
ature has undoubtedly been one of the great causes of the deep prejudice ex¬ 
isting in the minds of many eminent physicians against the popularization of 
medical facts; but this is really a most powerful reason for the pro¬ 
duction of a better class of literature to supply the existing demand, 
and to counteract the influence of the shameless pretensions of ignorant 
quacks and scheming charlatans. 

It has also been objected to works of this character that they are likely to 
do harm by teaching people to rely upon themselves instead of calling in a phy¬ 
sician when professional services are really required. HoAvever true this 
may be of some popular treatises on disease and medication, it is certainly 
no part of the object of this work to in any way detract from the dignity 
or usefulness of the profession of which we are proud in being a member. 


PREFACE. 


ill 


In fact, tlie very contrary lias been one of our chief aims in the production 
of this work. We may present the following as the principal objects which 
we have had in view in the preparation of this volume :— 

1 . To present in a popular and condensed form the latest and most relia¬ 
ble information on the subjects of Anatomy, Physiology, and Hygiene. Con¬ 
siderable space has been devoted to the description of the structure and func¬ 
tions of the various organs of the body, a. Because these subjects lie at 
the very foundation of all scientific medical knowledge; b. Because they 
have been universally neglected in works of a similar character. 

2 . To call especial attention to the causes of disease and the best means 
of prevention. It is universally admitted at the present time that prevent¬ 
ive medicine is of far greater importance than curative medication, and many 
of the most eminent members of the profession are devoting themselves ex¬ 
clusively to this branch. It has been attempted to make this work the most 
complete on this subject of any popular Treatise published. 

3 . To supply information respecting simple measures of treatment 
that can be employed by persons of ordinary intelligence in the absence of a 

• physician, when a physician cannot be obtained at once, or need not be 
called, as in cases of accidents and simple diseases or injuries which require 
only good nursing and the employment of simple remedies ; and also to render 
people competent to second the efforts of a wise physician in alleviating suf¬ 
fering and combating the fatal tendencies of disease. 

4 . To impress the importance of giving prompt attention to the first de¬ 
partures from health, and by controlling small beginnings to prevent the in¬ 
roads which result from a neglect of the employment of prompt and efficient 
measures. 

5 . To give a sufficiently clear outline of the nature of disease and of the 
most approved methods of treatment to enable the reader to discriminate be¬ 
tween the wise and reliable physician and the charlatan. 

How well we have succeeded in accomplishing the objects sought, we 
must leave the reader to decide. No pains or expense has been spared to 
make the work all that could be desired in a hand-book of this sort; and the 
present volume is the result of several years of research and earnest labor. 
The methods of treatment suggested are such as are recommended by the 
most eminent and scientific members of the profession, and such as we have 
found effective in our own experience. 

If it be remarked that drugs are recommended less frequently as remedies 
than in most similar works, we would say that we do not approve of the cus¬ 
tom of making an apothecary shop of the stomach by dosing for every 
trifling ailment of any part of the body. In our opinion, the use and pre¬ 
scription of drug remedies should be left almost exclusively to the family 


IV 


THE FACE. 


physician. Much more harm than good results from their domestic use. 
The design of this hook is not to displace the intelligent, careful physician, 
but to aid him in his philanthropic work, and to displace, so far as possible, 
the vast amount of worthless medical literature with which mercenary quacks 
have flooded the land. 

We are specially indebted to our friend Dr. H. B. Baker, Secretary of the 
State Board of Health of Michigan, for kindness shown in revising the proofs 
of the sections on “ Water,” “ Hygiene of the Air,” and “ Diseased Foods,” and 
for several valuable suggestions. We are also under obligations to Dr. B. C. 
Kedzie, Prof, of Chemistry in the State Agricultural College of Michigan and 
President of the State Board of Health, for revision of the proof-sheets of the 
section on “ Adulterations of Foods and Drinks,” and for several important 
suggestions which have enhanced the value of that portion of the book. 

For many of the original illustrations which embellish the pages of the 
work we are largely indebted to the artistic skill of our friend and colleague, 
Dr. W. J. Fairfield, who has unselfishly devoted nearly all his leisure mo¬ 
ments for many months in making designs, drawings, and engravings for use 
in the work, besides relieving us of many burdens which would otherwise 
have gi'eatly delayed the completion of the work. 

Lastly, we would acknowledge our great indebtedness for the means 
of making this work a useful one, if it shall prove to be such, to the long list 
of eminent medical authors, too numerous to mention here, whose works we 
have consulted, and especially to the kindness of the librarian of the great 
medical library of the Army and Navy Medical Museum, at Washington, 
D. C., who gave us free access to the vast amount of valuable material 
there collected, embodying all the latest discoveries and improvements in the 
science and art of medicine up to the present date, and of Mr. Apel, the em¬ 
inent linguist employed in the office of the Surgeon General as an intei'- 
preter and translator, who rendered us invaluable aid in acquainting our¬ 
self with the results of the researches of eminent medical authorities in va¬ 
rious continental European countries. 

We now commit this volume, the result of several years’ labor, to those 
into whose hands it may fall, believing that whatever of merit it possesses 
will be duly recognized and appreciated, and hoping that its faults will be 
faithfully pointed out for correction in future editions. 

AUTHOR. 

Battle Creek, Aug. 23, 1S80. 


CONTENTS. 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 

Definitions.—Anatomy—Physiology—Hygiene—Man’s place in nature 
—The constitution of matter—Matter the basis of existence— 

The nature of matter—Force and atoms—Organization—Low¬ 
est forms of life—The basis of life—The scale of being—How 
protoplasm works—Differences between inorganic and organized 
matter—Animals and vegetables—Distinctions between man and 

beast—What is right, and what is wrong?. 25—37 

General Anatomy, or Histology.—How a human machine is built— 

The anatomical elements—White fibrous tissue—Yellow clastic tis¬ 
sue—Connective tissue—Adipose tissue—Cartilage tissue—Osse¬ 
ous or bony tissue—Muscular tissue—Nerve tissue—Membranes 

—A general view of the human mechanism. 38-49 

The Bones.—Structure of bones—The joints—Varieties of joints—Di¬ 
visions of the skeleton—Bones of the head—The skull—Bones 
of the face—Bones of the trunk—The vertebrae—The thorax— 

The ribs—The sternum—The pelvis—The hyoid bone—Bones of 
the upper extremities—The scapula—The clavicle—The arm— 

The fore-arm—The hand—The inferior extremities—The thigh 
—The leg—The foot—The sesamoid bones—The wormian bones 
—Bones of the ear—Physiology of the bones—Support—Protec¬ 
tion—Motion—Possible function of the bones—Composition of 
the bones—Hygiene of the bones—Proper development—Im¬ 
proper food—Spinal curvatures—Deformity from tight-lacing— 

Abuse of the feet. 50-75 

The Muscles.—Two kinds of muscles—The tendons—Form and ar¬ 
rangement of muscles—Names and action of special muscles— 
Muscles of the head—The occipito-frontalis—The corrugator 
supercilii—Orbicularis palpebrarum—Auricular muscles—Mus¬ 
cles of the nose—Muscles of the mouth — Muscles of ex¬ 
pression—Muscles of mastication—Internal muscles of the eye 
—Internal ear muscles—Muscles of the neck—Muscles of the 
trunk—Muscles within the trunk—Muscles of the upper ex- 

(v) 







VI 


CONTEXTS. 


tremities—Muscles of the wrist—Muscles of the thumb and fin¬ 
gers—Muscles of the lower extremities—Muscles of the thigh 
—Muscles of the leg—Muscles of the foot—Physiology of the 
muscles—How a muscle contracts—Mechanical action of muscles 
—Uses of muscles—Locomotion—Manual motion—Speaking— 
Muscular action in respiration—Muscular action in digestion— 
Muscular action in the circulation of the blood—Relation of mus¬ 
cles and nerves—Fatigue—Muscular electricity—Muscular sense 
—Rigor mortis—Hygiene of the muscular system—Effect of dis¬ 
use of muscles—How to take exercise—Rest time to exercise— 

Kind of exercise to be taken—Deficient exercise by students— 
Over-training—Necessity for unrestrained action—Evils of tight- 
lacing and corset-wearing—Elastics—Pull-backs, low shoulders, 
etc.—Tight shoes—Bad positions—Bad positions in sleeping- 
improper attitudes in sitting—Bad positions in standing—How 

to walk—Relation of food to the muscles.76-115 

The Nervous System.—Anatomy of the brain and nerves—Structure of 
nerve tissue—Divisions of the nervous system—Description of the 
cerebro-spinal system—Structure of the brain—The spinal cord 
—The cerebro-spinal nerves—The sympathetic or organic system 
of nerves—General properties of nerves—Physiology of the brain 
and nerves—Functions of the medulla oblongata—Functions of the 
pons and optic lobes—Functions of the cerebellum—Functions of 
the central ganglia—Functions of the cerebrum—The functions 
of the spinal cord—Functions of the spinal nerves—Functions of 
the cranial nerves—Functions of the sympathetic system—The 
mind—The mechanism of thought—The will—Memory—Blush¬ 
ing—Pain and its uses—Sleep—Somnambulism—Mesmerism— 

Animal magnetism—Mind-reading—Phrenology—Hygiene of 
the brain and nerves—Necessity for mental exercise—Proper 
mode of developing the minds of children—School cramming— 
Unsymmetrical mental development—Evils of excessive brain- 

labor—Pernicious effects of stimulants and narcotics.116-165 

The Organs of Special Sense. —The skin—The sense of touch— 

The muscular sense—The sense of temperature—The sense of 
taste—Taste aided by other senses—The uses of taste—Electrical 
excitement of the sense of taste—The organs of smell—L'ses of the 
sense of smell—Hearing: the auditory sense—The external ear— 

The middle ear—The ear-bones—The internal ear—Physiology of 
the ear—The nature of sound—How we hear—The musical in¬ 
strument of the ear—The accommodation of hearing—L’se of the 





CONTENTS. 


Vll 


Eustachian tube—Source of the power of maintaining equi¬ 
librium—How direction of sounds is determined—Interesting 
facts about the sense of bearing—The eye and its functions—The 
orbit—The eyelids—The lachrymal apparatus—The eyeball— 

The iris—The ciliary muscle—The retina—The crystalline lens 
—The aqueous humor—The vitreous humor—The physiology of 
the eye—Properties of light—Properties of lenses—How we see 
—Accommodation of the eye—Visual judgments—Judgment of 
distance and size—Judgment of solidity—Curious facts about the 
sense of sight—After-images—The blind spot—Contrast—Hy¬ 
giene of the special senses—The law of use and abuse—Evils of 
excessive stimulation of the senses—Hygiene of the eye—Com¬ 
mon neglect of the eye—Tobacco a cause of eye disease—Effects 
of poor light—A cause of near-sightedness—Hygiene of the ears 
—Danger of meddling with the ears—Danger of boxing the ears 

—Taking cold in the ears—Exposures of the ears.166-201 

The Circulatory Apparatus.—The heart—Valves of the heart—The 
pericardium—The blood-vessels—Names of some of the principal 
arteries—The capillaries—The veins—Action of the heart— 

Heart sounds—Amount of work done by the heart—The pulse 
—Frequency of the pulse—The course of the blood in the circu¬ 
lation—The systemic circulation—The pulmonary circulation— 

The portal circulation—Forces of the circulation—The heart—The 
arteries—The capillaries—The muscles and the valves of the 
veins—Heat—The lungs—Regulation of the circulation—Reg¬ 
ulation of local blood supply—The blood—Composition of the 
blood—White blood corpuscles—The red blood corpuscles—The 
liquid portion of the blood—Eunctions of the blood—Function of 
the white blood corpuscles—Function of the red blood corpuscles 
—An interesting sight—The lymphatics—Functions of the lym¬ 
phatics—Hygiene of the circulation—Exercise necessary for a 
healthy circulation—Dangers of excessive exercise — Proper 
clothing essential to healthful circulation—Evil effects of con¬ 
striction—Effects of food on the circulation—Injurious effects of 

cold—Evil effects of heat . 202-230 

The Respiratory Apparatus.—The air-passages—The lungs—Physi¬ 
ology of respiration—Movements of respiration—Frequency of 
respiration—Coughing, sneezing, laughing, and other modifica¬ 
tions of respiration—Capacity of the lungs—Vital capacity— 
Composition of the air—Changes in the air during respiration— 
Changes in the blood in respiration—Respiration of the skin— 





vm 


CONTENTS. 


Hygiene of respiration—Lung exercise—The spirometer—Corset 
choking—Poisonous character of air which has been breathed— 
Rapidity with which the air is contaminated, by breathing—The 
effects of breathing impure air.231-245 

The Digestive Apparatus.—The alimentary canal—The mouth—The 
teeth—The milk teeth—The permanent teeth—The oesophagus 
—The stomach—The small intestine—The liver and pancreas— 

The colon—The digestive juices—The saliva—The gastric juice 
—The pancreatic juice—The bile—The intestinal juice—The 
physiology of digestion—The chemistry of digestion—The ele¬ 
ments of food—Action of the saliva—Action of the gastric juice 
—Action of the bile—Action of the pancreatic juice—Action of 
the intestinal juice—Review of the action of the digestive juices 
—The digestive process—Mastication—Insalivation—Stomach 
digestion — Intestinal digestion — Absorption — Oxygenation— 
Nervous relations—Vomiting—Hygiene of digestion — Hasty 
eating—Drinking at meals—Eating too frequently—Eating be¬ 
tween meals—Irregularity of meals—The proper number of meals 
—Eating when tired—Sleeping after meals—Late suppers—Too 
many varieties of food—Hot and cold bathing after meals—Er¬ 
rors in quantity of food—Overeating—Eating too little—How 
much should a person eat?—Deficient food elements—The quality 
of food—Bad cookery—Fried food—Uncooked food—Decayed 
food—Soft food—Too abundant use of fats—The use of sugar in 
excess—Condiments—Pickles—Vinegar—Tea and coffee—Alco¬ 
hol—Tobacco—Hard water—Alkalies—Perverted appetites— 
Adulterations of food—Unseasonable diet—Pressure upon the 
stomach—Drugs—Neglect of the bowels—Mental influence—Hy¬ 
giene of the teeth.246-299 

Secretion and Excretion.—Secretions—Excretions—The skin—The 
sweat glands—The hair—Sudden blanching of the hair—The 
sebaceous glands—The nails—Functions of the skin—Clean¬ 
liness—How to make the skin healthy—Bathing protects 
against colds—Aristocratic vermin—Bathing, a natural instinct 
—Clothing—Essential qualifications of clothing—False hair and 
hair dyes—The kidneys—The liver—The bile—The spleen— 

Other blood glands—Animal heat.300-315 

Reproduction.—Simplest form of generation—Sex—Hermaphrodism— 

Sex in plants—Sex in animals—Other sexual differences—Men and 
women differ in form—The male and the female brain—Vital organs 
of man and woman—The reproductive elements—Sexual organs of 








CONTENTS. ix 

plants—Sexual organs of animals—The ovum—Fecundation—Fe¬ 
cundation in flowers—Modes of fecundation in animals—Devel¬ 
opment—Unprotected development—Development in the higher 
animals and man—The uterus—Uterine gestation—The primi¬ 
tive trace—Curious relation to lower animals—Simplicity of early 
structures—The stages of growth—Duration of gestation—-Uter¬ 
ine life—How the unborn infant breathes—Parturition—Changes 
in the child at birth—Nursing—Puberty—Influence of diet on 
puberty—Premature development occasions early decay—Changes 
which occur at puberty—Menstruation—Nature of menstruation 
—Important hints—Custom of Indian women—Extra uterine 
pregnancy—Twins—Monsters—Hybrids—Law of sex—Hered¬ 
ity—Ante-natal influences—Sexual hygiene—Sexual precocity— 
Chastity—Mental unchastity—Early causes—Diet vs. chastity—- 
Tobacco and vice—Bad books—Unthought-of excesses—Conti¬ 
nence not injurious—Does not produce impotence—Difficulty of 
continence—Helps to continence—The will—Diet—Exercise— 
Bathing—Keligion—Sexual crimes—Criminal abortion—Secret 
vice—Evil associations—The evil underestimated.316-360 

I 

FOOD AND DIET. 

Definition of food—Classification of food—Albuminous elements ^ 

—Starch and sugar—Fats—Inorganic elements—Food elements 
not food—Food substances—Table of nutritive value of vari¬ 
ous articles of food—Proper proportion of the various elements 
—Table showing proportion of nitrogenous to carbonaceous elements 
in various foods—Table of combined foods—Table showing quantity 
of various foods necessary to furnish the required daily amount of 
nitrogenous elements—Popular errors relating to diet—It is an 
error to suppose that the appetite is always a correct crite¬ 
rion of the quality and quantity of food—It is an error to sup¬ 
pose that sick persons whose appetites are poor should be 
tempted to eat with tidbits and dainties—It is an error to 
suppose that children especially need large quantities of fat and 
sugar—It is an error to suppose that many varieties of food are 
essential to good digestion or nutrition—It is a very great error 
to suppose that brain-workers, students, clergymen, lawyers, and 
other persons whose vocation is largely sedentary, require but lit¬ 
tle food—It is an error to suppose that fish or any other single 
article of diet is brain food, muscle food, or food for any particu¬ 
lar part of the system—It is an error to suppose that people suf- 



X 


CONTENTS. 


fcring with nervous debility, neurasthenia, or other forms of 
nervous weakness, need large quantities of flesh food—It is a most 
erroneous notion that “ rich food ” is strengthening—It is an er¬ 
ror to suppose that persons engaged in laborious occupations re¬ 
quire a large amount of flesh food—It is an error to suppose that 
the system is better supported by meals at very frequent intervals 
than by food taken in accordance with the known time required 
for digestion—It is an error to suppose that the best preparation 
and support for extraordinary exertion is increasing the amount 
of food eaten proportionately—Vegetable and animal food—Testi¬ 
mony of eminent men—Lehman’s experiments—Dietetic impor¬ 
tance of meat overestimated—Meat a stimulant—Animal diet of 
Icelanders and its effects—Raw meat diet of the Abyssinians— 
Vegetable diet of the Mexicans—Cannibalism—Diseased foods— 

Origin of tape-worm—The trichinae—The liver fluke—The lung 
parasite—Bilious beasts—Parasites in wild game—Effect on ani¬ 
mals of abuse and violent exertion before slaughtering—Diseased 
and poisoned milk—Effect of diet upon meat, milk, and othei 
animal foods—Diseased vegetable foods—Pellagra—Rust, red-rag, 
or red-gum—Smut bolls, or pepper brand—Animal parasites— 

The meal-mite—The sugar-mite—Decayed food—Rotten cheese 
—Yeast and mold—Stale vegetables.361-414 

Adulterations of Foods and Drinks.—Modes of adulteration—Bread 
—Detection of alum in bread—To detect blue vitriol in bread— 

Flour—Butter—Milk—Sugar—Sirup—Test for iron—Test for 
sulphuric acid—Adulterated and artificial honey—Candy—Adul¬ 
teration of baking powders—Cheese—Canned fruits and veg¬ 
etables—Preserves, marmalade, etc.—Jellies—Fruit extracts—" 
Canned and potted meats—Vinegar and pickles—Lemon and lime 
juice—Tea and coffee—Adulteration of coffee, and modes of 
detection—Cayenne pepper—Artificial cider—Adulteration of tin 
—Poisoning from fruit-jars—Lead glazing—Accidental poisoning 
of water with zinc and lead.415-432 

WATER: ITS USES, AND DANGERS FROM CONTAMINATION. 

The hygienic value of water—Thirst—Regulation of tempera¬ 
ture—Depuration—Proportion of water in 1000 parts of various 
tissues—Composition of water—Pure water—Hard water—Is 
hard water wholesome ?—How to soften hard water—Organic im¬ 
purities in water—How to detect bad water—The fermentation 




CONTENTS. 


xi 


test—Permanganate of potash test—Suspended impurities—Im¬ 
pure ice—The purification of water—To remove turbidity—To re¬ 
move organic matter, color, and foul gases—Filtration—Care of 
filters—The best water.432-450 


STIMULANTS AND NARCOTICS. 

Alcoholic beverages—Wine—Beer—Cider—Alcohol—Gin— 

Whisky— Rum — Brandy — Pulque — Chica — Palm-wine, or 
toddy—Milk-beer, or koumiss—Arrack—Narcotics—Tobacco— 

Opium—Tea, coffee, cocoa, and chocolate—Mat6, or Paraguay 
tea—Indian hemp, or hashish—Lettuce—Hops—The Betel nut 
—Cocculus Indicus and sweet gale—Stramonium—Abysinthe 451-455 

Alcoholic Beverages.—Evil effects of alcohol—Effects of alcohol defi¬ 
nite and constant—Alcohol an irritant—Alcohol is a narcotic— 

Alcohol destroys the blood—Effects of alcohol on the heart— 

The whisky flush—Alcohol lessens muscular strength—Alcohol 
decreases animal heat—Alcohol as a cause of disease—Drunk¬ 
ards’ dyspepsia—Numerous functional diseases—Organic diseases 
induced by alcohol—The drunkard’s heart—Alcohol a cause of 
apoplexy—Alcoholic consumption—The gin liver—Alcohol a 
cause of kidney disease—Alcoholic insomnia—Nervous disor¬ 
ders of drinkers—Alcoholic insanity and idiocy—Alcohol pre¬ 
disposes to disease—The use of alcohol decreases longevity— 

Effects of moderate drinking—Hereditary effects of alcohol—Ef¬ 
fects of alcohol on the character—Adulteration of alcohol— 

The medical use of alcohol—Medical properties of alcohol— 

The vital instincts treat alcohol as a poison—Does change 
of name change properties ?—Does alcohol supply force ?— 

Is alcohol useful as a stimulant?—Does alcohol prevent waste? 

—Will alcohol prevent consumption ?—Medicinal use of alcohol 
leads to drunkenness—The medical use of alcohol an ally of in¬ 
temperance—Alcohol in delirium tremens—Alcohol for mothers 
—What does experience prove ?—Arguments in favor of alcohol 
considered—1. Alcohol is food—2. Alcoholic beverages preserve 
the body—3. Alcohol strengthens the muscles—4. Alcohol 
warms the body—5. Alcohol protects against excessive heat—G. 

Alcohol stimulates — 7. Alcoholic drinks protect the system 
against disease—8. Alcohol aids digestion—9. Alcohol is made 
from grain—10. Whisky does not hurt me—11. Pure liquor 
is not bad—12. Moderate drinking not harmful—13. Doctors 
recommend wine and brandy—14. Scientific men recommend the 



CONTEXTS. 


xii 


use of alcohol—15. All nations use stimulants—16. The use and 
sale of alcoholic liquors is a source of great revenue to the gov¬ 
ernment—17. The moderate use of wine is necessary to maintain 
nervous activity in old age—18. Alcohol drives away dull care— 

19. Alcohol increases mental power—20. Alcohol is a good med¬ 
icine ; and if it will make a man well when sick, will it not keep 
him well?—21. The Bible sanctions the use of wine—Two kinds 
of wine recognized in the Bible—Unintoxicating wine—Intox¬ 
icating wine—Scriptural distinctions of wines—Yayin—Shekar 
—Tirosh—The causes of intemperance—Tea and coffee encour¬ 
age drunkenness—The cure of intemperance.456-505 

Tobacco and Tobacco-Using.—Origin of the habit—The nature of to¬ 
bacco—Poisonous effects of tobacco—Why all smokers do not 
die of tobacco-poisoning—Effect of tobacco on the blood—To¬ 
bacco predisposes to disease—Smokers’ sore throat—Tobacco and 
consumption—Tobacco a cause of heart-disease—Tobacco and 
dyspepsia—Tobacco a cause of cancer—Tobacco paralysis—Nerv¬ 
ousness from tobacco—Hereditary effects of tobacco-using—Moral 
effects of tobacco-using—Apologies for tobacco-using considered. 506-518 

The Tea and Coffee Habit.—Tea—Coffee—Chocolate—Cocoa—Mate 
—History of the use of tea and coffee—Effects of theine upon 
man and lower animals—Evil effects of using tea and coffee— 

1 . They waste vital force—2. Tea and coffee injure digestion— 

3. The use of tea and coffee affects injuriously the nervous system 
—Moral effects—Tea-drinkers’ disorder—Arguments in favor of 
tea and coffee considered—Tea and coffee sustain the strength— 

Tea and coffee soothe the nerves—Tea and coffee assist digestion— 

Tea and coffee relieve headache—Tea and coffee supply the place 
of food—Tea and coffee increase mental vigor—Tea and coffee cor¬ 
rect the injurious effects of poor water—Tea and coffee are neces¬ 
sary condiments—Tea and coffee are substitutes for food—Tea 
“cheers and not inebriates”. 519-536 

The Opium Habit.—Enormous doses taken—Narcotic nostrums— 

Causes of the habit—Effects of the opium habit—Tyranny of 
the habit—Absinthe, chloral, ether, etc. 536-538 

'HYGIENE OF THE AIK 

The atmosphere — Impurities of the air — Carbonic acid 
gas—Test for carbonic acid—Carbonic oxide—Sulphureted 
hydrogen—Ammonia—Sulphuric acid—Disease germs — Dust 





Xlll 




CONTENTS. 

—Organic poison—Various sources of dangerous gases and 
disease germs—Cellars—Moldy walls—Privies—Barn-vards, hen¬ 
coops, etc.—Drains and cesspools—Decaying wood—Feather-beds 
and soiled clothing—Arsenical papers—Ventilation—Plans of 
ventilation—Window ventilation—Evils of window ventilation— 
Chimney ventilation—Ventilating shafts—Heating—Moistening 
of the air—Night air—Disinfection—Dry earth—Lime—Pulver¬ 
ized charcoal—Chloride of lime—Chlorine gas—Sulphurous acid 
—Copperas—Permanganate of potash—Ozone .53‘J-5S0 

RATIONAL REMEDIES FOR DISEASE, 

Bational remedies—What is disease ?—The medical pathies— 

The artificial method—Exclusive method—The expectant method 
—Rational medicine—Nature alone possesses power to heal— 

Any agent which will assist nature in effecting a cure is a reme¬ 
dial agent, and may, under proper circumstances, be used as such 
—Remedial agents affect the system beneficially not through 
their operations upon it, but through the reactions of the living 
tissue upon them—All remedial agents involve in their action an 
expenditure of the vitality of the patient—The best remedies are 
those which will furnish the most remedial aid with the least ex¬ 
pense to the vitality of the patient—Patients, not diseases, are to 
be treated—There is in nature no antidote for the results of the 
transgression of physical laws—Therapeutic agents or remedies 
for disease—Hygienic agents—Water—The physiological effects 
of water—Water as a diluent—The effects of the solvent proper¬ 
ties of water— a. An increase of the urinary excretion— b. An in¬ 
crease in the cutaneous excretion— c. An increase in the action 
of the liver— cl. Increased action of the intestinal mucous mem¬ 
brane—Effects resulting from the modification of temperature— 

The cold bath—Effect of cold upon the pulse—Effect of cold upon 
temperature—Rationale of effects of the cold bath—The hot bath 
-—Rationale of effects of the hot bath—The warm bath—Sympa¬ 
thetic effects—Modes of administration—Remedial properties of 
water, or hydro-therapeutics—Water as a refrigerant—Water as 
a tonic—Sedative effects of water—Antispasmodic—Water as an 
anodyne—Water as an anesthetic—Styptic effects of water— 

Water as a dissolvent—Eliminative effects of water—Laxative—- 
Emetic—Alterative—Derivative—History of hydro-therapeutics 
—The bath in Egypt—Bathing among the Jews—Persian baths 
—The bath among the Greeks—Roman baths—Testimony of 



I 


xiv 


CONTENTS. 

Arabian physicians—Modern bathing customs—Modern medical 
use of water—Testimony of eminent physicians—Errors in the 
use of water—Heroic treatment—Crises—Hydropathic quacks— 
Ignorance—A popular error—Absurd claims—Neglect of other 
remedies — Rational hydropathy — Applications of water — 1. 
Equalization of the circulation—2. Regulation of temperature— 
3. Removal of pain—4. To excite activity—5. Removal of obstruc¬ 
tions—6. Dilution of the blood—7. Influence on the nervous system 
—Temperature of baths—How to determine the temperature of a 
bath without a thermometer—Another method—Rules for bath¬ 
ing and the administration of baths—General applications—Swim¬ 
ming—Plunge bath—Sponge bath—Rubbing wet-sheet—Wet- 
sheet pack—Shower pack—Dry-sheet pack—Sweating pack— 
Full bath—Half bath—Shallow bath—Affusion—Pail douche— 
The cataract douche—Hose douche—Shower bath—Spray bath— 
Vapor bath—The Russian bath—Local applications—Sitz bath—• 
Leg bath—Foot bath—Half pack—Chest pack—Leg pack—Chest 
wrapper—Wet girdle—Ascending douche—Drop bath—Arm 
bath—Head bath—Eye bath—Ear bath—Nasal douche—Post¬ 
nasal douche—The uterine douche—Enema—Compresses—Fo¬ 
mentations—Applications of ice—Water drinking—Water emetic 
—Local applications of vapor—Applications of water in surgery 
—Miscellaneous baths—Sea-bathing—Mineral-water baths—The 
oil bath, or inunction—Novel baths—The milk bath—Mud bath— 
Earth bath—Therapeutical applications of temperature—Applica¬ 
tions of heat—The Turkish bath—Hot-air bath—Local applica¬ 
tions of dry heat—Applications of cold—Freezing—Aerotherapy, 
or remedial applications of air—Air bath—The use of com¬ 
pressed or rarefied air—Sunlight and insolation—Use of the 
concentrated solar rays—Ancient use of the sun bath—Electricity 
—Galvanic electricity—Faradic electricity—To prepare the ap¬ 
paratus for use—To distinguish the poles—To take care of the 
apparatus — Methods of modifying the current — Conducting 
wires—Electrodes—The effects of electricity—General faradiza¬ 
tion—Local faradization—The electric bath—Electro-vapor bath 
—Thermo-electric bath — Various combinations of electricity 
with water—Other electric appliances—Surgical uses of electricity 
-—Medical gymnastics or Swedish movements—The remedial value 
of movements—To regulate the circulation—To increase secre¬ 
tion and excretion—To increase respiratory power—To increase 
digestive power—To increase assimilation—To increase vital ac- 


CONTENTS. 


xv 


tion—To regulate muscular action—General principles governing 
the application of movements—Description of various move¬ 
ments—Movements to develop the muscles of the trunk—Mis¬ 
cellaneous movements—Passive and active-passive movements— 
Pulling movements — Kneading— Stroking—Clapping—Chop¬ 
ping—Knocking—Sawing—Vibration— Percussion—Massage— 

Muscle beating—Lung gymnastics—Mental therapeutics—Im¬ 
portance of employing mental therapeutics.581-727 

Medical Dietetics.— Meat, or flesh-food—Fats—Milk—Vegetables— 

Grains — F ruits — Sugar — Salt—Condimen ts — Drinks—Absti¬ 
nence from food—Digestibility of foods—Articles easy of diges¬ 
tion—Articles not easy of digestion—Indigestible articles—Nutri¬ 
tive injections—Meat solution—Pancreas and meat soldtion— 
Pancreas and cream—Beef tea and egg—Useful dietetic recipes 
—Milk and lime-water—Bran tea—Bran or wheat coffee—Acorn 
coffee—Water gruel—Milk gruel—Oatmeal gruel—Bice gruel 
—Milk porridge—Bice and apples—Bice blanc-mange—Arrow- 
root blanc-mange—Egg-nog—White of egg and milk—White of 
egg—Beef tea—Another method—Flaxseed tea—Barley water— 
Currant-jelly water—Apple water—Toast water—Lemonade— 

Ilot lemonade—Sago jelly—Bread jelly—Tapioca jelly—Gum 

arabic water—Diabetic bread No. 1.—Diabetic bread No. 2.727-743 

Medicinal Agents and Miscellaneous Remedies.—Tonics—Strych¬ 
nia— Mineral tonics—Heart stimulants — Ammonia—Alcohol 
—Digitalis—Heart sedatives—Antimony—Citric acid—Arnica 
— Prussic acid — Antispasmodics — Assafetida — Lactucarium 
— Coffee—Anodynes—Morphia—Belladonna—Hvosciamus and 
stramonium—Anesthetics—Chloroform — Ether — Nitrous oxide 
—Bi-chloride of methyl—Depresso-motors—Calabar bean—The 
bromides — Hydrate of chloral—Nitrite of amyl—Lobelia— 
Tobacco—Gelsemium—Alteratives—Arsenic—Mercury— Iodine 
— Iodide of potash—Iodoform—Cod-liver oil—Phosphoric acid 
—Colchicum—Sarsaparilla—Sassafras, taraxacum, etc.—Local 
remedies—Astringents—Alum—Sulphate of aluminum—Lead 
—Bismuth — Apomorphia — Mustard flour — Tartar emetic— 
Sulphate of zinc—Cathartics—Laxative food — Manna—Car¬ 
bonate of magnesia—Sulphur—The enema—Diuretics—Dia¬ 
phoretics — Expectorants — Emmenagogues — Oxytocics — Epi- 
spastics and rubefacients—Counter-irritation — Escharotics — 

Caustic potash—Vienna paste—Arsenic — Nitric acid — An¬ 
thelmintics—Senna—Spigelia—Koosso—Male fern—Pomegran- 




XVI 


CONTENTS. 


ate rind — Miscellaneous remedies — Pepsin—Dry cupping— 
Charcoal—Poultices—Bread and milk poultice—Bread and water 
poultice—Bran poultice — Indian meal mush poultice—Starch 
poultice—Slippery elm poultice—Linseed meal poultice—Char¬ 
coal poultice—Egg and alum poultice—Mustard poultice or plas¬ 
ter — Carrot and turnip poultices—Gargles—Alum gargle— 

Lime gargle—Chlorate of potash gargle—Brandy and water gar¬ 
gle—Permanganate of potash gargle—Carbolic acid gargle— 
Chlorine solutions—Lotions—Alcohol wash— Vinegar wash—- 
Wash for fetid feet—Wash for sore mouth and chapped hands— 

Borax wash—Wash for hands — Face-wash—To remove tan, 
clear the skin, etc.—Lotions for dandruff—Eye-washes—Lini¬ 
ments—Camphor Liniment—Ammonia liniment—Lime liniment 
—Chloroform liniment—Unguents, or ointments—Vaseline oint¬ 
ment—Cocoanut oil—Carbolic acid ointment—Itch ointments—• 
Ointments for sunburn—Inhalations—Oxygen—Ozone—Water 
—Vinegar—Lime—Carbolic acid—Balsam of Tolu—Glycerine 
—Glycerine and tannin—Gum arabic—Salt—Chlorinated soda 
—Permanganate of potash—Tar—Adhesive plasters — Decoc¬ 
tions— Blackberry-root tea—Tea of white-oak bark — Tooth 
powders—Medicated baths—Bran bath—Gelatine bath—Alkaline 
bath— Soap bath—Salt bath — Mustard bath —[Medicated fo¬ 
mentations—Sulpho-vapor bath— Glycerine bath—Salt-rubbing 
bath—The hot-air and vapor douche—Lime-water—To remove 
stains produced by nitrate of silver and iodine.743-810 

DESCRIPTION OF DISEASES AND THEIR TREATMENT. 

Structural derangements—Morbid conditions of the blood and 
other fluids—Diseased conditions of the solid structures of the 
body—Degenerations and morbid growths—Functional derange¬ 
ments— Irritation—Congestion — Inflammation — Depression — 

Fever—Causes of disease—Predisposing causes of disease — 
Symptoms of disease—Diagnosis—Prognosis—General principles 
of treatment.811-825 

General Diseases. —Irritation— Congestion—Depression—Inflammation 

825-836 

General Diseases of Nutrition. —Anaemia—Acute Anaemia—Chronic 
Anaemia—Chlorosis—Plethora—Obesity or corpulence—Scrofula 
or king’s evil—Hemorrhagic diathesis, or haemophilia—Scurvy 
—Diabetes mellitus, or true diabetes—Diabetes insipidis.837-871 





XVII 


CONTENTS. 


Diseases of the Digestive Organs.—Diseases of the mouth—Catarrh 
of the mouth—Aphthae—Cancrum oris, diphtheritic inflamma¬ 
tion of the mouth, or canker of the mouth—Ulcers of the mouth 
—Thrush or muguet—Inflammation of the tongue, glossitis—• 
Gangrenous sore mouth, or noma—Salivation — Pharyngitis, 
clergyman’s sore throat—Quinsy, tonsilitis — Enlarged tonsils—- 
Diseases of the oesophagus—Inflammation and ulceration of the 
oesophagus — Stricture of the oesophagus — Dilatation of the 
oesophagus—Morbid growths—Nervous diseases of the oesopha¬ 
gus—Paralysis of the oesophagus—Diseases of the stomach— 
Acute inflammation of the stomach, gastritis—Acute catarrh of 
the stomach, bilious attack—Cholera morbus—Cholera infantum 
— Chronic gastric catarrh—Dilatation of the stomach—Gastral- 
gia, or neuralgia of the stomach—Chronic ulcer of the stomach 
— Hemorrhage of the stomach — Cancer of the stomach—De¬ 
generation of the peptic glands—Diarrhea—Acute dysentery— 
Chronic dysentery— Colic — Enteralgia—Lead colic—Constipa¬ 
tion of the bowels—Intestinal hemorrhage—Intestinal obstruc¬ 
tions — Contraction—Twisting —Internal strangulation — Intus¬ 
susception—Hardened feces—Peritonitis—Abdominal dropsy, 
ascites—Consumption of the bowels, mesenteric consumption— 
—Dyspepsia—Errors in diet—General treatment—Removal of 
causes—Hygienic remedies—Diet—Table showing length of time 
required for digestion of various articles of food—Exercise—Rest 
and sleep—Traveling—Mental and Moral treatment—Dress— 
General measures of treatment—Baths — Inunction — Water¬ 
drinking—Special measures of treatment—To increase the secre¬ 
tion of gastric juice—Measures to increase muscular action— 
Flatulence—Acidity—Vomiting—Constipation—Acute dyspepsia 
—Simple dyspepsia, or slow digestion—Acid dyspepsia—Bilious 
or foul dyspepsia—Painful dyspepsia—Nervous dyspepsia—Mixed 
cases—An important caution—Depraved appetite—Polyphagia— 
Malacia and pica—Polydipsia—Inebriety—Intestinal parasites— 
Tape-worm— Round-worms, ascaris lumbricoides—Thread-worm, 
oxyuris vermicularis—Whip-worm, tricocephalus dispar—Strongy- 
lus duodenalis—Flukes—Diseases of the liver—Functional dis¬ 
eases of the liver—Torpid liver—Congestion of the liver—He¬ 
patitis, inflammation of the liver—Chronic inflammation of the 
liver—Inflammation of the bile-ducts—Gall-stones, biliary colic— 
Jaundice—Enlargement of the liver—Waxy liver—Fatty degen¬ 
eration of the liver—Hydatid tumor of the liver—Contraction 


XV111 


CONTENTS. 


of the liver—Displacement and distortion of the liver—Enlarge¬ 
ment of the spleen, ague-cake—Symptoms relating to the digest¬ 
ive organs—Flatulence—Acidity—Heart-burn—Nausea—Vomit¬ 
ing—Regurgitation of food—Swallowing air—Heaviness at the 
stomach—Faintness—Pain in the stomach—Pain in the bowels 
—Pain in small of back—Pain beneath shoulder-blades—Fullness, 
weight and pain in right side—Pain under ribs on left side— 

Painful defecation—Tenesmus, or constant desire to relieve the 
bowels—Weakness in bowels—Loss of appetite — Voracious 
appetite.872-972 

Diseases of the Respiratory Organs—Physical diagnosis—Inspection— 
Palpitation—Mensuration— Succussion—• Percussion—Ausculta¬ 
tion— Breathing iu disease—Rales — The voice in disease 
—Expectoration—Consistence—Quantity—Odor— Color— Con¬ 
stituents of the sputum—Cold in the head, coryza—Chronic nasal 
catarrh—Ozena—Nosebleed—Epistaxis—Catarrh of the larynx' 

•—Croup—(Edema of the glottis —Spasm of the glottis, laryngis¬ 
mus stridulus—Throat consumption, laryngeal tuberculosis— 

—Paralysis of the glottis, loss of voice, aphonia—Acute bron¬ 
chitis— Capillary bronchitis—Chronic bronchitis—Winter cough 
—Bronchial croup or croupous bronchitis—Asthma—Spasm of 
the diaphragm—Hay-Asthma, or hay fever—Emphysema—Col¬ 
lapse of lung—Congestion of the lungs'—Hemorrhage of the 
lungs—Pulmonary apoplexy — Inflammation of the lungs, 
Pneumonia—Croupous pneumonia—Catarrhal or lobular pneu¬ 
monia—Chronic pneumonia — Consumption—Causes—1. Im¬ 
pure air—2. Improper diet—3. Taking cold—4. Tight lacing— 

5. Contagium—6. Sexual excesses—7. Foreign bodies—8. Va¬ 
rious diseases—9. Alcoholic drinks—10. Tobacco—11. Depress¬ 
ing mental influences—12. Heredity—13. Prolonged nursing 
—14. Climate—Treatment—1. to check the fever.—2. To im¬ 
prove the patient’s nutrition—3. To arrest night sweats—4. To 
alleviate the cough—5. To develop the lungs—6. To sustain and 
invigorate the patient in every possible way—Miliary tuberculosis 
—Pleurisy—Hydrothorax, dropsy of the chest—Pneumothorax 
—Symptoms relating to the respiratory organs—Cough—Chin 
cough—Stomach cough—Nervous cough—Painful cough—Hack¬ 
ing or tickling cough—Heavy or hollow cough—Dry or tight 
cough—Short, sharp cough—The hoarse, barking cough—The 
whooping cough—Pain in the chest—Shortness of breath— 
Sneezing—Hiccough—Foul breath.973-1044 




CONTENTS. 


xix 


Diseases of the Circulatory Organs.—The pulse in health—The pulse 
in disease—Frequent pulse — Febrile pulse—Feeble pulse— 
Thready pulse—Slow pulse—Quick pulse—Hard pulse—Inter¬ 
mittent pulse—Irregular pulse—Irritable pulse—Wiry pulse—- 
Palpitation of the heart—Hemorrhage as a symptom—Hypertro¬ 
phy, or overgrowth of the heart—Dilatation of the heart—Fatty 
degeneration of the heart—Pericarditis, inflammation of the heart- 
case—Endocarditis, inflammation of the lining membrane of the 
heart—Inflammation of the heart—Valvular disease of the heart 
—Embolism and thrombosis—Bupture of the heart—Palpitation 
of the heart—Angina pectoris—Basedow’s disease, or exophthal¬ 
mic Goitre—Aneurism of the heart—Disease of the arteries— 

Disease of the veins—Varicose veins—Inflammation of the Lym¬ 
phatics—Leuchsemia, white blood—Cyanosis, blue disease. ...1044—1000 
Diseases of the Nervous System.—Causes of increased frequency of 
nervous diseases—Pain—Vertigo— Nervousness—Neurasthenia, 
or nervous exhaustion—Congestion or hyperemia of the brain— 
Anaemia of the brain—Apoplexy—Preventive treatment—Treat¬ 
ment during attack—Treatment immediately after the attack— 
Treatment of the after-results—Sunstroke—Brain fever—Soften¬ 
ing of the brain—Induration, or hardening of the brain—Hyper¬ 
trophy and atrophy of the^brain—Tumors of the brain—Spinal—■ 
meningitis—Inflammation of the spinal cord, Myelitis—Paraly¬ 
sis of the lower limbs, paraphlegia—Spinal irritation, or spinal 
anaemia—Locomotor ataxia—Neuralgia— Hemicrania, Migraine 
—Face-ache, or facial neuralgia—Lumbago—Intercostal neuralgia 
—Sciatica—Crural neuralgia—Headache—Congestive headache 
—Anaemic headache—Sympathetic headache—Sick, or bilious 
headache—Nervous headache—Headache from other diseases— 

Chorea, or St. Vitus’ dance—Epilepsy, or falling sickness—Hys¬ 
teria—Catalepsy—Tetanus, lockjaw—Paralysis agitans, shaking 
palsy—Muscular atrophy, wasting palsy:-Neuritis, inflammation of 
the nerve — Facial paralysis — Temporary paralysis—Mimetic 
spasm of the face—Torticollis, wry neck—Writer’s cramp— 

Cramp—Sleeplessness, or insomnia—Somnambulism—Homesick¬ 
ness or nostalgia—Hypochondria—Insanity—Illusion—Halluci¬ 
nation—Delusion—Incoherence—Delirium—Mania—Melancholia 
Dementia—Paresis, or general paralysis of the insane—Idiocy and 
imbecility—Lead palsy, or wrist drop—Alcoholism—Delirium 
trrmens—The opium habit—The tobacco habit,—The tea and 
coffee habit—Fatty degeneration of the nerves—Disorders of 
S p eec h—Aphasia—Stammering—Stuttering—Seasickness. . .1000-4144 


XX 


CONTENTS. 


Diseases of the TJrinary Organs.—Retention of the urine—Suppres¬ 
sion of the urine—Painful urination—Frequent urination—- 
Scanty urination—Color of the urine—Odor of urine—Taste of 
Urine—Reaction of urine—Density of Urine—Urinary deposits 
—Uric acid—Urates—Phosphates—Oxalate of lime—Pus in the 
urine—Bloody urine, or hematurea—Casts and ephithelium—• 
Chylous urine—Congestion of the kidneys—Hemorrhage from 
the kidneys—Acute inflammation of the kidneys, acute Bright’s 
disease—Chronic Bright’s disease—Abscess of the kidneys—Ab¬ 
scess near the kidneys—Fatty degeneration of kidneys—Waxy 
degeneration of the kidneys—Cancer and consumption of the kid¬ 
neys—Floating kidneys—Addison’s disease, bronze skin—Pye¬ 
litis, inflammation of the pelvis of the kidneys—Gravel in the 
kidneys, renal colic—Parasites of the kidneys—Catarrh of the 
bladder, cystitis—Hemorrhage of the bladder—Incontinence of 
the urine, enuresis—Spasm of the bladder—Paralysis of the blad¬ 
der—Irritability of the bladder—Gravel—Stone in the bladder— 

Tumors of the bladder.1145-1168 

Diseases of the Locomotive Organs.—Acute rheumatism—Chronic 
rheumatism—Deforming rheumatism, or rheumatic gout—Mus¬ 
cular rheumatism—Gout—Softening of the bone, mollitis ossium, 
ostomalachia—Fatty degeneration of the muscles.1169-1178 

Infections Diseases.—The germ theory of disease—Fever—The tem¬ 
perature—Classification of fevers—Febricula—Typhoid fever—- 
Typhus fever, ship fever—Relapsing fever—Bilious typhoid— 

Yellow fever—The plague—The black death—Sweating sickness, 
miliary fever—Erysipelatous fever, black tongue—Dengue, break- 
bone fever—Influenza, catarrhal fever—Mumps, or parotitis— 

Cholera—Whooping cough, chin cough, pertussis—Diphtheria—- 
Predisposing causes—Paralysis and other after-results—Local 
treatment—Disinfectants—Deodorants—General treatment—Pa- 
ralysis — Glander’s, farcy—Varicella, chicken-pox, wind-pox — 

Measles—German measles, rubeola—Scarlatina, scarlet fever— 

Rose rash—Cerebro-spinal meningitis, spotted fever—Small pox 

1145-1240 

Malarial Diseases.—What is malaria?—Chronic malarial poisoning— 
Protection from Malaria—Intermittent fever, ague-chills and 
fever—Treatment during the paroxysm—Ague-cake—Pernicious 
intermittent fever, congestive chills—Remittent, or bilious fever 
—Typo-Malarial fever—Masked intermittent.1145-1254 






CONTENTS. 


xxi 


Diseases of the Skin and Hair.—General principles of treatment— 
Various forms of eruption—Redness, or hyperacmia—Wheels— 

Papula, or pimples—Vesicles—Blebs—Pustules—Squamae, or 
scales—Tubercles—Nodules—Scabs, or crusts—Excoriations— 
Ulceration— Fissure—Cicatrix, or scar—Erythema — Urticaria, 
nettle-rash, hives—Heat-rash—Erysipelas, St. Anthony’s fire— 
Chilblains—Cold, or fever sores, herpes—Eczema, salt-rheum, 
moist tetter, scall—Psoriasis, dry tetter—Acne, face pimples— 
Comedo, or grubs—Pemphigus, water blebs—Impetigo —Ec¬ 
thyma—Pityriasis—Prurigo — Elephantiasis — Medicinal erup¬ 
tions—Oily skin—Dry skin—Dandruff—Milia and wens—Ex¬ 
cessive sweating—Offensive perspiration—Itching, pruritis — 
Purpura, the purples, land scurvy—Freckles, lentigo—Moth 
patches, liver spots, chloasma—Mother’s mark, mole, naevus— 
Albinism, piebald skin—Fishskin disease, ichthyosis—Slerodema 
—Keloid—Lupus, eating tetter—Callus—Itch, scabiei—Lice— 

Favus—Tinea versicolor—Hirsutes, overgrowth of the hair— 
Baldness—Gray hair, canities.1255-1287 

Diseases of the Male Generative Organs.—Inflammation of the pros¬ 
tate gland, prostatitis—Enlargement of the prostate—Balanitis— 
Catarrh of the urethra, urethritis—Priapism—Inflammation of 
the testicles—Nocturnal emissions, seminal losses, exhausted vital¬ 
ity—Treatment of self-abuse—Spermatorrhoea—Impotence—Ster¬ 
ility—Neuralgia of the testicles—Humors of the testicles—Syph¬ 
ilis, pox—Chancroid.1287-1299 

Diseases of Women.—Inflammation of the ovary—Congestion of the 
ovary, ovarian irritation—Ovarian dropsy—Inflammation of the 
uterus, Amenorrhaea—Scanty menstruation—Menorrhagia, pro¬ 
fuse menstruation—Metrorrhagia, uterine hemorrhage—Dysmen¬ 
orrhea, painful menstruation—Nymphomania—Sterility—Uterine 
catarrh, endometritis—Inflammation of the womb, metritis— 
Granular inflammation of the lips of the womb—Stricture of the 
uterine canal—Tumors of the womb—Displacement of the w 7 omb 
—Anteversion—Retroversion—Prolapsus of the womb—Flexions 
—Leucorrhaea, whites—Inflammation of the vagina, vaginitis— 
Vaginismus—Cystocele—Rectocele—Itching of the genitals, pru¬ 
ritis—Imperforate hymen—Inflammation of the breast, mastitis 
—Galactorrhaea—Overgrowth of the breast—Atrophy of the 
breast—Cracked nipple—Cancer of the breast—Fibrous tumor of 
the breast—Irritable breast—Rupture of the neck of the womb— 
Rupture of the perinaeum—Laceration of the perinaeum—Change 
of life—Coccyodynia, painful sitting—Enlarged abdomen.. . .1300-1338 






XXII 


CONTENTS. 


Obstetrics or Midwifery.— Signs of pregnancy—Quickening—Hygiene 
of pregnancy—Parturition without pain—Exercise—Diet—Dress 
—Bathing—Care of the breasts—Mental conditions—Labor of 
childbirth—Presentation and position—Stages of Labor—Man¬ 
agement of labor—Washing and dressing the child—The binder 
—Milk fever—Care of the breasts—Sore nipples—Inflammation 
of the breast—To check the secretion of milk—To promote the 
secretion of milk—Getting up—Hemorrhage after labor—Deten¬ 
tion of the after-birth—Inactivity of the womb—Frigidity of the 
womb—Rigidity of the perinseum—After-pains—The use of ergot 
—The use of anaesthetics—Twins—Abdominal pregnancy.. .1339-1358 
Disorders of Pregnancy. — Constipation — Piles, or hemorrhoids— 
Morning sickness—Disorders of the bladder and womb—Itching 
genitals—Vaginal discharges—Varicose or enlarged veins—Drop¬ 
sical swelling of the feet and limbs—Difficult respiration—Head¬ 
ache and disturbance of sight—Neuralgia—Miscarriage and abor¬ 
tion—Premature labor—Death of the fetus—Molar or false preg¬ 
nancy—Flooding—Puerperal convulsions—Puerperal fever. . 1359-1365 
Feeding and Care of Infants. —Infant diet—Cautions respecting infant 
i'eeding—Weaning—General care of infants—The bowels and 
bladder—Clothing—Bathing—Sleeping—Exercise—Teething 

1366-1373 

Diseases of Children. —General appearance—Pulse—Respiration—Ex¬ 
pression of countenance—Gestures—The cry—Posture—The eye 
—The tongue—Development—The bowels—General Symptoms 
—Convulsions—Infantile trismus, nine day fits—Tetanie—Night 
terrors, nightmare—Acute hydrocephalus, tubercular meningitis 
—Chronic hydrocephalus, water on the brain—False dropsy of 
the brain—Paralysis of the soft palate—Infantile paralysis—Spina- 
bifida, cleft spine—Rickets, rachitis—Consumptive constitution 
—Cephalhematoma, blood tumor of the scalp—Pain in the bow¬ 
els—Vomiting—Infantile dyspepsia—Worms—Skin eruptions 

1371-1393 


ACCIDENTS AND EMERGENCIES, 

Sudden illness—Fainting—Convulsions—Apoplexy—Sunstroke 
—V ertigo — Sudden mania—Shock — Hemorrhage — Bleeding 
from the nose—Hemorrhage from a cut throat—Hemorrhage from 
the arm or leg—Hemorrhage from the palm of the hand—Bice 1- 
ing from the gums—Hemorrhage from the arm below the elbow, 


CONTENTS. 


xxm 


or the leg below the knee—Hemorrhage from the stomach—Hem¬ 
orrhage from the lungs—Hemorrhage from the bowels—Bleeding 
from a rupture of varicose veins—Wounds—Punctured wounds— 

Torn and contused wounds—Dissection wounds—Bites of animals 
Hydrophobia, rabies—Snake bites—Bites and stings of insects— 

Bruises—Strains—Sprains—Burns and scalds—Fractures—The 
healing of fractures—General treatment of fractures—Bandages— 

Splints—Pyaemia and septaemia—Fractures of the skull—Frac¬ 
tures of the spine—Fracture of the nose—Fracture of the lower 
jaw—Fracture of the upper jaw—Fracture of collar bone—Frac¬ 
ture of the ribs—Fractures of the humerus—Fractures of the 
forearm—Fracture of the bones of the hand—Fracture of the 
fingers—Fracture of the thigh—Fracture of the knee-pan— 
Fracture of the leg—Fractures of the bones of the foot—Dislo¬ 
cations—Treatment of dislocations—Dislocation of the jaw—Dis¬ 
location of the shoulder—Dislocation of the elbow—Dislocation of 
the wrist—Dislocation from pulling the arm—Dislocation of the 
thumb and fingers—Dislocation of the hip—Dislocation of the 
knee-joint—Dislocation of the ankle—Dislocation of the bones of 
the foot—Dislocation of the toes—Miscellaneous accidents— 
Treatment of the drowned—Lightning-stroke—Freezing—Clothes 
on fire—Swallowing foreign bodies—Choking—Dirt in the eye—- 
Lime in the eye—Foreign bodies in the ear—Foreign bodies in 
tlie nose—Accidental poisoning—Specific methods of treatment in 
cases of poisoning—Table of poisons and their antidotes.1394-1445 

■ SURGERY. 

Abscess—Boils—Carbuncles—Bed-sores— Ulcers—Synovitis 
—Gangrene—Senile gangrene—Varicose veins—Aneurism—Vas¬ 
cular growths—Enlargement of the lymphatics.1446-1455 

Diseases of the Hands and Feet.—Ag-nail—Hang-nail—Run-around— 
Claw-like nails—Felon—Warts—Corns—Bunions —Stone bruises 
—Cracks between the toes—Ingrowing toe-nails—Deformities of 
hands and feet—Clubbed hands—Club-foot—Flat-foot—Deform¬ 
ities of the feet from improperly made shoes—Weak ankles— 
Bow-legs, or bandy legs—Knock-knee, or genu valgum —Short 

leg.. . T.. 1466-1468 

Diseases of the Eye.— Congestion of the conjunctiva, or mucous 
membrane of the eye—Catarrhal conjunctivitis, cold in the eye 
—Purulent conjunctivitis, suppurative inflammation of the eye— 
Inflammation of the eyes in the newly born—Sympathetic in- 





XXIV 


CONTENTS. 


flammation of the eye— Granular lids, trachoma—Inflammation of 
the edges of the lids—Acne of the eyelids—Blear eyes—Stye, 
hordeolum—Pterygium—Tumors of the eyelids—Ptosis, inabil¬ 
ity to open the eye—Inability to close the eye—Deformities of the 
eyelids—Wild hairs in the eye—Spasm of the eyelids—Twitch¬ 
ing of the eyelids—Adhesion of the lids—Epiphora, weeping eye— 
Cross-eye—Oscillation of the eyes—Inflammation of the cornea 
—Ulcers of the cornea—Opacities of the cornea—Arcus senilis— 

Iritis—Dilated pupils, mydriasis—Contraction of the pupil— 

Myosis—Cataract—Disease of the choroid or color coat of the 
eye—Disease of the retina—Disease of the optic nerve—Glan- 
coma—Specks before the eyes—Muscae volitantes—Amaurosis 
Pain in the eye—Blurred sight—Loss of sight—Test types—Old- 
. sight—Long-sight—Short-sight—Astigmatism—Glasses— Color 

blindness.1479-1506 

Diseases of the Ear.—Discharge from the ear—Abscesses in the audi¬ 
tory canal—Earache—Hardened ear-wax—Ringing in the ears, 
tinnitus aurium—Parasitic inflammation of the auditory canal— 

Acute catarrh of the ear—Chronic catarrh of the middle ear—• 
Nervous deafness—Rupture, or perforation of the membrane of 

the ear—rEar trumpets—Deaf-mutism.1506-1517 

Tumors.—Fibrous tumors—Fatty tumors—Cartilaginous tumors—Bony 

tumors—Cystic tumors—Horny tumors—Cancer.1518-1520 

Miscellaneous Surgical Diseases and Operations.—Ligation of blood¬ 
vessels—Hare-lip—Cleft palate—Restoration of nose—Polypus in 
the nose—Elongated uvula—Gum boil—Tartar on the teeth— 

Decay of teeth—Tongue-tie—Removal of tongue—Ranula—Tra¬ 
cheotomy—Goitre—Hernia—Piles—Fissure of the anus—Itch- 
in sr of the anus—Abscess near the anus—Fistula in ano—Ulcer 

O 

of the rectum—Stricture of the rectum—Prolapsus of the rectum 
—Polypus of the rectum—Absence of anus—Artificial anus— 

Use of the catheter—Urinary calculus—Extroversion of the blad¬ 
der—Hypospadias—Stricture of the urethra—Varicocele— Hy- » 
drocele — Phimosis — Paraphimosis — Circumcision — Castration 

1520-1530 





LIST OF ILLUSTRATIONS 


Fm. Page. 

1-8. Illustrate protoplasm and cells. 3d 

9, 10. White and yellow fibrous tissue. 40 

11, 12. Connective and adipose tissue. 41 

13. Cartilage tissue, showing the character¬ 

istic cells. 42 

14. Transverse section of bone as seen with 

the microscope. 43 

15. Magnified view of longitudinal section of 

bone. 43 

16. Muscular tissue showing smallest fibres 

with striae. 44 

17. Non-striated muscular fibres. 41 

18. Nerve cells, showing poles. 45 

19. Nerve fibres, showing fibrillae. 45 

20. Epithelial cells. 47 

21. 22. Skeleton, and long bone, showing 

periosteum. 50 

23. Longitudinal section of the large end of 

a Done. 51 

21. Skull, showing the sutures. 52 

25. “ with bones separated. 62 

26. “ “ outer plate removed, showing 

the diploe and the channels for blood¬ 
vessels. 53 

27. The spinal column. 56 

28. Vertical section of two contiguous verte¬ 

brae, showing their spongy structure 
and cartilage between them. 56 

29. The first vertebra, called the atlas. 57 

30. Bones of the foot. 62 

31. Malleus, incus, and stapes. 63 

32. Designed to show how the jar of walking 

is prevented from reaching the brain.. 64 

33. Bone rendered flexible and tied in a knot 66 

34. Section of vertebrae, showing fibro-carti- 

lage disc of normal shape. 71 

35. Showing cartilage thickened as the re¬ 

sult of anterior curvature. 71 

36. Showing cartilage thinned, as result of 

posterior curvature. . 71 

37. Double curvature of the spine. 72 

37. Fusiform muscle. 77 

38. Pennate “ ., 77 

39. Fan-shaped “ 77 

40. Circular “ 77 

41 General view of the muscles. 78 

42. Muscles of the head and neck. 79 

43. “ “ face “ “ 80 

44. Showing muscles of the eye. 80 

45. “ “ “ trunk. 81 

46. Illustrating first kind of lever. 86 

47. “ second “ “ 86 

48. “ third “ “ 86 

49. Second kind of lever ill. by the foot. 87 

50. Third “ “ “ “ arm. 87 

51. Di-gastric, illustrating the pulley. 88 

52. Waist of natural shape. 100 

53. “ compressed by tight-lacing. 100 

54. Ribs in their natural position. 101 

55 “ distorted by corset-wearing. 101 

56. Chinese lady's foot and slipper. 103 

57, 58. Improper positions in sleeping. 107 

59, 60, 61, 62. Improper positions in sitting. 108 
61. Proper position “ “ 109 

64. Unhealthy position made necessary by 

old-style school seat. 110 


Fig. . Page 

65. Correct attitude encouraged by Auto¬ 

matic school seat. Ill 

66. Improper position in standing. 112 

67. Proper “ “ “ . 112 

68. General view of nervous system. 116 

69. The brain and spinal cord. 117 

70. View of upper surface of brain. 117 

71. “ “ under “ “ showing 

the origins of several pairs of nerves. 118 

72. The left half of the brain. 118 

73. Horizontal section of the brain through 

its middle portion, showing relation of 
the white matter to the gray. 119 

74. View of the cranial nerves, with their 

points of origin in the brain. 119 

75. View of Sympathetic Nervous System... 121 

76. Diagram showing position of “bumps” 

as located by phrenology. 153 

77. Illustrating sense of touch. 168 

78. The ear, showing all three parts. 175 

79. Incus, malleus, and stapes. 176 

80. The internal ear. 177 

81. The eye, showing apparatus for remov¬ 

ing tears from the eye. 182 

82. Glandular apparatus of the eye. 183 

83. Vertical section of the eyeball. 184 

84. Diagram, showing optical properties of 

lenses. 187 

85. Card, showing limit of accommodation 

to the eye. 189 

86. Crystalline lens, adjusted for different 

distances. 189 

87. Illustrates the blind spot on the retina.. 192 

88. The heart. 202 

89. Shows two sides of the heart and their 

cavities. 203 

90. Double heart of dugong. 203 

91. The heart with portions of its walls re¬ 

moved, showing interior cavities. 204 

92. Heart, showing relative size of its cavi¬ 

ties and thickness of the walls of ven¬ 
tricles. 204 

93. The arterial system. 205 

94. “ venous “ 206 

95. Valves of veins closed. 207 

96. “ “ as they appear when the 

vein is slit open. 207 

97. Diagram, showing valve between auricle 

and ventricle open, and semi-lunar 
valve closed. 207 

98. Diagram, showing valve between auricle 

and ventricle closed, and semi-lunar 
valve open. 208 

99. Tracing of the pulse obtained by the 

sphygmograpli. 209 

100. Diagram of the circulation. 210 

101. Diagram showing direction of blood 

current in blood-vessels. 211 

102. Shows how valves of the veins aid the 

circulation. 213 

103. Red and white blood corpuscles. 216 

104. Red blood corpuscles. 217 

105. Lymphatic gland. 221 

106. Lymphatic glands and vessels of the 

head and neck. 222 

107. Lymphatic vessels of arm. 223 


(xxv) 


























































































XXVI 


LIST OF ILLUSTRATIONS. 


Fig. Page. 

108. Lymphatic vessels showing valves. 223 

109. Means of protecting back of head and 

neck from exposure to the sun. 230 

110. The pharynx. 231 

111. The larynx. 231 

112. The air-passages of the lungs. 232 

113. Lobules of lung, showing air-cells. 233 

114. Cut showing relation of lungs and heart 234 

115. “ “ how capacity of chest is 

enlarged by expansion of its walls, &c. 235 

116. A literal view, illustrating the same... 235 

117. Relative capacity of the chest and po¬ 

sition of diaphragm after complete ex¬ 


piration . 237 

118. Relative capacity of the chest and posi¬ 

tion of the diaphragm after a full in¬ 
spiration. 237 

119. Spirometer. 241 

120. The alimentary canal. 246 

121. The mouth. 247 

122. The temporary or milk teeth. 248 

123. The permanent teeth. 249 

124. The stomach and portion of duodenum. 250 

125. Villi of intestines magnified. 252 

126. Villi of intestinal mucous membrane... 252 

127. Folds of intestinal mucous membrane. 253 

128. Pancreas, duodenum, spleen. 253 

129. Portion of intestinal canal, showing 

mesenteric glands and lacteals. 264 

130. Root of a hair. 302 

131. The kidney. 313 

132. Internal structure of kidney. 313 

133. Spleen. 314 

134. Sexual organs of plants. 321 

135. Spermatozoa; human, and of lower ani¬ 

mals. 321 

136. Human ovum. 322 

137. Diagram illustrating segmentation of 

ovum. 325 

138. Ovum after fecundation. 325 

139. Chang and Eng, Siamese twins. 339 

1*0. Starch Granules. 363 

141. Milk globules. 365 

142. Fat cells. 365 

143. Grain of wheat magnified. 367 

144. “ “ “ with husk removed_ 367 

145. Transverse section of grain of wheat.. 367 

146. Cut showing various layers of the grain 

of wheat. 367 

147. Same as Fig. 146 more highly magni¬ 

fied. 368 

148. Same as Fig. 146 greatly magnified. 368 

149. Teeth of carnivorous animal. 880 

150. Skull of baboon tfrugivorous). 330 

151. “ “ wild boar (omnivorous). 3so 

152. “ “ rodent. 330 

153. Skull of chimpanzee. 381 

154. The human skull. 381 

155. Measly pork containing young tape¬ 

worms . 395 

156. Trichinae.—Two in a single capsule. 397 

157. Meat containing trichinae in calcareous 

cysts. 398 

158. Same as Fig. 157 enlarged. 393 

159. Healthy milk as seen through the micro¬ 

scope . 403 

160. Diseased milk . 403 

161. Spurred rye, or ergot. 40 

162. Ergot grains enlarged. 407 

163. Flour infested with rust as seen under 

the microscope. 408 

164. The rust fungus. 409 

165. Spores of smut bolls. 409 

166. Spores of yeast. .. 412 

167. Yeast fungus. 413 

168. Green mold of old cheese and stale 414 

bread . . 

169. A reservoir filter . 446 


Fig. Page. 

170. Same as Fig. 169, but showing filter in 

sections. 446 

171. Simple form of filter. 447 

172. Another filter. 447 

173. Pocket filter. 447 

174. Cistern filter. 448 

175. Nicotiana Tabacum. 506 

176. Stem of tea plant, showing flowers. 519 

177. Leaf and fruit of ci coa. 520 

178. Mate or Paraguay tea. 621 

179. Candle extinguished by carbonic acid.. 

gas. 542 

180. Pouring carbonic acid gas. 542 

181. Atmospheric germs greatly magnified.. 548 

182. Pail for use with dry-earth system. 555 

183. Dry-earth pail in position. 555 

184. Trap for drain. 558 

185. 186, 187. Experiments with carbon gas. 565 

188, 189. Evils of window ventilation. 563 

190. Best ventilation. 569 

191. Stove-pipe ventilator. 570 

192. Air inlet box. 571 

193. Ventilation working wrong way. 572 

194. Diagram showing defective system of 

ventilation. 572 

195. Stove-pipe ventilation. 575 

196. Wet rubbing sheet. 640 

197. Wet-sheet pack. 642 

198. Shower pack. 644 

199. The full bath. 645 

200. Portable rubber bath. 646 

201. The half bath. 647 

202. The shower bath. 649 

203. A simple shower bath. 650 

204. Vapor bath. 651 

205. The sitz-bath tub. 653 

206. Leg bath. 654 

207. Foot bath. 655 

208. The drop bath. 658 

209. Arm bath . 658 

210. The nasal douche. 660 

211. The syphon syringe. 661 

212. The syphon syringe so arranged as to 

supply a large quantity of water. 662 

213. Application of continuous cold to the.. 

chest for hemorrhage of lungs. 679 

214. Double bag for applying continuous 

cold to the knee. 680 

215. Ice head-cap. 680 

216. Spinal ice-bag. 680 

217. Pneumatic cabinet.. 682 

218. Apparatus for inhaling compressed air. 682 

219. Juuod’s boot with air pump. 683 

220. Junod's arm. 6 S3 

221. Faradic battery. 688 

222. Family faradic battery. 639 

223. Galvanic battery. 692 

224. Galvano-cautery battery. 692 

225-203. Instruments used in applying elec¬ 
tricity . 693 

231. Administering electricity. 6'4 

2 )2-266. Swedish Movements.708-717 

267-272. Muscle-beating.717-720 

273. A steam inhaler. 802 

274. Section of an inhaler. 802 

275. Improved stomach pump .. 898 

276. Egg of tienia saginata. 947 

277. Egg of taenia bothriocephalus latus_ 947 

278. Egg of tienia solium. 947 

279. 280. Embryo of tape-worm.. 947 

281. Sections of tsenia solium... 943 

282. Sections of tienia saginata.1. 948 

283. Head of tape-worm. 949 

284. Round worm, natural size . 950 

285. Thread worm, natural size. 951 

286. Thread worm shedding its skin. 952 

287. Whip worm . . 952 

288. Natural size and position of liver_ 961 
























































































































LIST OF ILLUSTRATIONS. 


xxvii 


Fi®. Page. 

289. Greatly enlarged liver . 962 

290. Gin-liver. 963 

291. Liver distorted by tight lne'ng. 964 

292. Liver deformed by compression. 965 

293. Liver Bhowing effects of compression.,. 965 

294. 966 

295. “Tight-lace fissure” of the liver. 966 

296. Using the laryngoscope. 973 

297. Healthy vocal cords..*. 974 

298. Ulceration of vocal cords . 974 

299. Tongue depressor.,. 974 

300. The stethoscope. 976 

301. Relative position of internal organs_ 978 

302. Parement epithelium from the mouth.,. 980 

303. Cylindrical epithelium. 980 

304. Yellow elastic tissue fibre from lungs. 981 

305. Cast of bronchial tubes, . 981 

306. Plugging the nose . 988 

307. Magnified portion of lung affected by 

emphysema. 1006 

308. Residual air-pump. 1007 

309. Respirator. 1008 

310. Applying cold to chest for hemorrhage 

of lungs. 1012 

311. Magnified portion of lung tissue in con¬ 

sumption. 1023 

312. Pneumatometer. 1030 

313. Spirometer. 1030 

314. Aspirator. 1038 

315. Pulse of a healthy person. 1045 

316. Irregular pulse of a tobacco-user. 1045 

317. Transfusion of blood. 1057 

318. Hypodermic syringe. 1066 

319. 320. Showing points at which electricity 

should be applied to affect special 
nerves and muscles. 1085 

321. Splint for wry neck. 1113 

322. Apparatus for relief of writer’s cramp 1114 

323. Strait-jacket. 1133 

324. 325. Crystals of uric acid . 1150 

326. Crystals of triple phosphates. 1151 

327. “ “ oxalate of Jime . 1151 

328. Pus cells . 1152 

329. Epithelial casts. 1152 

330. Granular ** 1152 

331. Hyaline “ . 1 52 

332. Congested kidneys... 1153 

333. Hand deformed by rheumatism. 1175 

334. Healthy muscular fibres. 1178 

335. Fatty muscular fibres. 1178 

336. Fever thermometer. 1180 

337. A diphtheritic throat. 1209 

338. Diphtheritic germs. 1211 

339. Female itch mite laying eggs in a bur¬ 

row . 1277 

340. The head louse. 1279 

341. The body or clothes louse. 1279 

342. The crab or pubic louse .".. 1279 

343. Nits or eggs of head louse. 1279 

344. Ringworm parasite, greatly magnified.. 1281 

345. A hair affected by ringworm, . 1281 

346. Fungus of favus. 1282 

347. Parasitic fungus of tinae versicolor. 1283 

348. 349. Examples of hirsutes. 1283 

350, 351. Rubber nipples for nursing-bottles 1367 
352-354. Side, vertex, and front view of head 

of hydrocephalic child. 1383 

355. Compression of artery of the arm. 1397 

356. Another method. 1398 

357. Centipede. 1407 

358. Scorpion. 1407 

359. Jigger . 1407 

36 ». Bedbug. 1407 

361. Tick. 1407 

362. Flea highly magnified. 4407 

363. Lancet of musquito. 1408 

364. Tarantula. 1408 

365. 366. The roller bandage and the mode of 

applying it. 1415 


1 AiiiVt 

367. A limb after being bandaged. 1415 

368. Bandage for factored jaw,. 1417 

369,370. Adhesive straps for fractured collar- 


371. Adhesive plaster for fractured ribs. 1419 

•U2- Splint for fracture of the arm-bone .... 1419 

373 . Apparatus for fractured thigh,. 1422 

374. Illustrates method for treating frac¬ 

ture of the knee-pan. 1423 

375. Fracture box. 1424 

376. Illustrates method for reducing dislo¬ 

cated shoulder by pulley. 1427 

377. Apparatus for dislocated shoulder. 1428 

378. Dislocated thumb. 1429 

379. Apparatus for setting dislocated finger. 1429 

380. Illustrates method of reduction by pul¬ 

leys for dislocated hip. 1430 

331-385. Restoration of the drowned_1432-1435 

386. Clothing on fire,. 1437 

387. Bristle probang. 1438 

388. Scalpel . 1447 

389. Bistoury. 1447 

390. Air cushion. 1449 

391. Amputation of the arm. 1454 

392. Apparatus for stiff joint. 1457 

393. Another appparatus for the same. 1458 

394. 395. Ilip-joint disease. 1459 

396. Hip splint. 1460 

397. Harness for spinal curvature. 1461 

398. Wheel carriage. 1.462 

399. Apparatus for curved spine. 1462 

400. Lateral curvature of spine. 1463 

401. Spinal swing. 1463 

402. Apparatus for lateral curvature. 1464 

403. House-maid’s knee . 1465 

404. Section of acorn. 1469 

405. Distorted foot. 1470 

406. Apparatus for bunions. 1470 

407. Apparatus for ingrowing nail. 1471 

408-418. Congenital deformities of the hands 

and feet. 1472 

419. Talipes eqninus . 1473 

420. Talipes valgus. 1473 

4.1. Talipes varus. 1473 

422. 1’alipes Calcaneus. 1473 

423. Talipes Calcaneus. 1473 

424. Shoe for talipes calcaneus. 1474 

425. Shoe for talipes varus . 1474 

426. Outline sole of a normal foot. 1474 

427. Outline sole of normal foot showing 

size of fashionable shoe. . 1474 

428. Effects of wearing narrow-toed shoes.. 1474 
429-431. Deformed feet from improperly 

made shoes. 1475 


432. Deformi y of Chinese woman’s foot .... 1475 

433. Outline of sole of Chinese woman’s foot 1475 
434-436. Ou line of improperly made shoes.. 1476 
437, 438. Outline of soles of the Meyer’s shoe 1476 


439. Shoe and brace for weak ankles.1477 

449. Brace for bandy leg. 1477 

441. Brace for knock-knee . 1478 

442. Extension for short leg. 1478 

443. Apparatus for short leg . 1478 

444. Dirt in the eye. 1484 

445. Bowman’s probes. 1491 

446. Medicine dropper. 1494 

447. Cataract knife. 1495 

448,449. Ophthalmoscope. 1496 

450. Convex lens. 1500 

451. Eyeball of long-sighted eye. 1503 

452. Shor -sighted eye. 1503 

453. Bi concave lens. 1504 

454. Test diagram. 1505 

455. Politzer’s rubber bag. 1511 

456. Eustachian catheter . 1512 

457. Diagnostic tube. 1512 

458. Ea specula of three sizes. 1514 

459. Bi-valve ear specula. 1514 

460. 461. Ear trumpets,. 1515 


































































































































XXV111 


LIST OF ILLUSTRATIONS. 


Fig. Page. 

462. Auricles. 1515 

463. Conversation tube.. 1515 

464. Silver cornets. 1515 

465. Artificial drum membrane. 1515 

466. Audiphone. 1515 

467* 494. Deaf and dumb alphabet . 1517 


Fig. Page. 

495. Artery forceps. 1520 

496-498. Hare-lip. 1521 

499. Truss. 1524 

500. Probe-pointed bistoury . 1526 

501. Catheter. 1528 

502. Lilhotrite. 1529 


LIST OF COLORED PLATES. 


Plate I .—THE SKELETON. 

Plate II.—THE MUSCLES. 

Plate III.—THE NERVOUS SYSTEM. 

Plate IN.—THE SKIN. 

Plate N.—THE CIRCULATION. 

Plate VI .—THE HEART , BLOOD CORPUSCLES , AND CIRCULA¬ 
TION IN THE FOOT OF A FROG. ' 

Plate VII.— DIAGRAM OF INTERNAL ORGANS. 

Plate VIII .—DEMODEXFOLLICULORUM AND ACARUS SCABIE1. 
Plate IX. TRICHINAE AND OTHER PARASITES. 

Plate X. — PARASITES FOUND IN MEAL AND SUGAR. 

Plates XI, XII.— LEAVES OF TEA , AND VARIOUS LEAVES USED 
IN ADULTER A TION. 

Plate XIII.—ANIMALCULES AND INFUSORIA IN WATER. 
Plate XIV .—EFFECTS OF ALCOHOL AND TOBACCO. 

Plates XV, XVI .—ILLUSTRATING INSANITARY CONDITIONS. 
Plate XVII.— POISON IVY—STRAMONIUM. 

Plate XVIII.— BLACK HELLEBORE—FOXGLOVE. 

Plate XIX.— FOOL'S PARSLEY—FLOWERS AND ROOT OF 
ACONITE. 

Plate XX .—GARDEN NIGHTSHADE—INDIAN TURNIP. 

Plate XXI .—HENBANE—SHEEP LAUREL. 

Plate XXII.—YELLOW JASMINE—MAY APPLE. 

















ANATOMY, PHYSIOLOGY, and HYGIENE. 


Definitions. — Anatomy is derived from two Greek words which 
literally signify to cut, or dissect. The word is used to designate the 
study of the form, structure, and other apparent properties of organ¬ 
ized bodies, whether animal or vegetable. In our use of the word it 
will be confined to the study of the human form. Comparative anat¬ 
omy is the study of each separate organ of an animal as compared 
with corresponding organs in other animals; this is one of the most 
fascinating and instructive branches of science. Our space will not 
allow of the extended study of this division of anatomy, but we shall 
call attention to some of the more interesting and important points 
connected with the subject. 

Physiology is a term derived from two Greek words which liter¬ 
ally mean a description of nature. When first coined by the ancient 
Greeks the word meant essentially the same as does the term physics 
at the present day. The philosophers of ancient Greece led their pu¬ 
pils about among the fields, through forests, and beside the lakes and 
rivers of that picturesque country, discoursing of the various animals, 
plants, rocks, and other natural objects which attracted their attention. 
This was a literal study of nature, and the study was called physi¬ 
ology. The term is now used to denote the science of the functions 
of living creatures. We have vegetable physiology as well as animal 
and human physiology. There is also comparative physiology, the 
complement of comparative anatomy, already defined, which relates 
to the comparative study of the functions of various animals. 

Hygiene is a word taken directly from the French language. It 
is used to signify the study of those laws which relate to the healthy 
action of the various organs of the body. It is one of the most im¬ 
portant and practical of all the subjects with which we have to deal, 
and will receive a proportionate amount of attention, both in connec¬ 
tion with the study of the anatomy and physiology of the several or¬ 
gans of the body, and in chapters especially devoted to the subject. 

(25) 



26 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


Man’s Place in Nature. —Much has been said of late regarding 
man’s place in nature, the general drift of the discussion of the sub¬ 
ject being to show that man is but the final product of a process of 
development which in the course of some millions of ages has raised 
him from a mere speck of dust to his present position at the head of 
all animate objects which come within the scope of our knowledge. 
It is not in this sense that we wish to speak of man’s position in the 
universe. We wish to direct the reader’s attention to the following 
facts:— 

1. That man is a part of the material universe. Whatever theory 
may be held respecting his nature, whether it is partly material and 
partly spiritual, being double, or whether wholly spiritual as affirmed 
by some or wholly material as claimed by others, it is generally con¬ 
ceded that science recognizes man only as a material object, a part of 
the great universe of matter, wonderfully complex in his constitution 
and organized with the most marvelous delicacy, yet no less a part 
of the world of matter which appears on every hand in such wondrous 
diversity of forms. 

2. That man is subject to the same general laws which govern 
other material objects. The same destructive agents which effect 
nearly all the changes in matter, fire, water, gases, and various chem¬ 
ical agents, operate upon man as upon other material objects. The 
law of gravitation holds him to the earth in precisely the same man¬ 
ner as though he were a stone. Electricity, that most potent of all 
the subtle, unseen agencies of nature, operates upon man as upon 
other objects, animate or inanimate, using him as a conductor when 
no more easy passage is at hand, utterly disregarding his presence cr 
existence when a more facile route is offered. So with all the a^en- 

O 

cies and forces of nature. 

3. That the special laws which govern all organized bodies relate 
to man in common with all other animals and vegetables. It will be 
clearly seen by our future study of the human constitution that man is 
but a part of tl e general scheme of organization which includes all 
animal and vegetable life. Man is not a vegetable, but possesses 
many things in common with the lowest forms of vegetable life, even 
the microscopic mold which vegetates upon a stale fragment of bread. 

The Constitution of Matter. —In order for us to fully under¬ 
stand the varied relations of the human form divine to the rest of 
the universe, we must first study physiology in its broad, original 


MATTER THE BASIS OF EXISTENCE. 


27 


meaning; that is, we must study nature as a whole sufficiently to 
gain a knowledge of the great general laws which lie at the founda¬ 
tion of all existence animate or inanimate. By this study we shall 
discover that a senseless, lifeless stone may rightfully claim kinship 
with a king upon his throne. We shall learn that there is a common 
brotherhood existing between all material things. Nor will this 
knowledge, as some might fear, in any degree detract from the dig¬ 
nity of man, the lord of creation, though it will add to the dignity 
of many objects which we are, through the influence of early erro¬ 
neous education, inclined to look down upon. 

Before entering upon a more precise account of the nature and 
constitution of matter, we must premise a few points with which we 
are sure all candid, thinking persons will agree. 

1. We possess very little positive knowledge on any subject. 
Whenever we attempt to get back to fundamental propositions, we 
find that nearly all our reasoning is based upon assumptions. 

2. Nevertheless we must have something as a starting-point in 
all lines of thought or reasoning; and in the absence of absolute 
or positive knowledge, the only proper course left for us to pursue is 
to assume that which is the most 'probable . 

3. That which all will agree in accepting as the most probable is 
that which presents the most evidence in its favor, even though none 
of the evidence may be absolutely conclusive. 

4. The various organs of sense are our only means of receiving 
knowledge; hence we must accept the evidence of the senses, weighed 
by reason, as to what is most probable. 

Matter tlie Basis of Existence. —Viewing the subject in the 
light of the propositions stated, we are shut up to the conclusion that 
matter is the basis of all existence. We do not affirm that there is no 
other than material existence. We know that there must be, since 
ideas, qualities, and all abstract things exist, though immaterial; but 
still, science recognizes matter as the basis of all, since abstract exist¬ 
ence is only possible through the relation of abstract to concrete 
things. To illustrate, sweetness cannot exist independent of some 
sweet thing, and depends for its existence upon that object. So with 
all other properties, qualities, and relations. Science does not deny 
the existence of other than material entities, but does declare its ina¬ 
bility to recognize them, since it can deal only with material things, 
which must be evident to all when it is recollected that man possesses 


28 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


only seven senses, none of which are capable of recognizing any other 
than material objects. Any knowledge of immaterial objects must be 
obtained elsewhere than through scientific investigation. In this, all 
scientists are agreed. 

The Nature of Matter. —All the evidence we have on this subject 
points to the conclusion that all material things are composed of infi¬ 
nitely small particles which are indivisible, and which possess certain 
properties common to all forms of matter. For instance, we will sup¬ 
pose that we take a rock and grind it into an impalpable powder. 
Now we will take as small a quantity of this dust as will adhere to 
the point of a pin. Placing it upon a perfectly clean slip of glass, we 
will look at it with a powerful microscope. The invisible particles 
now appear each like a great rock rivaling in proportions the original 
mass. Now, by means of delicate appliances, we will divide one of 
these portions into particles so fine as to be invisible even with the 
microscope employed. A much more powerful instrument still brings 
them into view. Another subdivision by chemical means places the 
particles beyond the power of any microscope, yet the spectroscope 
will still discover their presence, so that we know they are not lost. 
So far as our knowledge goes, no further subdivision can be made, 
and the ultimate, invisible particles are known as atoms. 

Atoms do not exist separately, but are combined in groups, which 
are known as molecules. 

The size of atoms cannot be accurately known; but it has been 
determined within certain limits by calculations based on very proba¬ 
ble data, the results of which seem to show that if an apple were mag¬ 
nified to the size of the earth, the atoms which compose it would be 
not larger than cricket balls nor smaller than fine shot. 

Force and Atoms. —A mischievous doctrine has been taught from 
early ages down to the present time respecting the nature of force and 
its relations to matter and material objects. The ancient and popu¬ 
lar view has been that force is a separately existing something which 
operates upon matter and material objects, producing all the various 
changes and operations observable in matter. Science has in modern 
times thoroughly exposed the fallacy of this theory. What evidence 
we have on this subject goes to establish the view that force is but a 
property of matter, and that it is inseparably connected with matter. 
That matter and force are inseparable is quite patent when we at¬ 
tempt to conceive of either one as existing alone. Such a conception 


ORGANIZATION —LOWEST FORMS OF LIFE. 


29 


is as impossible as the formation of an idea concerning a thing which 
is utterly devoid of properties. 

It is further established by philosophical research that each atom 
possesses a certain definite amount of force, which is of necessity un¬ 
changing. This force may be sometimes active in one way, and some¬ 
times in another, but is always present. 

We do not need to trouble ourselves with the various theories 
respecting the exact nature of atoms, since the general principles laid 
down hold equally good with all. Whether atoms are hard, indivisi¬ 
ble particles, or whether they are something different, does not mat¬ 
ter, since we do know that they possess certain definite properties, 
many of which have been determined. It may be, indeed, that, as not 
a few eminent philosophers have supposed, there is but one funda¬ 
mental atom and one primary force; still, our reasoning holds good. 

Organization. —As matter is the basis of material existence, so or¬ 
ganization is the basis of life in its great diversity of forms. This 
question has been the subject of an almost endless amount of discus¬ 
sion, which we shall not attempt to review here. We will simply 
state as before, and we do so without fear of successful contradiction, 
that what evidence we have on the subject leads directly and irresist¬ 
ibly to the conclusion that life is the result of organization, being the 
manifestation of the forces of nature connected with matter, modified 
by a peculiar arrangement. This special arrangement, which occa¬ 
sions the peculiar manifestations constituting the phenomena of life, 
is what is known as organization. All that makes a plant different 
from the soil out of which it grows, and the air and water which 
nourish it, is the peculiar arrangement given to the various elements 
which are taken in from the surroundings of the plant. The organi¬ 
zation of a plant is analogous to the organization of an army or a gov¬ 
ernment, simply an arrangement of the component parts. Each par¬ 
ticular plant has its own peculiar arrangement, just as each particular 
government has its peculiar organization. Destroy the organization, 
and the life which depended on it is also destroyed. What is true of 
a plant is also true of an animal, and of a human being. 

Lowest Forms of Life. —A little speck of scum from a stagnant 
pool or a drop of slime from a moist rock by the sea-shore, when 
viewed with a good microscope, is seen to be almost wholly made up 
of minute living organisms. Stagnant water always teems with these 
low forms of life. In some localities the bottom of the sea is covered 


30 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


with them. Some of the simplest forms of these minute organisms 
are mere specks of life which do not differ much in appearance from 
particles of dust. Indeed, eminent observers have not infrequently 
confounded these curious little living atoms with inanimate dust. A 
close inspection, however, shows that they possess some very different 
properties from dust particles; in other words, that they are alive. 
Other forms appear like little drops of jelly. Round, transparent, 
they might be easily mistaken for bubbles or masses of some gelati¬ 
nous substance were it not that now and then they will be seen to 
move. If watched closely, it will be observed that they change their 
form and position, and even eat. They possess no eyes, no mouth, no 
teeth, no organs of locomotion, in fact are nothing apparently, but 
tiny jelly drops; and yet they seem to be conscious, they move about 
from place to place, and feed upon the little particles with which they 
come in contact. 

Here is life in its most lowly form. It is not hard to think that 
these tiny creatures, so like the inanimate particles with which we are 
familiar in the study of chemistry and physics, are but unique ar¬ 
rangements of the same matter which in other forms obeys the well- 
known laws of matter in its simplest forms. 

The Basis of Life. —The little jelly drop sustains to higher or¬ 
ganisms the same relation that the atom does to all ether forms of 
matter. It is the basis of life. Protoplasm is the technical term 
which scientists apply to the atom of living forms. Out of these sim¬ 
ple forms of life all higher and more complex organisms are formed. 
This is true of animals as well as vegetables. Take a man in pieces, 
and he will be found to be made of similar masses connected together 
by various devices. Dissect a tree, and the same will be found to hold 
true. Examine a drop of blood with a microscope, and it will be seen 
that the blood is simply a stream in which are floating, swimming, 
moving, and working, millions of little creatures so nearly like the 
microscopic creatures found in the scum of a stagnant pool that they 
have received the same name. The arteries and veins of the body 
may be looked upon as corresponding to the rivers and streams of a 
continent, and the blood corpuscles to the fish which swim in the 
waters. 

The Scale of Being. —Man must be looked upon as a part of the 
great world of life. He is not a distinct and wholly unique creation, 
totally unlike all other living forms. The little mass of protoplasm 


HOW PROTOPLASM WORKS. 


O 1 

oJL 


which swims in a drop of stagnant water is at one end of the scale 
of being, and man, with his magnificent and wonderfully complicated 
mechanism stands at the other. The two are connected by an unbro¬ 
ken chain of living forms which rise in complexity and superiority in 
regular gradations from the living atom in the speck of green scum to 
the human form divine at the summit of the scale. 

The scale of life includes all living forms, not simply animals, as 
might be easily supposed. In all, protoplasm remains the same, al¬ 
ways apparently identical, yet sufficiently different to give to the 
forms of life which it helps to constitute, individuality of existence 
and characteristic properties. 

How Protoplasm Works. —See Figs. 1 to 8. There is nothing more 
interesting in all the realm of science than to watch with a microscope 
the operations of protoplasm. Let us study this wonderful phenom¬ 
enon for a few minutes. In anticipation of wanting material for such 
a study, a few weeks ago we pulled a handful of grass from the lawn 
in front of our office, and placing it in a platter half tilled with water, 
put it in a warm place. Now we bring out the platter and find that 
the grass has undergone partial decomposition. With a glass tube we 
draw up a few drops of the dirty-looking fluid in which the half de¬ 
composed grass is submerged, and placing a single tiny drop upon a 
clean slip of glass we put it in the focus of a powerful microscope. 
Adjusting the glass and the light perfectly, we soon see sundry shreds 
of brown grass, and numerous floating particles of dust and other for¬ 
eign matter of no particular interest. If we had not sought a similar 
view many times before, we should soon put aside the instrument and 
turn our attention to something more attractive ; but we have learned 
to look a little sharper, and now we are rewarded by seeing j ust what 
we were in search of, curious little round masses so transparent as to 
be almost invisible. They are not very numerous, but scattered here 
and there about the field. Presently we perceive that some are chang¬ 
ing their form. A moment ago the first one we inspected was as 
round as a watch crystal ; now it has become elliptical in form. A 
few minutes later we look again, and it has stretched itself out into a 
long filament like an angle-worm. Presently it begins to draw itself 
up into a round mass again; and before we can write it, it has as¬ 
sumed its original shape, but has changed its position. r Ihat is the 
way the little creature moves about. It makes itself into- the shape 
of a worm and then crawls just as a worm does, by making one end 


32 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


fast and drawing the rest of the body up. But what does it move 
about for ? "Why may it not remain stationary ? Shortly we shall 
see if we watch carefully. Even now the reason is evident. Reader, 
just peep over our. shoulder a moment. Put your eye down to the 
eye-piece of our microscope. Do you see the little fellow ? Look 
sharp, and you will. A few seconds ago it was round as a full moon. 
Now there is a little pocket in one side. The pocket is growing 



Fig. l. 




Fig-. 4. 



Fig:. 5. 




the centers are nuclei. 

Figs. 2, 3, and 4 show different varieties of cells. 

Figs. 5, 6, and 7, show how cells divide or multiply. 

Fig. 8 is a representation of the manner in which cells unite by their arms to form capillary 
vessels. 


deeper and deeper. "What is the object of such a curious procedure ? 
Let us put on another eye-piece. Now we have magnified the object 
a million times. See how much larger it looks. Now look at the 
pocket. The mystery is solved. There is a little speck of food which 
the little creature wishes to get, and so he has made a pocket to put it 
in. The queerest part is to come yet, so we must watch patiently a 
moment more. Now the mouth of the pocket is closing up. Evi¬ 
dently the little fellow is afraid he may lose the precious morsel, and 











INORGANIC AND ORGANIZED MATTER. 


33 


so he is going to shut the pocket to prevent its escape. Now the open¬ 
ing is closed, and before we are aware of it, the pocket itself has dis¬ 
appeared, and there is the little particle inside. This seems a miracu¬ 
lous process, but it is the peculiar way these little creatures have of 
taking food. When they wish to eat, they make a mouth or a stom¬ 
ach on purpose. If we wait a few minutes we shall see that the lit¬ 
tle particle taken in has disappeared. It has been digested. Thus 
the lowest forms of life can perform some of the same functions which 
higher animals and vegetables perform, but by much simpler processes. 

The smaller living creatures are, the more remarkable seem to be 
their powers. As we become better acquainted with protoplasm, it 
does not seem so strange after all that it should be capable of making 
a plant, painting a flower, building a tree, or even of forming a man; 
and that is just what it does. How, we shall see further on when we 
study the various tissues of the body. Let us now consider some of 
the principal differences between inorganic and organized or living 
matter. 

Differences between Inorganic and Organized Matter.— Mat¬ 
ter that does not manifest life in any form is called inorganic; living 
matter is said to be organized, because life depends upon organization. 
The following table exhibits the principal differences between these 
two forms of matter:—■ 


INORGANIC MATTER. 

1. Not alive. 

2. Usually has angular outlines. 

3. Has a crystalline structure. 

4. Grows by accretion. 

5. Does not reproduce itself. 

6. Does not ferment or decay. 


ORGANIZED MATTER. 

Alive. 

Characterized by rounded forms. 
Has a cellular structure. 

Grows by assimilation. 
Reproduces itself. 

Ferments or decays. 


1. Inorganic matter, such as sand, rocks, and all forms of mineral, 
earthy, and gaseous bodies and chemical compounds, never exhibit 
the peculiar phenomena which are commonly known as life. These 
phenomena are confined wholly to plants and animals. 

2. Nearly all inorganic objects, unless artificially modified in form, 
have angular outlines, being usually bounded by straight lines. Or¬ 
ganized bodies are bounded by curved and graceful outlines. 

3. Most inorganic bodies are crystalline in structure, or are made 
up of particles which at some time have been crystals. Organized 
bodies, on the other hand, are generally composed of cells. A cell 

3 


34 ANATOMY, PHYSIOLOGY, AND HYGIENE. 

consists of a mass of protoplasm, which is sometimes surrounded by a 
thin wall. 

4. Inorganic bodies grow by accretion, that is, by additions to the 
outside, of matter of the same kind. The increase in size of a snow¬ 
ball is a good illustration of growth by accretion. Organized bodies, 
on the contrary, grow by assimilation, that is, by taking into them¬ 
selves, from the outside, matter of an unlike character and making it 
into their own kind of tissue. Thus, a plant grows by taking in food 
through its roots and leaves; an animal, by taking food into its stom¬ 
ach, assimilation taking place in both. 

5. Reproduction is a process wholly peculiar to organized beings. 
Stones never reproduce their kind. All organized bodies possess the 
power to create new beings like themselves. Reproduction is really 
a process of creation, and as such is the most wonderful of all the 
phenomena of life. 

6. Fermentation and decay are processes by which a living organ¬ 
ism returns to the inorganic state, which is commonly known as death. 
As inorganic bodies do not possess life, of course they cannot lose it. 

The classification of all objects into inorganic and organized is not 
strictly correct, since this division does not include a peculiar class of 
substances not strictly belonging to either of the two mentioned, since 
it possesses some of the properties of each. These substances may be 
distinguished as organic. They are not organized since they have 
not a cellular structure, and are often crystalline; yet they are man¬ 
ifestly not wholly inorganic, since they are subject to fermentation. 
Sugar, starch, fat, albumen, and sundry other substances which are 
generally known as proximate elements, belong to this class. 

Animals and Yegetables.— If we should scrape from the surface 
of an old watering-trough some of the slime which is commonly found 
in such places, and submit it to examination with the microscope, we 
should find it to be composed almost wholly of living creatures of al¬ 
most every imaginable form, possessing wonderful activity, and going 
through the various processes of life common to higher orders of liv¬ 
ing beings. Should the question be asked, Are these curious organ¬ 
isms animals or vegetables ? we might find it more difficult to 
answer than would be at first imagined. Very likely we should at 
first call them all animals, since they appear to be swimming about, 
seemingly possessing volition as distinctly developed as in fishes, birds, 
and larger animals. But a more careful study of the subject would 


DISTINCTIONS BETWEEN MAN AND BEAST. 


35 


show us our mistake. The general ideas regarding the distinctions 
between animals and vegetables hold good only regarding the higher 
orders of animals and vegetables. In the lower orders nearly all of 
these distinctions disappear. For example, it is generally supposed 
that animals alone possess the power of locomotion, vegetables remain¬ 
ing stationary wherever they happen to begin their growth. This is 
not true with the l<fver orders, as microscopic vegetables move about 
in the water as freely, and apparently with as much volitionary 
power, as animals. These minute plants are indeed actually provided 
with organs for swimming or otherwise propelling themselves in the 
water. The same discrepancy is foimd respecting the other distinc¬ 
tions formerly laid down. The difference between the two classes is, 
in fact, finally narrowed down to a mere question of diet. If care¬ 
fully watched, the various minute organisms under observation will 
be seen to take different kinds of food. Individuals of one class draw 
nutriment from the inorganic matters held in solution in the fluid in 
which they float; those of the other subsist upon solid particles of 
organized matter, perhaps even indulging in an occasional meal upon 
creatures of their own kind. Here is the primary distinction which, 
with a single exception, holds good with all the various species of ani¬ 
mals and vegetables: vegetables feed upon inorganic matter, animals 
upon organized matter. There is no exception to this rule among 
animals; but among vegetables there is the one exception of the class 
of cryptogamous plants known as fungi, which subsist upon organic 
and organized matter instead of upon inorganic. 

Distinctions between Man and Beast. —Man is an animal, but 
is not a beast; at least he should not be a beast, though some men 
will insist in placing themselves on a level with the brute creation. 
Man stands at the head of the animal kingdom, the peer of all animate 
creatures, but not above and outside of the great family of animal ex¬ 
istence. Although man is an animal, and as such is related to all the 
lower orders of animal life, yet he possesses faculties and powers 
which are not only superior in degree, but some which are totally 
different in kind from any enjoyed by the lower orders. In order 
that we may correctly understand man’s relation to the rest of the 
animate, creation we must consider the difference between him and 
lower animals. Without giving attention to minor points, the fol¬ 
lowing may be stated as the most prominent features of difference:— 

1. Man has a chin; the beast has none. 


36 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


2. Man stands erect; no beast naturally assumes the erect position. 

3. Man has a conscience, the expression of his moral organs; the 
beast has none, not possessing moral faculties. 

1. The anatomical difference mentioned, the fact that man has a 
chin while no lower animal has, is an interesting fact, especially when 
considered in connection with the fact that idiots who are born such 
usually have retreating chins. Indeed, all the exahiples of this class 
we have ever seen presented so slight a prominence of the inferior 
maxilla that they could scarcely be said to possess a chin. It must 
not be supposed, however, that it is possible to determine a person’s 
mental capacity by the size of his chin, although the chin is undoubt¬ 
edly a valuable index to character. 

2. There are animals which naturally progress upon two legs only, 
as birds and some few other animals. Monkeys and various quadru¬ 
peds have been trained to walk upon two limbs; but in none of these 
instances is the erect attitude assumed. Indeed, the anatomical struct¬ 
ure of all animals below man in the scale of being is such that the 
erect position is not only unnatural but impossible. 

3. By far the most important distinction between man and his in¬ 
ferior relatives is the third difference noted, that which relates to the 
conscience. The old distinction that man has reason, while the beast 
has only instinct, will not at the present day stand the test of logical 
criticism. Scientific investigations have shown that the beast has 
reason as well as man. Indeed, it may be readily shown that man 
possesses instinct, though in less degree than the brute. The fact is 
now well established that both man and beast have both reason and 
instinct, reason predominating in man, and instinct in the beast. 
The real intellectual distinction is, as before remarked, that man has 
a conscience while the beast has not, being devoid of moral organs. 

The objection will be offered to this view, that dogs and some other 
of the higher animals sometimes show a knowledge of right and 
wrong. This leads necessarily to the consideration of the question,— 

What is Right, and What is Wrong?— Undoubtedly con¬ 
science is the recognition of right and of wrong. If we can deter¬ 
mine what is right and what is wrong, we shall then be able to de¬ 
cide what conscience is. Probably no better definition for right can 
be framed than the simple one, “obedience to law.” Wrong is mani¬ 
festly the reverse. Conscience, then, involves the recognition of a 
law, and also the recognition of the obligation to obey that law. No 


WHAT IS BIGHT AND WHAT IS WRONG. 


37 


brute lias the power to do this. If he possessed a sufficiently high 
degree of intelligence to enable him to recognize the existence of law, 
which he does not, he has no conscience to inform him of his duty to 
obey that law. It is for this reason that a brute is not morally re¬ 
sponsible. If he possessed moral faculties, he would be morally re¬ 
sponsible as much as is man. A man is responsible to the laws of di¬ 
gestion, because he has an organ of digestion. A beast is subject to 
the same laws, and for the same reason. Man is morally responsible 
because he has moral faculties. The beast cannot be morally responsi¬ 
ble, because he does not possess moral faculties. The seeming exhibi¬ 
tions of knowledge of right and wrong on the part of dogs and other 
lower animals on careful examination will prove in every case to be 
prompted by hope of reward or fear of punishment, or some other 
similar incentive. A dog can be taught to do things very contrary 
to his nature by appealing to his sense of fear or some other faculty 
stronger than the one suppressed. There is in this no recognition 
of obligation to law. The brute classifies actions not as right or 
wrong, but as what will bring reward or pleasure and what will bring 
punishment or suffering. Much that passes for conscientiousness 
among human beings is equally distinct from the exercise of true con¬ 
science. True conscience recognizes right and wrong on their own 
merits without regard for consequences, either rewards or penalties. 

The fact that man possesses a will does not make him morally re¬ 
sponsible, since lower animals possess a will as well as man. Moral 
responsibility consists not in the power to do right or wrong, but in 
the power to discriminate between that which is lawful and that 
which is unlawful. No difference in kind can be shown to exist be¬ 
tween the human will and that of brutes, the only difference being 
one of degree. 

Thus it appears that the possession of a conscience or of a moral 
nature is the true mental characteristic of the human species, and not 
the power of thought or the possession of will. The importance of 
the will from a psychologic point of view is found to be far less than 
has generally been supposed when it is made to appear, as will be seen 
farther on, that desire, and not the will, is the primary incentive to 
action. 


38 


ANATOMY , PHYSIOLOGY, AND HYGIENE. 


GENERAL ANATOMY, OR HISTOLOGY. 

We must now confine our study more closely to the structure of the 
human body, and we shall begin where students in their study usu¬ 
ally leave off; viz., with the minute elements of which the body is 
composed, the tissues. All the various vital processes upon the proper 
performance of which the life of each individual depends, are per¬ 
formed by the minute tissue elements which we are about to consider, 
and cannot be understood without a careful study of these elements. 
Hence it seems to us to be eminently philosophical to begin at the 
foundation in order that we may secure an accurate knowledge of the 
subject under investigation. 

How a Human Machine is Built. —The human body may be re¬ 
garded as the most marvelously constructed of all mechanisms. Its 
parts are far more delicate, and their mutual adjustments infinitely 
more accurate than those of the most perfect chronometer ever con¬ 
structed. In order to understand the structure of this wonderful 
mechanism, let us go back to the earliest period of its existence. At 
this time we find the body to be but a mere speck of matter, a single 
cell, a delicate little mass of jelly-like protoplasm so small that a hun¬ 
dred or two would not measure more than an inch if arranged in a row. 
Under proper circumstances this little cell grows, expands, and finally 
subdivides into two, through the operations of the protoplasm which 
chiefly composes it. The same activity occasions another subdivision, 
making four cells of the two. Still another division produces eight 
cells. Thus the processes of growth and division continue until the one 
original cell has developed into hundreds, even thousands and millions, 
under the active working of the protoplasm, which is the chief compo¬ 
nent of the cells and the potent agent in their activities. Develop¬ 
ment and division still continue while a new process of folding and 
reduplication is set up, layers of cells being formed, groups and sub¬ 
groups being set off, which develop into special systems and organs in 
accordance with the wants of the organism, until by and by the whole 
complex organism which we call man is developed. Throughout the 
whole process, protoplasm is the active agent, the skillful workman 
that builds and fashions and molds the crude material out of which 
human tissue is made and brought into its final delicate and won¬ 
drous harmony and beauty. 


THE ANATOMICAL ELEMENTS. 


39 


Let us now study with greater care the mode of working. The 
little masses of protoplasm already described are untiring workers. 
They also work in a great diversity of ways. For instance, a single 
mass of protoplasm will sometimes build a delicate wall about itself, 
when it becomes a true cell, being shut up in a tiny house of its own 
construction. The protoplasmic body may remain in its self-made 
prison during its whole life, and die there; or through a wonderful 
property it possesses it may escape from its prison cell by passing di¬ 
rectly through the wall, and proceed to build other cells similar to the 
first, thus building a large number in the course of its lifetime. An 
army of protoplasmic bodies working in this way may in time con¬ 
struct a huge tree. Indeed, it is in exactly this manner that trees are 
built. 

But protoplasm does not always operate in this way. In animals, 
particularly, it usually works in a different fashion. Instead of build¬ 
ing a wall about itself, it makes fibres, tubes, bands, and a great di¬ 
versity of other structures, such as are needed in a complicated mech¬ 
anism like the human organism. The structures thus formed in the 
construction of the human body are known as anatomical elements. 
These we will now describe. 

The Anatomical Elements. —Notwithstanding the great com¬ 
plexity of the human organism, its great variety of structure, and the 
wonderful diversity of function performed by its different parts, it is 
wholly made up of a very few simple elementary structures, not more 
than six or at most seven in number. These may be divided into two 
classes: 1. Those which possess a very low grade of life, being sim¬ 
ply useful in supporting or holding together, or protecting more 
highly vitalized and more important parts ; and, 2. Those possessed of 
a high degree of vitality, being chiefly composed of protoplasm, and 
upon which all the activities of the system really depend. The first 
dass consists of the connective tissues, comprising the two varieties of 
fibrous tissue, adipose tissue, osseous tissue, and cartilaginous tissue; 
the second class comprises nervous and muscular tissue. We will now 
proceed to describe each of these tissue elements separately. 

White Fibrous Tissue. —Fig. 9. This, the most abundant of all the 
anatomical elements in the body, when viewed under the microscope is 
found to be composed of minute fibres varying in thickness from one 
forty-thousandth (^.^crTf), f° one twelve-thousandth (TT.Wtf)) an inch 
in diameter, and of varying length. The fibres are white in color, and 


40 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 



Fig. 9. White Fibroua Tissue. 


wholly inelastic. White fibrous tissue constitutes the chief element of 
tendons, ligaments, and other parts where firmness is required. This 
element is also found intimately interwoven with all the other ele¬ 
ments of the body, serving to unite 
them together and give firmness 
and solidity to the whole. 

White fibrous tissue possesses 
the curious property of being sol¬ 
uble in some acids. Acetic acid 
will dissolve its fibres and cause 
them to entirely disappear from 
view under the microscope. 

Yellow Elastic Tissue. —Fig. 10. This tissue is perhaps the next 
most abundant element, being found in greater or less abundance in 
all parts of the body. It differs much from white fibrous tissue, its fi¬ 
bres being yellow in color, and 
very elastic. The fibres instead 
of being straight are more or less 
curled and branched, and are 
much larger than those of white 
fibrous tissue. Yellow elastic 
tissue is quite abundant in the 
skin and all other animal mem¬ 
branes, to which the high degree of elasticitv of membranes is due. 
The ligamentum nuchce, a ligament located at the back of the neck, 
is composed almost wholly of this tissue. In the ox and other grazing 
animals this ligament is greatly developed, and serves the animal a 
very important purpose, holding the head in position without the 
action of muscles when the animal is not reaching down for its food. 



Fig. lO. Yellow Fibrous Tissue. 


In the giraffe this ligament is six feet in length, and possesses such a 
high degree of elasticity that it is said that it can be stretched to the 
length of twenty feet. 

Connective Tissue. —Fig. 11. This tissue is not an anatomical ele¬ 
ment, being wholly made up of the two former. It constitutes a great 
share of the bulk of the body, forming, in fact, a framework by which 
the various parts are held together, and serving to bind together the 
several elements of which the different organs are composed. The skin 
and other membranes are almost wholly made up of connective tissue. 
The white and yellow fibres are in this compound tissue interwoven 














THE ANATOMICAL ELEMENTS. 


41 


together in such a way as to form a fine network with meshes. These 
interspaces are usually occupied by the fluid part of the blood, which 
bathes the minute elements of the body in every part, and supplies 
them with the needed nutriment. It is in these spaces that the 
lymph channels, the set of vessels which run from all parts of the 
body toward the center of the circulation, have their beginning. In 
general dropsy or oedema, these spaces are distended with serum. 
Cases sometimes occur in which the spaces become filled with air, as 
in injuries to the lungs in which the pulmonary cavity is made to 
communicate with the connective- 
tissue spaces, when by a sort of 
pumping action the process of res¬ 
piration has been known to cause 
enormous distention of tne whole 
body. Some years ago a couple of 
unnatural parents were arrested 
for the most revolting cruelty to a 
little girl whom they were exhib¬ 
iting about the country. The child 
was shown as a monstrosity, its 
head being distended to enormous 
proportions. Upon investigation 
of the case, it was found that the child’s scalp had been gradually 
distended to its unnatural proportions by means of inflation with air 
through a pipe-stem. It is a well-known practice with butchers to 
thus distend the connective tissue of sheep in dressing them for the 
market, by which means they are rendered much more attractive than 
they would otherwise be. 



Fig. 11. Connective Tissue, showing spa 
ces produced by drawing the fibres apart. 



Adipose Tissue. —Fig. 12. This tissue really consists of connective 


tissue in which the spaces be¬ 
tween the fibres have been filled 
with fat cells, the size of which 
is variable, but probably aver¬ 
ages about one one-hundred-and- 
twenty-fifth ( T \ 6 ) of an inch. 
Adipose tissue is found in greater 
or less quantities in nearly all 
parts of the organism, but par¬ 
ticularly just beneath the skin, 


Fig. 12. Adipose Tissue, showing fat cells 
deposited in the connective-tissue spaces. 









42 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


where a layer is deposited seemingly as a protection from cold. Adi¬ 
pose tissue is much more abundant in winter than in summer, being 
then needed much more than in the warmer seasons of the year. 

Cartilage Tissue. —This tissue, in its typical form, consists of a 
homogeneous, structureless base in which are scattered, with a consid¬ 
erable degree of regularity, cav¬ 
ities in which are found cells 
which during life fill the entire 
cavity. The structure of this 
peculiar tissue will be readily 
seen in Fig. 13. Cartilage is 
chiefly found in adults at the 
ends of bones, where a moder¬ 
ate degree of elasticity with 
very slight sensibility to press¬ 
ure is required. These proper¬ 
ties are admirably supplied in 
cartilage. In early life the bones are composed of cartilage, the 
change from cartilage to bone taking place during the period of 
growth. After complete ossification has taken place, no further devel¬ 
opment can occur. 

A peculiar kind of cartilage known as fibro-cartilage is found be¬ 
tween the vertebras, and at some other points where there is a very 
limited decree of motion. Cartilage is in some few instances devel- 
oped in tendons and even in the skin and other tissues, where it is 
always more or less intimately blended with connective tissue. In old 
age, cartilage sometimes undergoes a process of hardening from the de¬ 
posit of lime, which is known as calcification. 

Osseous or Bony Tissue. —In Figs. 14 and 15 will be seen an ex¬ 
cellent representation of the minute structure of bony tissue. The 
large irregular canals seen in Fig. 15, and represented by circular open¬ 
ings in Fig. 14, are the blood-vessels of bone, here known as Haversian 
canals. The dark spaces with the lines radiating from them are 
lacunae and canaliculi, together forming the bone corpuscles. Fig. 14 
shows very beautifully the admirably systematic arrangement of these 
corpuscles, and the manner in which they communicate with each 
other and with the blood channels. The dark spaces are cavities in 
the bone, and the small lines running out from them represent minute 
canals by which they are connected. Each cavity is occupied by a 



Fig - . 13. Cartilage Tissue, showing the 
characteristic cells. 



THE ANATOMICAL ELEMENTS. 


43 




mass of pro¬ 
toplasm, a cell, 
which puts out 
a number of 
protoplasmic 
fingers by 
which it touch¬ 
es other cells 
near by; and 
thus the mi¬ 
nute creatures 
which inhabit 
these little 
caves in the 

Fig-. 14. Transverse section of bone ns seen with the microscope. bone are en¬ 
abled to communicate with one another through all its parts. The 
business of these little creatures is to develop the bone and to keep 
it in good repair. They have charge of the bone-building business of 
the body, each having its par¬ 
ticular little section of bone to 
look after. The portion of the 
tissue surrounding the cavities 
and canals, and forming the 
great bulk of the tissue, is made 
up of a curious compound of 
animal matter with various salts 
in a partially organized state, 
the chief of which are phosphate 
and carbonate of lime. The evi¬ 
dence is that they are in a state 
of partial organization, a condi¬ 
tion which might be termed or¬ 
ganic. Some eminent observers 
say that in very old age the 
protoplasmic bodies which oc¬ 
cupy the cells of bone tissue 
die, the spaces being then filled " a 

with air. 

Osseous tissue forms the skeleton of the body, the bony framework 







44 


ANATOMY, FHYSIOLOGY, AND HYGIENE. 


upon which the soft parts are built, together with a portion of the 
substance of the teeth. In lower animals, bony tissue is also depos¬ 
ited in the skin, the white of the eye, and other soft parts. Very 
singularly, it also happens in some cases of disease that bony tissue is 
developed in the soft tissues. 

Muscular Tissue. —There are two varieties of muscular tissue. 
One consists of long, unbranching fibres, marked by transverse 
lines called stride, the other of short, branching, spindle-shaped fibres 

which are smooth or 
unstriated. Fig. 16 
represents those of 
the first class, or stri¬ 
ated muscular fibres, 
which compose the 
greater portion of the 
soft parts of thebody, 
constituting the lean 
meat of animals. 
They can be easily 
seen with a strong 
microscope, and are 
very interesting ob¬ 
jects of study. This 
variety is sometimes 
distinguished from 
the other by the dif¬ 
ference in action, 
being called volun¬ 
tary muscular tissue because it composes all muscles which are un¬ 
der the immediate control of the will. A striated muscular fibre 
consists of a tubular sheath containing the active muscular substance, 
which appears to be divided into minute beaded fibres, although the 
exact ultimate structure of these primary fibrillse is not very well un¬ 
derstood. 

Non-striated or involuntary muscular fibres are found in mus¬ 
cular organs not under control of the will, as the gullet, the stom¬ 
ach, intestines, bladder, and urinary passages. The form and simple 
structure of this kind of tissue are sufficiently well seen in Fig. 17, so 


Fig - . 16. Voluntary Muscular Tis¬ 
sue, showing smallest fibers with striae. 



Fig. 17. Involuntary, 
or non-striated Muscu¬ 
lar Fibre. 















THE ANATOMICAL ELEMENTS. 


45 


that no further description is necessary. It should be mentioned that 
the heart, although an involuntary muscle, is composed of a muscular 
tissue peculiar to itself, its fibres in some respects resembling both 
voluntary and involuntary muscular fibres. This is probably owing 
to the physiological fact that voluntary fibres contract with rapidity 
and vigor, while the contraction of involuntary fibres is slow and less 
vigorous. However, voluntary muscles soon tire by continuous exer¬ 
cise, while involuntary fibres are capable of maintaining their activity 
for a long time. The heart admirably combines both properties. 




Fig:. 18. Nerve Cells, showing pro¬ 
longations, or poles, three of which are 
prolonged to fQrm nerve fibres. 


Fig:. 19. c. Nerve Fibre moderately mag¬ 
nified ; a. Greatly magnified, showing fibrill®; 
b. Fibrill® magnified still more, showing 
beaded appearance. 


Nerve Tissue. —This is by all odds the most interesting, and per¬ 
haps the most important, of all the anatomical elements. As is the 
case with muscular tissue, there are two varieties of nerve tissue. 
These are familiarly known as cells and fibres, the gross distinctions 
between which may be readily seen by reference to Figs. 18 and 19. 

Nerve cells are irregularly shaped bodies of protoplasm, usually 
provided with one or more arms or projections of the same substance. 
In the center of the cell may be seen a nucleus, and, usually, within 
the nucleus another smaller center, called a nucleolus. The branching 
arms are termed poles. Nerve cells are foimd chiefly in the brain and 
spinal cord; but they are also found in groups known as ganglia in va¬ 
rious parts of the body. They are the generators of nerve force, and 
correspond to the batteries used in telegraphy. 






46 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


Nerve fibres are composed of a bundle of minute fibres, which 
forms the axis-cylinder, invested by a peculiar substance which acts 
as an insulator. The nerve fibrillae are minute filaments of proto¬ 
plasm, being simple prolongations of the protoplasm of nerve cells in 
the brain and spinal cord. These filaments are continuous from their 
starting-point in the nerve cells to the part of the body, near or re¬ 
mote, in which they terminate. Thus there is formed a complete 
network of protoplasmic threads through all parts of the body, con¬ 
necting every minute portion of the system with the central organ, 
the brain, much like the network of telegraph wire which may be seen 
traversing the air in every direction in any large city, connecting its 
most distant parts with the central office. 

When it is understood that all thought, feeling, sensation, and even 
all motion and vital action of every sort, is dependent upon nerves and 
nerve cells, it will be granted that we have not overstated in calling 
this the most important of all the tissues of the body. 

Membranes .—Membranes are chiefly made up of connective tis¬ 
sue. They are not anatomical elements, but simple combinations of 
elements. A membrane consists essentially of a layer of connective 
tissue which forms the basis, over which are spread several layers of 
cells, or protoplasmic bodies, called epithelium. Besides the skin, 
which is a form of membrane, there are three other kinds of mem¬ 
brane, mucous , serous, and synovial. Mucous membranes line cavities 
which communicate directly with the outside of the body, as the 
mouth and the whole digestive tract, the air passages, and the uri¬ 
nary cavities and passages. Serous membranes line closed cavities. 
Synovial membranes partially line the cavities of joints. Each of 
these several kinds of membrane, including the skin, secretes a fluid 
peculiar to itself. The skin produces perspiration, or sweat, by means 
of the sweat glands. Mucous membrane produces mucus, from its 
mucous follicles. The serous membrane produces a serous fluid; and 
, the synovial membrane secretes a fluid for the lubrication of the 
joints. 

The cells, or epithelium, covering these various membranes, differ 
very considerably, and also differ on the same kind of membrane in 
different parts of the body. Some forms of epithelium are exceed¬ 
ingly curious and interesting. For example, a kind known as ciliated 
epithelium is covered with delicate hairs which are kept in constant 
and rapid motion during the life of the cell. A small section of mu- 


GENERAL VIEW OF THE HUMAN MECHANISM. 47 

cous membrane having this kind of 
cells when viewed under a micro¬ 
scope presents the appearance of a 
field of grain waving in the breeze. 

Specimens of this kind of cells can 
be obtained for examination from 
the air passage or from the mouth 
of a frog, or, better, from what is 
termed “the beard” of a live oys¬ 
ter. Fig. 20 exhibits a number of 
varieties of epithelial cells. 

As the other tissues will receive ample consideration in connection 
with the description of the various organs in which they are found, 
we will not devote more space here to the subject of general anatomy, 
or histology, although it is a subject of great interest. 

A General Yiew of the Human Mechanism. —Having now 
viewed quite minutely the anatomical elements, the brick and mortar, 
so to speak, of the human body, let us briefly glance at this wonderful 
machine as a whole, before beginning a minute description of its sev¬ 
eral organs and their functions, as by this means we shall be better 
able to understand the relations of each part to the whole. 

The human body may be considered as a machine constructed for 
the purpose of thinking, feeling, and acting; at any rate, these three 
things comprise all the capabilities of any human being. For the per¬ 
formance of these functions there is necessary,— 

1. A set of organs capable of thinking and feeling. This we have 
in the nervous system. Certain of the nerve cells of the brain are un¬ 
doubtedly endowed with the power to think. Their activity is 
thought. By means of certain accessory apparatus, the organs of 
sense, which comprise hearing, sight, taste, smell, touch, the sense of 
weight and the power to distinguish temperature, the thought or mind 
cells of the brain are able to take cognizance of external things; in 
other words, to feel or receive sensations. Through the almost infinite 
ramifications of the delicate nerve fibrillse already described, all parts 
of the body are not only made tributary to the brain, but are brought 
under its domination. 

2. There is needed a special set of organs by means of which 
motions of various sorts can be executed. This want is exactly sup¬ 
plied by the muscular system, acting in connection with the bones 



Fig 1 . 20. Specimens of Epithelial Celia 
of various sorts. 


« 



48 


ANATOMY, PHYSIOLOGY , AND HYGIENE. 


and the nervous system. The bones serve as points of attachment 
for the muscles, by which they are employed as levers. The nervous 
system furnishes the impulse, and the muscles execute the order by 
contracting in accordance with the directions given to them through 
the nerve telegraphic communications from the brain. 

If the human machine operated without friction or wear, this would 
be all we should require to perform all the necessary functions of in¬ 
dividual life; but every thought, every sensation, every motion or 
muscular action, is at the expense of tissue. The vital machinery 
wears and wastes as do all other mechanisms. This necessitates a 
constant supply of fresh material, and a system of repair. The new 
material is supplied by the circulatory apparatus, which comprises 
the heart and the blood-vessels, the chief object of which is to dis¬ 
tribute the material for repairs wherever it may be needed through¬ 
out the system, the nutrient fluid, the blood, being itself replenished 
through the digestive apparatus, which is specially designed for the 
purpose. Unlike any machine of human invention or construction, 
this wonderful mechanism possesses the power, within certain limits, 
to repair itself and keep its own parts in order. Each particular part 
possesses the power to repair and renovate itself; and so long as this 
power remains intact, provided the proper amount of new material is 
furnished, so long will the machine continue to run. 

But our machine is not yet wholly complete. The waste products 
which result from the wear and tear of the tissues in action must be 
disposed of. If allowed to remain in the system, they would very 
soon obstruct the delicate machinery so that proper action would be 
impossible, and activity would speedily cease. This necessitates a 
special set of cleansing organs to dispose of waste and worn-out par¬ 
ticles. This want is supplied in the eliminative system, comprising 
the lungs, which throw off a pound of gaseous filth every day, the 
skin, which is almost equally active, the kidneys, the liver, and the 
bowels. These five active organs are constantly at work removing 
from the body substances that are of no use, and which will obstruct 
and retard vital action if retained. The human machine clears itself 
of obstructions. The blood also plays an important part in this work, 
since in addition to distributing nutriment where needed, it bathes 
and washes every tissue free from the obstructions which may have 
accumulated in or about it and hurries them off to the proper organ 

which is designed to eliminate or remove them. 

© 


GENERAL VIEW OF THE HUMAN MECHANISM. 


49 


As a certain temperature is necessary for the perfect action of this 
delicate mechanism, nature has so planned that all the various proc¬ 
esses named shall result in the production of animal heat, so that this 
want is supplied at the least possible expense to the vital economy. 
As uniformity of temperature is also necessary for the proper per¬ 
formance of the various bodily functions, special means are provided 
by which a deficient supply of heat may be economized and a super¬ 
abundance rapidly dispersed so as to protect the body from extremes. 

So far as the individual man is concerned, the mechanism is now 
complete; but as the machine ultimately wears out, it is important 
that there should be some means provided for the perpetuation of 
the race. This necessity is met by the reproductive apparatus , by 
which new individuals, possessing essentially the same qualities and 
capable of performing the same functions, may be produced. As we 
shall elsewhere see, this is one of the most remarkable of all the 
bodily functions. Indeed, the mysteries of generation are as much 
beyond the power of the human mind to solve as are the problems 
which cluster about the origin of all things. In his reproductive 
function, man approaches nearest to the Creator, though in this he 
only uses a power delegated to him by the Creator in common with 
all other living things. 

Thus we have complete, in every detail, this marvelous human 
machine, which stands as an unanswerable argument against all the 
sophistry that can be invented to sustain atheism, establishing 
beyond the possibility of cavil that there must have been at some 
time at work an intelligent power as much superior to the highest 
type of human power and intellect as this delicate mechanism is above 
the most ingenious piece of workmanship the most skilled mechanic 
has ever produced. 

Having taken a general survey of the human system, its vari¬ 
ous systems of organs and their general functions, let us now look a 
little more carefully into the details of structure and function, so that 
by a thorough understanding of the nature of the various parts and 
organs of the body we may be the better able to understand what 
means are necessary to preserve them in health and to cure and pre¬ 
vent disease. Our attention is naturally directed to the bones, which, 
as we have already seen, constitute the framework of the body. 

4 


50 * 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


THE BONES. 



Although the bones are the firmest parts of the system, they are 


not, as many suppose, possessed of a 


very small degree of life. Mere 
lifeless sticks would come far 
short of performing the func¬ 
tions of bones. While not as 
highly vitalized as some of the 
more rapidly changing tissues, 
they possess sufficient vital ac¬ 
tivity to enable them to perform 
their functions and to repair in¬ 
juries which may occur. All 
the bones of the body taken to¬ 
gether form the skeleton, for a 
representation of which see Fig. 
21 or Plate I. 


Fig-. 21. The Skeleton. 


Fig. 22. Portion of a long bone, showing 
the periosteum slit up and separated 
from the bone. 


Structure of Bones,— Bones 
are made up of a peculiar struc¬ 
ture, which has been already de¬ 
scribed. The osseous tissue 
proper is covered over with a 
tough membrane called the 'per¬ 
iosteum, and commonly known 
as the whit-leather. Fig. 22. 
This membrane supplies blood¬ 
vessels to the bone, and it is 
from it that the bone grows. 
Bones are classified according to 

O 

their form into long, short, flat, 
and irregular. Long bones are 

O O 

hollow, having a canal running 
through a greater or lesser por¬ 
tion of their length, which is 
called the medullary canal. 
This canal is lined with a mem¬ 
brane similar to the periosteum. 






















Plate I .—THE SKELETON. 


NAMES OF THE BONES. 

1. Frontal; 2. Parietal; 3. Na¬ 
sal; 4. Temporal; 5. Lachrymal; 
0. Malar; 7 7. Maxillary; S. Vo¬ 
mer; 9. Cervical vertebrae; 10. 
Clavicle; 11. Scapula; 12. Stern¬ 
um; 13. Ribs; 14 14. Lumbar 
vertebra;; 15 15. Ossa Innominata; 
1(5. Sacrum; 17. Humerus; IS. 
Radius; 19. Ulna; 20. Carpus; 
21. Metacarpus; 22. Phalanges of 
band; 23. Femur; 24. Patella; 
25. Fibula; 26. Tibia; 27. Os Cal- 
eis; 2S. Tarsus; 29; Metatarsus; 
30. Phalanges of foot. 

















VARIETIES OF JOINTS. 


51 


called the endosteum , and is filled with 
medullary substance, which consists of 
blood-vessels, nerves, fat, and connective 
tissue. The shaft of long bones is com¬ 
posed of a dense, firm structure, called com¬ 
pact tissue, while the expanded ends are 
chiefly made up of a looser structure, known 
as cancellous tissue. See Fig. 23. Short, 
flat, and irregular bones are composed of 
a shell of compact tissue, the interior being 
spongy in character. 

The periosteum and the medullary sub¬ 
stance, or marrow, of bone are very impor¬ 
tant portions of these organs, since injury 
to either of these parts is quite certain to 
be followed by death of the bone on ac¬ 
count of interference with its nutrition. 



The Joints. —The points at which bones Fig-. 23. Tlie upper part of the 

come together are called articulations, or the large end of a bone. At 3 is to 
joints. The parts which enter into the for- beseeu a transverse section of the 

° * ... . . shaft, showing the medullary canal. 

mation of joints, in addition to the bone^, are 

cartilage, synovial membrane* and ligaments. Wherever bones come 
in contact with any degree of motion, the surfaces of contact are cov¬ 
ered with a dense, elastic, non-sensitive substance known as cartilage. 
In order that the bones shall be held together in proper position, they 
are bound by firm bands of fibrous tissue, called ligaments, which are 
so arranged as to secure firmness without interfering with the nec- 

o o 


essary movements of the joint. In order to provide for the main¬ 
tenance of the joint in a healthy condition, a means is furnished for 
lubricating the articulating surfaces and thus lessening friction. The 
lubricating material is known as synovia, and is furnished by the syn¬ 
ovial membrane, with which every joint is provided for this purpose. 

Varieties of Joints. —A number of different kinds of joints are 
illustrated in the human body, the most important of which are, the 
hinge joint, illustrated by the knee, the elbow, the fingers and toes; 
the ball-and-socket joint, of which the hip and shoulder joints are ex¬ 
amples; and the gliding or planiform joint, in which one flat surface 
glides over another, as in the short bones of the wrist and the ankle. 


Divisions of the Skeleton. —The skeleton is divided into three 
parts; viz., the head, the trunk, and the extremities. The number of 


52 


ANATOMY , PHYSIOLOGY , ^2YD HYGIENE. 


bones contained in each of these portions is as follows: The head, 
22 ; the trunk, 52; the extremities, upper and lower, 126; making 200, 
the whole number of bones in the body. 


BONES OF THE HEAD, 



Fig. 24. The Skull, showing the sutures, or points 
of union between the several bones. 



Fig. 25- The Skull, with the bones separated so as to 
show their shape. 1. Frontal; 2. Parietal; 3. Occip¬ 
ital; 4. Temporal; 5. Nasal; 6. Malar; 7. Superior 
Maxilla; 8. Lachrymal; 9. Inferior Maxilla. Several 
bones are not shown. 


Of the twenty-two bones 
forming the head, eight en- 

O 7 o 

ter into the structure of the 
skull, or cranium, the re¬ 
maining fourteen forming the 

O O 

face. 

The Skull. —The cavity 
of the skull is designed for 
the reception and protection 
of the brain, a purpose to 
which it is most admirably 
adapted both by its general 
shape and its minute struct¬ 
ure. The bones of the skull 
each consist of two plates of 
compact tissue connected to¬ 
ft gether by a layer of very 
spongy tissue called diploe. 
See Fig. 26. This gives to 
the skull a degree of elastic¬ 
ity which it could not oth¬ 
erwise possess, thus protect¬ 
ing it from fracture, and also 
serves to deaden the effect of 
blows upon the head before 
the force has been transmit¬ 
ted to the delicate brain be¬ 
neath. The bones of the 
skull are firmly joined to¬ 
gether by means of sutures, 
which in infancy allow of 
some degree of motion; but 
as the skull assumes its full 
size, the sutures become 
knit together so firmly 











THE SKULL. 


53 


as to preclude the possibility of motion. It is owing to this fact that 
different nations are enabled by different modes of dressing the head to 
cause it to assume different shapes. For example, certain Indian tribes, 
by applying a flat surface to the forehead and binding it firmly in place 
in early infancy, are enabled to 
produce a permanent flattening 
of the forehead. A class of the 
natives of India are noted for the 
peculiar cone-shaped form of the 
head which they produce by a 
similar process. 

A number of openings are 
found in the skull, the largest of 
which, called the foramen mag¬ 
num from its larsre size, is located 
in the inferior and back part, and 
affords a passage for the spinal 
cord. The numerous other smaller 
openings are for the passage of blood-vessels and nerves. 

The interior of the cranial cavity presents many ridges, depressions, 
and processes, which correspond with the uneven surface of the brain, 

which with its membranes exactlv fills the cavity. 

•/ */ 

The names and location of the eight bones forming the skull are, the 
occipital, which forms the whole posterior portion ; the two parietal, 
which chiefly form the sides and upper portion ; the two temporal, sit¬ 
uated low down upon the sides ; the frontal, forming the whole front 
portion of the skull; the ethmoid, which is placed in the lower part of 
the skull near the root of the nose ; and the sphenoid, which joins all 
the other bones together at the base. At birth it Is usually the case that 
the frontal bone is in two parts, it being always formed in this way, the 
two halves being afterward joined together very early in life. At birth, 
ossification of the bones of the cranium has not fully taken place, the 
deficiency being very apparent at two points, one at the anterior portion 
of the head and the other at the upper and back part. At these points 
the covering of the brain is so thin that it yields readily to pressure, and 
the beatincr of the arteries can be easily felt. On this account, these 
points are commonly' termed “soft spots.” The medical term is fonta- 
nelles. As ossification progresses rapidly after birth, the fontanelles 
are soon closed up. 



Fig - . 26. The Skull with the outer plate 
removed, showing the diploe and the channels for 
blood-vessels. 



54 


ANATOMY, PHYSIOLOGY , AND HYGIENE. 


The Bones of the Face. —The fourteen bones which form the 
face are named as follows: two nasal, two lachrymal, two malar or 
cheek-bones, two upper maxillary, two palate, two turbinated or 
spongy bones of the nose, the vomer, and the lower maxillary or un¬ 
der jaw-bone. 

The two nasal bones form the upper part or bridge of the nose, 
joining the frontal bone of the skull. They are small bones, and are 
lengthened out upon the sides of the nose by cartilage. 

The two lachrymal bones are so called because they contain a small 
canal which conveys the tears from the eye to the nose. They are 
situated at the inner corners of the eyes, and join the nasal bones. 

The malar or cheek-bones are situated at the outer and upper part 
of the face. In some nations, as the Tartars and North American In¬ 
dians, these bones are very prominent, giving an angular appearance to 
the features. 

The superior maxillary bonas constitute the greater portion of the 
face, joining in front beneath the nose. They also form the greater 
portion of the roof of the mouth, and afford a place for the insertion 
of the sixteen upper teeth. Each of the maxillary bones has in its up¬ 
per portion a cavity of considerable size which is lined with mucous 
membrane, and communicates with the nasal cavity through a small 
opening. This cavity is known as the antrum of Highmore. It often 
becomes a seat of disease through the formation of abscesses and the 
production of polypi or other morbid growths, which occasion very 
great trouble and annoyance on account of the difficulty of gaining ac¬ 
cess to the diseased part. It is supposed that the object of these cav¬ 
ities is to improve the quality of the voice. 

The superior maxillary bones usually unite at birth or soon after, 
being joined by two small intervening bones called intermaxillary, 
from their position. In case the maxillary and intermaxillary bones 
fail to unite, a fissure is left which usually extends down through the 
roof of the mouth as well as through the lip, producing a deformity 
which from its peculiar resemblance to the lip of a hare is known as 
hare-lip. When the deformity exists upon both sides it is known as 
double hare-lip. The only remedy is a surgical operation. 

The palate bones are small structures placed at the back part of 
the mouth, forming the upper part of the roof of the mouth and ex¬ 
tending upward to aid in forming a socket for the eye. 

The turbinated or spongy bones are located in the upper part of the 


THE VERTEBRJE. 


oo 


nostrils. They are very spongy in character, and by their scroll shape 
present an extensive surface for the nasal mucous membrane, in which 
are located the nerves of smell. 

The vomer derives its name from its resemblance to a plowshare. 
It is a thin, flat bone, and forms the septum of the nose. 

The inferior maxillary bone forms the lower jaw, in connection 
with the teeth which it carries in its upper portion. It is a somewhat 
V-shaped bone, the apex of the angle being in front and forming the 
chin. The two lateral portions after extending backward about one- 
half their length take a somewhat abrupt turn upward, thus forming 
what is called the angle of the jaw. The upper ends of the ascending 
portions are joined by a hinge-like articulation to the skull. The socket 
of the joint being rather shallow, the bone not infrequently slips out of 
place in violent yawning or laughing, producing dislocation. The man¬ 
ner of remedying this difficulty will be fully described in the proper place. 

The length of the jaw gradually increases with the growth of other 
parts of the body, additional teeth being produced at the back part as 
there is room for them, so that in adult life we find sixteen full-sized 
teeth, whereas in childhood there are but ten small ones. The teeth 
are placed in sockets provided for them by the alveolar processes. 
When the teeth fall out, from disease or old age, the processes are usu¬ 
ally absorbed. It is this which occasions the peculiar prominence of 
the chin noticeable in elderly persons. 

The form and location of most of the bones of the face and skull 
will be better seen in Figs. 2-t and 25 than they can be described. 

The teeth will be fully described in connection with the organs of 
digestion. 

O 

BONES OF THE TRUNK, 

The bones of the trunk consist of the vertebra 2 , the ribs, the ster¬ 
num, and the pelvis. 

The Vertebrae. —Fig. 27. These bones are twenty-four in num¬ 
ber, and are arranged one above the other, forming a bony column 
called the vertebral or spinal column, which is the central axis of the 
body. Each vertebra (Fig. 28) is an irregularly shaped bone, the 
larger portion of which, called the body, is concave behind, convex 
in front, and nearly flat on its upper and lower surfaces. Pro¬ 
jecting from the back side of the body is a bony arch which has at 
the center behind a more or less distinct prominence known as the 


56 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 



spine cf the vertebra, or the spinous process. There are various 
other projections from the sides of the body and arch which serve as 
means for joining the vertebrae together and for the attachment of 
muscles. There is also noticeable a notch at the junction of the body 
and the arch on either side of the vertebrae, both 
above and below in most cases. When the vertebrae 
are arranged one above another in the spinal column, 
the bodies form a bony pillar, while the arches, being 
placed one above another, form a bony canal for the 
spinal cord. The notches before mentioned, being also 
superimposed one abbve another, form lateral open- 


Fig. 28. A vertical section of two contiguous Ver¬ 
tebra;, showing the spongy structure of the bodies, and 
the Fibro-Cartilage between them. 

ings through which the spinal nerves and blood-vessels 
may pass. Between each two vertebrae are placed 
discs of fbro-cartilage, the use of which will be seen 
farther on. 

The vertebrae of the spinal column are divided into 
three portions: the cervical, or neck portion, compris¬ 
ing the first seven, which form the neck, supporting 
the head; the dorsal, or back portion, which are connected with the 
ribs, consisting of twelve vertebrae; and the lumbar portion, the re¬ 
maining five, comprising the vertebrae of the loins. 

Each of these three classes of vertebrae possesses certain special 
characteristics by which they may be known; but as most of these 
are of merely anatomical interest, we will not stop to consider them, 
only noticing the interesting peculiarities of the first two vertebrae of 
the neck, those next the skull. The first vertebra, called the atlas 


Fig. 27. The 
spinal or vertebral 
column. 





THE TIIORAX. 


57 


(Fig. 29), instead of h wing a body, arch, and various processes, is 
simply a ring of bone made to fit the under part of the head, sur¬ 
rounding the foramen magnum. The articulation of this bone with 
the head is such as to admit of free motion backward and forward, 
hinge-fashion, but no lateral or rotary motion. The second vertebra 
is equally peculiar, having upon one side a large tooth-like promi¬ 
nence which fits into one side of the ring-shaped 
bone above, and provides for lateral or rotating 
motion of the head. This tooth-like promi¬ 
nence, known as the odontoid process, is kept 
in place, and prevented from injuring the deli¬ 
cate spinal cord which passes close beside it, by 
means of ligaments which inclose it and hold 

O 

it firmly in position. 

Another peculiarity worthy of mention is the fact that the arches 
of the cervical vertebrae being larger than in other parts, the spinal 
canal is larger in the neck than in any other part of its length. This 
is undoubtedly a wise provision of nature to allow of the greatest 
possible freedom of motion without injury to the delicate structures 
within. 

The skull itself may be considered as simply the expanded upper 
extremity of the spinal column, representing three or four vertebrae 
which have been consolidated and greatly modified. 

The Thorax.—This is a bony cavity formed by the spinal column 
0 

behind, the sternum in front, and the ribs at the sides. It contains 
the lungs, heart, great blood-vessels, nerves, and other important or¬ 
gans. Having already described the vertebrae, we will now notice 

The Ribs .—These bones are twelve in number on each side. Oc¬ 
casionally there are found thirteen, instead of twelve, and sometimes 
there are but eleven. The ribs are joined, behind, to the sides of the 
vertebrae in such a manner as to allow a slight hinge motion. In 
front they are not united directly to any bone, but by means of an 
intervening piece of cartilage they are joined to the sternum. The 
first seven ribs, being united by separate cartilages, are called true 
ribs, while the last five, being joined to a single cartilage which unites 
them to the sternum, are called false ribs. The last one or two ribs, 
being sometimes not united to the sternum at all, are denominated 
floating ribs. 

Alono- the lower and inner border of the ribs runs a groove in 



Fig:. 29. The first ver¬ 
tebra, called the Atlas. 


58 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


which are placed the nerves and blood-vessels of the chest walls, 
which are thus shielded from injury. The two edges of this groove 
serve as points of attachment for the two sets of muscles which fill 
the spaces between the ribs. 

The Sternum .—This bone, commonly called the breast-bone, is 
really made up of four separate parts, three of which are bony, being 
joined together by cartilage, the fourth and lower part being cartilag¬ 
inous, and known as the xiphoid or ensiform cartilage. The ster¬ 
num receives upon either side the cartilages of the seven upper ribs 
and the conjoined cartilage of the false ribs, together with the inner 
ends of the collar-bone, or clavicle. The object of the sternum is to 
brace and strengthen the ribs and clavicles, and help to inclose the 
chest. 

We should mention that the ensiform cartilage is very variable in 
its form, sometimes curving outward abruptly, causing a considerable 
prominence, and at other times curving inward. We have frequently 
been consulted by persons possessing some peculiarity of this organ 
who had been made to believe by quacks that they were suffering 
with some very severe malady. Not long ago we received a letter 
from a young lady, a former patient, who was in great distress, hav¬ 
ing been told by a physician whom she had consulted, or a man who 
called himself a physician and had practiced on the credulity of the 
people for many years, that she was suffering with cancer, and that 
she should by all means visit a surgeon at once and have the malig¬ 
nant growth removed. Suspecting that there was some blunder in 
the matter, we advised the young lady to visit us before having any 
operation performed, which she accordingly did; and greatly to her 
relief we were enabled to inform her that no operation was required. 
The ignorant doctor had mistaken an unusually prominent ensiform 
cartilage for a cancer, probably considering his diagnosis confirmed by 
the fact that there was extreme tenderness just beneath the end of 
the sternum, due to abnormal sensibility of the stomach, the patient 
suffering from painful dyspepsia. Having met in practice one or two 
similar causes, we deem it worth while to call attention to this source 
of error. 

The Pelvis. —This portion of the trunk is situated at its base, con¬ 
stituting the point of junction of the lower extremities with the trunk. 
It is composed of four bones: the sacrum, a wedge-shaped bone be¬ 
hind; the ossa innominata, two bones upon the sides ; and the coccyx 


THE HYOID BOSE. 


59 


below. These four bones are so shaped and joined together as to form 
a sort of basin by which are supported the upper soft parts of the body, 
particularly the abdominal organs. The several bones arc joined to¬ 
gether so firmly that scarcely any degree of motion is possible, es¬ 
pecially in the adult. In early childhood each of the several bones 
named is made up of several separate portions, which are usually de¬ 
scribed in the anatomies, but which have no special practical interest, 
and so need not be noticed here except in a general way. Upon the 
back side of the sacrum is found an incomplete canal which is a con¬ 
tinuation of the spinal canal and is occupied by the spinal column, 
which spreads out upon the lower portion of the bone in a peculiar 
manner that has given it the name of cauda equina, from a fancied 
resemblance to the tail of a horse. Through large openings in the sa¬ 
crum the spinal nerves pass forward to supply important organs within 
the pelvis and the anterior portions of the lower extremities. 

At the outer and inferior part of the os innominatum , at the point 
of junction of the three original portions of the bone, is found a deep 
socket called the acetabalum from its resemblance to an ancient Roman 
vinegar cup. This deep pocket is for the reception of the head of the 
femur, the bone of the thigh, by which is formed the hip joint. In life 
the socket is further deepened and strengthened by a rim of cartilage 
which surmounts its edge, as also by a strong band called the capsular 
ligament which surrounds the socket and the head of the bone, being at¬ 
tached to each, an arrangement which also exists in most other joints. 

Upon the lower side of the two hip bones are broad prominences 
which support the weight of the body in sitting. 

The female pelvis differs from that of the male in being larger, smoother, 
and less curved. This difference is so marked that it is an important 
means of distinguishing 1 between male and female skeletons. 

The form and position of the pelvis are well shown in the view of the 
skeleton given in Plate I. 

The Hyoid Rone. —This little bone, though situated so near the head 
as to be hardly included in the bones of the trunk, is yet of sufficient im¬ 
portance to require mention and description, and may as well be noticed 
here as elsewhere. It is the bone of the tongue, to which it is attached, 
and is not connected with any other bone. It is shaped some like a 
horseshoe, and is situated about an inch below the chin, between the root 
of the tongue and the upper part of the larynx. It carries the epiglot¬ 
tis, the cartilaginous valve which guards the entrance to the windpipe. 


GO 


ANATOMY, Til YSIOLOGY, AND HYGIENE. 


It also forms the center of attachment for the muscles which move the 
tongue and throat. 

BONES OF THE UPPER EXTREMITIES, 

The bones of each superior extremity consist of the scapula, clavicle, 
humerus, ulna, radius, eight wrist or carpal bones, five hand or meta¬ 
carpal bones, and fourteen phalanges or finger bones, making thirty-two 
in all. 

The Scapula.— This is an irregular flat bone of triangular shape, 
situated at the posterior part of the shoulder, forming what is com¬ 
monly known as the shoulder-blade. Crossing the upper part of the 
bone is a sharp prominence known as the spine, which passes forward 
and terminates in a beak-shaped projection which overhangs the shoul¬ 
der joint; beneath this is a shallow depression known as the glenoidl 
fossa, which receives the head of the arm bone in the formation of the 
shoulder joint. The scapula is not joined either by articulation or by 
ligaments to any of the other bones of the trunk, as it is designal to al¬ 
low to the shoulder joint the greatest possible freedom of motion, being 
attached to the trunk by strong muscles which hold it in place with 
sufficient firmness to give all needed strength to the joint. 

The Clavicle. —This bone, commonly known as the collar-bone, is 
shaped almost exactly like the italic letter f. It is attached at its inner 
extremity to the breast-bone, and by its outer to the great prominence 
of the scapula. Its object is to brace the shoulders apart and thus add 
to the strength of the upper extremities. The clavicle is found in but 
few quadrupeds, but is largely developed in birds for the same reason 
that it is present in man. This bone is frequently broken, but as the 
parts cannot be very greatly displaced, the fractured ends usually unite 
with little difficulty and only slight deformity. 

The inn. —The bone of the arm proper is the humerus, which ex¬ 
tends from the shoulder to the elbow, of both of which j oints it forms a 
part. It has a straight shaft and rounded extremities which are protected 
by cartilage in the manner common to all bones entering into freely act¬ 
ing joints. The lower end of the bone presents a notch at its inner side 
through which passes an important nerve which is distributed to the in¬ 
ner side of the hand. It is this nerve which is hit when a person causes 
tino-ling sensations in the little finger by striking the elbow against a 
sharp corner. In common parlance this part is called the funny or 
crazy bone, though, as just seen, it is not a bone at all, but a nerve. By 


THE FORE-ARM—THE IIAXE. 


Cl 


placing the end of the thumb in this notch and pressing hard it is pos¬ 
sible to produce the peculiar sensation at any time. 

The Fore-Arm. —The fore-arm is composed of two bones, the ulna 
and the radius. The first-mentioned of these is the longer of the two, 
and forms with the humerus the principal part of the elbow joint, ex¬ 
tending from the elbow down to the wrist on the little-finger side of 
the arm. It has but a slight articulation with the wrist. 

The radius has a large articulating surface at the wrist and a very 
small one at the elbow. The two bones are united their whole length by 
a strong ligament. The upper end of the radius rolls in a notch upon 
the side of the ulna, its end resting against the lower end of the humerus. 

The Hand. —The remaining bones of the upper extremity are in¬ 
cluded in the hand, which is divided into three portions : the carpus, 
or wrist; the metacarpus, the portion between the wrist and the fin¬ 
gers; and the fingers, or phalanges. 

The carpus, or wrist, is composed of eight small bones arranged in 
two rows, possessing smooth articular surfaces, which allows of great 
freedom of motion in a great variety of directions. 

The metacarpus consists of five bones, which join the digits to the 
wrist. Their motion is quite limited. 

The digits consist of four fingers and a thumb. The fingers have 
each three phalanges, but the thumb has only two. Some, however, 
consider that there are but four metacarpal bones, which would allow 
the thumb three phalanges like the other digits. 

The finger joints are so constructed that they are capable of not 
only a hinge-motion, but also a slight degree of rotary motion, which 
gives to the hand great suppleness and diversity of action. 

THE INFERIOR EXTREMITIES, 

The lower extremities comprise thirty bones, which will be de¬ 
scribed in their order. 

The Thigh. —The femur, or thigh bone, is the largest and longest 
of all the bones in the body. It presents at its upper end a remarkable 
prominence called its head, by which it forms, with the acetabulum of 
the os innominatum, the hip joint. Its lower end is greatly expanded 
to form the knee joint, the most extensive articulation in the body. 

The Leg. —The leg, like the fore-arm, is made up of two bones. 
The larger of these, the tibia, is the principal bone of the leg, forming 


62 


ANATOMY, PHYSIOLOGY, AND HYGIENE . 


the chief part in the leg portion of both the knee and the ankle joints, its 
companion bone, the fibula, taking but little part in either. The latter 
bone is a long, slim structure, placed beside the tibia upon the outer 
nart of the leer. Its lower end forms the outer ankle. The two bones 

x o 

are firmly united throughout their whole length by a strong ligament. 

A third small bone is found in the tendon of one of the large muscles 
of the leg which passes over the front portion of the knee; this is 
termed the patella, or knee-cap. It exactly fits upon and protects the 
front side of the knee joint, which would otherwise be exposed to injury. 



Fig:. 30. Outline of the bones of the foot, showing at c, the 
Astragalus; the Os Calcis, or heel bone; h , the Tarsus ; and 
i, the Phalanges of the toes. 


Tho Foot. —Fig. SO. Like the hand, the foot is divided into three 
parts,—the ankle, instep, or tarsus, the metatarsus, and the digits or toes 

The tarsus is made up of seven bones corresponding to the eight 
bones of the wrist. One of these, the astragalus, supports the lower end 
of the tibia; another, known as the os calcis, forms the heel and receives 
the attachment of the tendo-Achilles, the strongest tendon in the bodv. 
All are so firmly bound together that the ankle is strong enough to sustain 
the whole weight of the body, notwithstanding the great number of sep¬ 
arate bones which enter into its formation. 

The metatarsus consists of five bones closely resembling the bones of 
the hand, and answering the same purpose. 

The digits are five in number, each, except the great toe, having 
three phalanges, the latter having but two, as in the case of the thumb. 

The peculiar manner in which the bones of the foot are united is a 
matter worthy of attention. Instead of being joined together on the 
same plane, they are so united as to form an arch from every point of 
view, both laterally and longitudinally. This arrangement greatly adds 
to the strength of the foot, and gives it an elasticity which protects other 
parts of the body from sudden j ars and shocks. 

The general shape and mutual relation of the bones of both extrem- 




BOXES OF THE EAR 


G3 


ities can be readily seen by reference to the view of the skeleton given 
in Plate 1. 

Sesamoid Bones. —In various parts of the body where tendons 
pass over joints with considerable friction, small bones are often formed 
in the tendons, which from their resemblance to the seeds of the sesamum 
are termed sesamoid bones. The patellse are bones of this class. Other 
sesamoid bones are often found in the feet and hands. 

AY brill ian Bones. —Extra bones are sometimes formed in the cra¬ 
nium for the purpose of filling up a deficiency between contiguous bones. 
In some skulls large numbers of these bones may be found, varying in 
size from that of half a pea to the size of a half-dollar. These are called 
wormian bones. 

Bones of the Ear. —Fig. 31. The list of bones is not complete 




Fig - . 31. Bones of the ear. a. Malleus, or mallet; b. Incus, or anvil; c. Stajies, or stirrup. 

without the eight minute ossicles which help to form the apparatus for 
hearing. These we shall not describe in this connection, however, as 
their full description more properly belongs to the special anatomy of 
the ear, which see. ♦ 

PHYSIOLOGY OF THE BONES, 

As the particular uses of the different bones of the body have already 
been noticed in connection with their description, we need now concern 
ourselves only in relation to the general functions of the bones and the 
uses of special groups. The functions of bones may be said to be sup¬ 
port, protection, and motion. Each of these functions we will now ex¬ 
amine more particularly. 

Support. —As a whole, the skeleton forms the framework of the 
entire body. Upon its firmness depends that of the softer parts which 
are built upon it, the muscles, nerves, membranes, and other tissues. 
Without the skeleton, the other tissues would fall limp, into inextricable 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


G4 

confusion. By means of the skeleton, the head is held erect, and the 
limbs supported in proper position, giving them efficiency and symmetry. 

Protection. —Equally striking is the dependence of numerous parts 
of the body upon the skeleton for protection from external injury. Of 
this we have many examples. The skull is admirably adapted to the 
protection of the brain, the most delicate of all the vital tissues, be¬ 
ing a bony cell, well arched to secure the greatest possible strength to 
resist external violence, and composed of two walls with a peculiar ar¬ 
rangement of tissue between especially calculated to deaden the effect of 
blows applied to the head by accident or design. 

The head is still further protected 
by the peculiar curves of the spmal 
column, upon which it rests. This will 
be best understood by reference to Fig. 
32, by which it will be seen that blows 
received from below, as in jumping, or 
even in walking upon a hard surface, 
are little felt by the head, since the vari¬ 
ous curves conduct away the lines of 
force and thus prevent much from reach¬ 
ing the head. 

Still another means of protection is 
provided for the delicate brain, as if to 
secure it against the possibility of injury, 
in the fibro-cartilaginous cushions placed 
between the vertebrae. See Fio - . 2d. 

o 

The elasticity of these discs of cartilage 
causes them to yield to pressure whether 
it be slowly or suddenly applied, and 
thus the brain is protected from the full 
force of concussions which otherwise 

Fig - . 32. Designed to show how the might seiiously injuic. Ft en the slight 
.iar of walking is prevented from reach- concussions constantly occurring when 

ing the brain, by means of the curves of .... ^ ° 

the body. one is walking over an uneven surface 

would, without this provision, undoubt¬ 
edly occasion serious injury to the brain and the delicate organs con¬ 
nected with it. The amount of this kind of action is better appreciated 
by reference to the well-known fact that people who are much upon 
their feet during the day, especially those who are traveling about over 




POSSIBLE FUNCTION OF THE BONES. 


Go 


uneven surfaces, diminish very appreciably in height between morn¬ 
ing and evening. Most persons vary an inch in height, and instances 
have been noted in which persons have lost more than two inches in 
height through vigorous and prolonged exercise. This is caused by the 
thinning of the cartilage discs from the prolonged pressure to which 
they are subjected. In elderly people the same thinning takes place, 
permanently diminishing their stature. 

The spinal cord is protected by the bony canal formed by the rings 
of the several vertebrae composing the spinal column. The enlargement 
of this canal in the cervical portion, where it is much larger than the 
cord, is a marked instance of nature’s line adaptation of means to ends. 
The neck is designed to be turned in every direction freely; but this 
freedom of motion would disturb the function of the spinal cord except 
for the arrangement mentioned. 

Another example of protection is seen in the thorax, which is a bony 
cage in which are encased the lungs, heart, great blood-vessels, impor¬ 
tant nerves, and several other important organs. 

The pelvis also protects within its wide-spreading arch several im¬ 
portant vital organs. 

Throughout the body, as a rule, the large blood-vessels and most im¬ 
portant nerve trunks are protected by their position upon the inner and 
under sides of the bones near which they run. 

Motion. —The bones are the passive agents in the production of 
motion. The muscles, being excited to action by the nerves, employ the 
bones as levers. In walking, the body is, by means of the muscles act¬ 
ing on the bones, pried about from place to place. It is a curious fact 
that nearly all of the simple kinds of mechanical appliances are utilized 
in the production of motion; but as this subject will be dwelt upon at 
much greater length in connection with the study of the muscles, we will 
devote no further space to it here. 

Possible Function of the Bones. —It has been supposed by some 
of the most eminent physiologists that bones having a medullary canal 
may play an important part in the production of white blood corpuscles, 
it being thought that the medullary substance is capable of producing 
these bodies, the origin of which has been a subject of study by physiol¬ 
ogists ever since they were first discovered in the blood. Whether the 
supposition is correct or not cannot be positively asserted at the present 
time, as there have been no conclusive investigations on the subject. 

5 


G6 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


Composition of tlie Bones. —Bone substance is a curious com¬ 
pound of living matter, and matter possessing so low a grade of life that 
it is even doubted by some whether or not it possesses life at all. For 
convenience of description, it is customary to speak of the elements of 
bone as being organized and inorganic, the two being supposed to be in¬ 
timately blended together. It is more than probable, as .before intimated, 
that this is not a correct statement of the fact, but that bone, like all 
other tissues, is a living, organized .structure throughout, but so exceed¬ 
ingly complex in its nature that its elements are easily separated from 
their combination. 

Recollecting the real truth in the matter, we may proceed to examine 
the composition of bone, for convenience considering it as a mechanical 
compound of certain living elements with others that are not possessed of 
life. If a bone is placed in the fire for a short time, when taken out it 
will be found to have changed its nature very remarkably. First, it 
will be noticed that it has lost one-third of its weight; and, second, it 
will be observed that it has lost its strength and toughnass. A slight 
force will break it, and it may be easily crumbled to a fine powder; 
yet it retains precisely its original form and general appearance. 

If, instead of placing the bone in the fire, we had immersed it in a so¬ 
lution of muriatic acid for a few days or 
weeks, we should have obtained very differ¬ 
ent results. Supposing that we have done so, 
we find the bone still retaining its original 
form and appearance, but upon weighing it 
we discover that it has lost two-thirds of its 
weig-ht. Its nature has also changed; for in- 
stead of being firm and inflexible, it is now 
so flexible that, if a rib or a fibula, it may be 
tied into a knot. Fig. S3. 

If bones which have been treated in these 
•ways be submitted to a careful chemical ex¬ 
amination, it will be found that the bone 
which has been burned has lost all of its an¬ 
imal matter, the residue being a mixture of 
carbonates and phosphates of various bases. 
The bone which was immersed in acid will be 
found, on the other hand, to have lost all its 
mineral matter, the animal or vitalized or^an- 

- 7 O 

ized portion of the bone remaining. 



Fig’. 33. A long bone which 
has been rendered so flexible by- 
soaking in diluted muriatic acid 
that it can be tied into a knot. 











PROPER DEVELOPMENT. 07 

A careful analysis of the bones conducted in this manner, by the aid 
of the most refined processes known to chemical science, has determined 
the composition of bone to be as shown in the following table:—- 


Organic Matter, Gelatine and blood-vessels, 

' Phosphate of lime, 
Inorganic, Carbonate of Hme, 

or < Fluoride of calcium, 

Earthy matter, Phosphate of magnesia, 

Soda and chloride of sodium 


33.30 
51.04 

11.30 
2.00 
1.16 
1.20 


100.00 

In childhood the proportion of animal matter is much greater, so that 
the bones of infants and children are much more flexible than those of 
older people, and much less liable to fracture. In old age, on the con¬ 
trary, the proportion of mineral matter greatly increases, so that the 
bones become exceedingly brittle, and break with very slight violence. 
A child will fall several feet without suffering graver injury than slight 
bruises which will heal in a few hours. An old person, suffering 
half the violence, will not escape without broken limbs. It has often 
happened that an elderly person has broken an arm or a leg by simply 
rolling off the bed during sleep, or even tripping upon a door-sill and fall¬ 
ing upon the floor. 


HYGIENE OF THE BONES. 

Although the bones when once well formed are much less liable to 
disease than most of the softer parts of the body, yet they are un¬ 
doubtedly affected by various morbid influences, and during the period of 
development ai-e especially liable to become diseased hi a variety of ways. 
We shall attempt to point out in as brief and concise a manner as possi¬ 
ble some of the principal sources of danger to the integrity of this part 
of the system and the means necessary to secure the healthy develop¬ 
ment of the bones in early life, and their maintenance in a healthy 
condition in adult life. 

Proper Development. —First of all, proper development is essen¬ 
tial to the health of the bones as well as of other tissues of the body. If 
a morbid condition has been received by inheritance, of course the defect 
cannot be remedied; but most frequently faulty development is due to 








cs 


ANATOMY, PHYSIOLOGY , AND HYGIENE. 


faults which can be avoided. The chief causes of faulty development 
may be said to be,— 

1. Improper Food .—By improper food we mean that which is lack¬ 
ing hi the elements of nutrition necessary to form healthy bones. This 
is sometimes due to poor health, as defective digestion, on the part of the 
mother, so that the food she furnishes her infant both before and after 
birth is lacking hi the proper elements of nutrition not only for the 
bones but for all the tissues. The defect may be in the quality of the 
mother’s food. If she attempts to gain nourishment from fine-flour 
bread, strong tea, and lager beer, with perhaps a long list of harmful ar¬ 
ticles besides, the child will certainly sutler, not only with defective 
bones, but with defective mental development, and will be lacking gen¬ 
erally 

%/ 

Not infrequently, perhaps most often, defective nutrition for the 
bones arises from the attempt to rear an infant by hand upon such trash 
as corn-starch, tapioca, fine-flour gruel, and almost any one of a dozen 
varieties of “ baby food ” which are lauded in the newspapers, but the • 
only recommendation of which is that they hasten the little sufferers out 
of misery. No food is so good for the young infant as that furnished it 
by nature. If through illness or incapacity the mother is unable to fur¬ 
nish the proper quality or amount of food, then cow’s or goat’s milk, or 
some other proper substitute, should be provided. Full directions for 
such cases are given under the proper heading. 

Another cause of defective development is deficient or too early ex¬ 
ercise. Children that are kept constantly confined indoors cannot de¬ 
velop strong, h.a'.i y bones, anymore than they can develop vigorous 
muscles. Exercis . is essential to the development of every organ of the 
body, as well as to the maintenance of health in organs originally well 
developed. 

On the other hand, allowing children to begin to exercise too early, 
as attempting to teach them to walk before the bones have acquired suf¬ 
ficient firmness to sustain without injury the weight of the body, may 
dwarf and deform a child so that proper development may be impossible. 

Putting children at work at employments which tax them by requir¬ 
ing continuous application for long periods is a most injurious and inhu¬ 
man practice. When this is done, ossification is hastened, and becomes 
completed before the individual has attained his full growth, thus dwarf¬ 
ing him. The thousands of diminutive young men and women to be 


PROPER DEVELOPMENT. 


69 


found in the vicinity of large manufacturing cities bear testimony to 
the truth of this observation. 

The bones of young children are soft and pliable, and yield when 
subjected to more strain than they can bear, thus becoming distorted. 
The exercise of children should always be varied, and should be given 
with frequent intervals for rest. Prolonged action is much more tax¬ 
ing to children than more violent exercise with frequent periods 
of rest; but both should be avoided. Moderate exertion and plenty of 
rest are the essential principles of development by exercise for children. 

Spinal Curvatures .—Almost a volume might be written on the evil 
results of improper positions assumed in lying, sitting, standing, and 
walking; but our space is limited, and as the subject will be again 
referred to under the head of “ Hygiene of the Muscles ” we shall now 
simply touch upon the most important points which bear particularly 
upon the hygiene of the bones. It is in childhood especially that errors 
of this kind exert most strongly their baneful influence. 

Probably to improper positions in school-rooms, where boys and 
girls as students are usually confined several hours of each of five 
days in the week, is due a large share of the distortions of the spine 
which are so exceedingly common nowadays. Dress-makers* and 
most tailors are well posted on the frequency of spinal curvature, 
on account of the great number of instances in which dresses, coats, 
and other garments have to be cut and padded to hide deformities of 
this sort. Spinal curvatures are much more common among young la¬ 
dies than in the opposite sex, for the reason that young men and boys 
usually engage in such vigorous, active sports out of school-hours that 
the evils occasioned by confinement in improper attitudes are in a con¬ 
siderable degree counteracted. We have for several years made a 
special point of observing with considerable care the persons whom we 
meet in traveling, in the streets, and in various other ways, with ref¬ 
erence to this point; and we have been astonished to see in what a 
large proportion of young persons, particularly young ladies, some de¬ 
gree of variation of the spinal column from the natural form exists. 
We have noticed particularly on more than one occasion the very 
great frequency of this form of deformity in young ladies in attend¬ 
ance at our city schools. In cases in which the curvature is lateral it 
may be discovered at a glance by the difference in prominence of the 
two shoulders. The shoulder upon the concave or hollow side of the 
curve is always lower than that on the opposite side. 


70 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


One great cause of the serious injury to students, and especially 
the younger class of school-children, is the use of improper seats and 
desks, or seats and desks not adapted to the age or size of those who 
occupy them. It may be well to remark, however, that the evil is be¬ 
coming generally recognized by our foremost educators, and the im¬ 
provements already made in this direction by manufacturers give rea¬ 
son to hope that the difficulty will soon be remedied, so far as the me¬ 
chanical construction of seats and desks is concerned. But this alone 
will not remedy the evil; teachers must fully appreciate its gravity and 
must do their part in inducing students to assume and maintain a cor¬ 
rect attitude in sitting at their studies. AVhen engaged in study, stu¬ 
dents, especially if they are near-sighted or if the light is poor or print 
defective, are very apt to lean forward until the spine is very consid¬ 
erably curved. This is especially the case when engaged in ciphering 
or writing. The effect of this is to produce a permanent forward 
curving of the spine, and round shoulders, a deformity the most seri¬ 
ous aspect of which is by no means its detraction from the good ap¬ 
pearance of an individual. At the same time, most generally, a lateral 
curvature is produced by sitting with one arm upon the desk while 
the other is not, the desk being so high as to require the shoulder to 
be elevated to bring the elbow upon it. This position is a very com¬ 
mon one with students, and to it is due the greater share of the cases 
of lateral curvature. 

At first a curvature is only a functional distortion, being due to 
weakening of some of the muscles of the back, but by degrees it be¬ 
comes permanent, as will be seen by a glance at the structure of the 
spinal column. It will be recollected that the vertebral column is 
made up of twenty-four separate bones arranged one above another, 
with discs of elastic cartilage between. It will also be recollected 
that the observation was made that these cartilages may lose their 
elasticity in some degree by continuous pressure, so that they become 
thinned, thus making a person shorter at night than in the morn¬ 
ing, the variation being from one to two inches in different persons, 
and according to the amount of exercise taken. From these facts it 
will be readily seen that if the spinal column be bent and retained in 
a curved position for any considerable time, the discs of cartilage will 
become thinner upon the side upon which the pressure is applied, that 
is upon the hollow side of the curve, than upon the opposite side. 
Again, it will be readily understood that if this occurs daily for a con- 


PROPER DEVELOPMENT. 


71 





siderable period, the thinning 
upon the side brought under 
pressure may become perma¬ 
nent. This is exactly what 
does occur. The cartilages, 
which are naturally of equal 
thickness on the two sides, 
become so changed that they 
resemble wedges. This is well 
seen in the illustrations. See 
Figs. 34, 35. 

We have in our possession a 
section of the spinal column 
which we removed from the 
bodv of an individual in whom 

J 

it had become so curved as to 
almost exactly resemble the let¬ 
ter S. In this case the carti¬ 
lages were in exactly the condi¬ 
tion represented in the accom¬ 
panying cut above referred to. 
We have recently had under 
treatment a number of cases of 
this sort in young ladies, whose 
bad positions assumed in sitting 
at school were wholly respon¬ 
sible for the deformity of which 
they suffered. In one instance 
in which there was double curv¬ 
ature of spine, as represented in 
Fig. 37, the young lady’s height 
was increased by treatment two 
inches in a few weeks, by sim¬ 
ply straightening the spine and 
restoring the cartilage discs to 
their proper uniform thickness. 
In another case an inch and a 
half was gained in the same 
way, though in the latter in¬ 
stance there was posterior as 


Fig 1 . 34. Section of vertebrae, showing, at 3, 
Fibro-Cartilage Disc of normal shape. 


Fig:. 35. Diagram showing the Cartilage,3, 
thickened as the result of an anterior curvature 
of the spine, the spines of the vertebrae, 88, be¬ 
ing brought near together. 


Fig. 33. Diagram showing the Cartilage. 3, 
thinned by pressure resulting from a posterior 
curvature, the ends of the spines, 88, being sep¬ 
arated more than usual. 








72 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


well as double lateral curvature. The mode of treatment employed is 
detailed elsewhere. 

It is too evident to need special explanation that if 
the permanent thinning of the intervertebral cartilages 
has existed a very long time no method of treatment will 
be of avail. Hence the importance, not only of taking 
every precaution to prevent the evil in the first place, but 
of adopting the necessary curative measure as soon as the 
deformity is discovered. 

Deformity from Tight-Lacing. —While the bones 

suffer the least of any organs from the absurd custom 

which fashion has imposed upon the gentler sex,—and, we 

are informed, at times upon the other sex as well,—tight- 

lacing the waist and encasing the body in a vise of stays 

Fig 37 °f hone or steel, is of positive and often incurable injury 

Double curvature to this part of the vital economy, and is indirectly the 
of the spine. nr. , i . •, i , 

source of tar greater damage to more vital parts. 

The reader will recall that in considering the anatomy of the thorax 
attention was called to the fact that the bony ribs do not join the .ster¬ 
num or breast-bone directly, but indirectly through the medium of flex¬ 
ible cartilages, an arrangement which gives to the thorax the power to 
expand and thus enable the lungs the better to perform their important 
functions. Careful study has shown that this flexibility of the costal 
cartilages is due to their constant exercise. Hay and night, sleeping or 
waking, twenty times a minute, these flexible parts are bent and allowed 
to return again to their natural position. This constant bending and un¬ 
bending allows them no opportunity to become stiff and unyielding like 
the bones. But when the chest is imprisoned in a corset, this constant 
movement becomes impossible ; and the consequence is that a process of 
stiffening is set up, and after a time the once flexible, yielding cartilages 
become as rigid as the rest of the ribs. The inevitable result of this 
change is a permanent limitation of the movements of the lungs. It be¬ 
comes impossible for them to expand except to a limited degree upward 
and downward. Lateral expansion is as impossible when the corset is 
laid aside as when it is in place. The deformity, which was at first tem¬ 
porary, has become permanent. There are thousands of delicate ladies 
all over the land whose costal cartilages have been thus changed through 
their own willful abuse of their bodies, and who will undoubtedly go 
down into premature graves in consequence, in spite of all that the most 
skillful physicians can do for them. 



ABUSE OF THE FEET. 


78 


The chest ought to be capable of expansion from two to five inches, 
—even greater expansion is attainable. But if you put a tape-line 
around one of these corset-stiffened chests you will be unable to ob¬ 
tain more than a scant quarter-inch of difference in measurement 
between the chest when empty and when filled to its utmost capacity. 
We have often tried the experiment when making physical exami¬ 
nations of the chest, and though the ^atient is almost always anxious 
to do her best, in order to demonstrate if possible what every lady 
) will eagerly contend for, that her corset never did her any harm because 
it was worn so loose, and ro & up her shoulders to her utmost and 
makes a desperate attempt to swallow more air than there is room for, 
we have often found that the expansion of the sic 1 , of the chest was so 
slight as to be imperceptible. If tight-lacing did no other harm than 
this, we should certainly wish to condemn it in the strongest terms we 
could find language to express; and we cannot help feeling sometimes 
that it is a great misappropriation of money to support an army of mis¬ 
sionaries among the inappreciative and degenerated inhabitants of Af¬ 
rican jungles and other heathen countries, who value human life so 
little that they feed their superfluous little ones to the crocodiles, and 
sacrifice a score of women to commemorate the death of a king, while 
there are sg many thousands, perhaps millions, in civilized lands who are 
sacrificing lives which might be a hundred-fold more useful, in ways 
equally absurd and senseless. Let us have health missionaries to go into 
every city, village, and community, and preach the life-saving gospel of 
health. Such a mission is needed ; and it oughfc*to be instituted and 
supported, even if at the expense of some of our numerous and worthy, 
though far less important, missions to the degraded and benighted of 
foreign lands. 

O 

Abuse of the Feet. —Though we have not space here to elucidate 
fully the subject of the hygiene of the feet, we cannot forbear calling 
attention to the very common evil practices which relate to them. 
Nothing could bo more absurd than the modern mode of dressing the 
feet. If some of the shoes and boots which we have seen worn, and 
which seemed to be highly prized by the wearers as being in the height 
of fashion, had been constructed by the Inquisition, and the same individ¬ 
uals had been compelled to wear them in punishment for some real or 
alleged crime, they would have been regarded as diabolical instruments 
of torture; and so they are. Who has not seen a young miss mincing 
along in a wholly unnatural way, vainly striving not to seem to limp, 


74 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


in the sinful attempt to compel her feet to be reconciled to the scanty 
capacity of a pair of shoes two sizes too small for her. Within a short 
period, Fashion has let go her iron grasp upon the young men; but she 
still holds as firm a grip as ever upon the tender feet of misses and 
maidens as well as their elder sisters and mothers, and compels them 
to place upon their feet pretenses of coverings which cannot but pro¬ 
duce discomfort and disease. The narrow soles, and high, narrow heels 
set forward near the middle of the foot, are qualities most worthy of 
being heartily despised; and the man or woman who invented the foot¬ 
covering possessing these properties, so finely adapted to torture the 
feminine foot, is responsible for an amount of discomfort and misery, 
individual and domestic unhappiness, and possibly of actual vice, which 
certainly entitles him to the dishonor of being heartily despised and 
abundantly i*eproached by the whole human kind. 

A year or two ago we thought Fashion had concluded to be sensible 
at last, at least in the matter of foot-coverings, but alas for our hopes! 
Another turn of the wheel and she comes up as fickle and untrue to the 
requirements of Nature as ever, and demands that woman shall wear 
French heels, or be ostracized from the society of the elite, which to the 
majority of fashionable women would be a fate as bad or worse than 
death. We declare without mental reservation and without the slight- 

o 

est remorse of conscience, as a professional man and as a professed 
champion of truth, that a French slipper or shoe, as made at present 
(in the year 1880), is as unfit for a human foot as a horseshoe. Far 
more sensible would it be to return to the ancient custom and wear 
the rude, homely sandals which graced the feet of the maidens of an¬ 
cient Egypt and the Orient. 

But let us look a moment at the real evils of these fashionable cover¬ 
ings for the feet, at least for ladies’ feet. The custom of wearing tight 
shoes with narrow soles and high, narrow heels, begins in early maiden¬ 
hood, if not in childhood or infancy,—and sometimes the absurd fashion 
even seizes upon the child as soon as she leaves the cradle, for the preco¬ 
cious little one is so smart she must be a lady at once, and so must do as 
ladies do. At this period the bones are so soft and flexible, the ligaments 
so yielding, that they are easily forced into almost any mold, and the 
process of deforming them begins. The small boot or gaiter worn,—and 
it is always as small as can possibly be pressed upon the foot with the 
thinnest possible stocking,—allows no room for development of the organ, 
and the improper shape produces deformity and distortion. The fash- 


ABUSE OF TUE FEET. 


75 


ionable American girl does in a somewhat more limited degree exactly 
what is done for the Chinese maiden by a process of bandaging, of which 
we will elsewhere give our readers a description. The narrow soles and 
small toes cramp the foot and prevent it from supporting the weight of 
the body upon its whole under surface as designed by nature. The high 
heel throws the weight forward upon the toes, which still further em¬ 
barrasses them in their cramped condition, and greatly increases the in- 
j ury arising from narrow toes and soles. We have often witnessed some 
of these unfortunate young women tiptoeing along the streets, evidently 
conscious of appearing awkward and uncouth, and vainly endeavoring 
to conceal their crippling gait. The farther toward the toes the heel is 
set, the worse this difficulty becomes. In some of the latest foreign styles 
the wearer is barely able to touch her toe to the ground, except at the 
risk of tipping over forward, and when walking appears like a person 
stumping along on stilts. We heartily believe in laws against stealing, 
defrauding, taking life, disturbing the peace, even for the prohibition of 
the sale of liquor, and we can conceive of no reason why a shoemaker 
who deliberately goes to work and manufactures an instrument of tor¬ 
ture which he perfectly well knows must spoil the happiness, ruin the 
temper, and make cripples of half the women of Christendom, should not 
be placed under the ban of the law and visited with punishment commen¬ 
surate to his crimes. 

But perhaps we are beginning at the wrong end. It cannot be de¬ 
nied that ladies can obtain if they wish loosely fitting shoes, with broad 
soles, wide toes, and low and wide heels, and made of leather sufficiently 
thick to afford at least as much protection as a good quality of brown 
paper from the dampness and chilliness of the moist walks which must 
be encountered during the greater part of the year out of doors. If la¬ 
dies will do their duty by themselves and their daughters, the evil may 
be speedily corrected; for French heels will not be made only so long as 
there is a demand for them. We are not sure, after all, but they owe 
their existence far more to female vanity than to any malignant designs 
on the part of the shoemakers. 


7G 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


THE MUSCLES. 


The muscles constitute the flesh, or lean meat, of animals. Their gen¬ 
eral structure may be readily seen in the boiled leg of a fowl. By a 
little care the round mass of flesh forming the thigh may be separated 
into coarse fibres, which by careful manipulation can be still further di¬ 
vided into tiny threads. Under the microscope the finest fibres which 
can be seen by the naked eye are found to be composed of still smaller 
fibres, which are the anatomical elements of muscular tissue, and have 
already been studied. In a muscle these minute fibres are bound up in 
little bundles, which are again united into larger bundles, and these are 
bound up together in a common sheath to form the complete muscle. 

Two Kinds of Muscles. —As already pointed out, there are two 
varieties of muscles, which are distinguished both bv their structure and 
by their mode of action. They are known as voluntary and involun¬ 
tary muscles. The voluntary muscles are chiefly located upon the ex¬ 
terior of the body, giving roundness and symmetry to the form. They 
are employed in all voluntary motions. The involuntary muscles are 
chiefly found in the interior of the body, in membranes, the walls of cav¬ 
ities, of blood-vessels, and of the various outlets of the body. Involun¬ 
tary fibres also abound in the skin, being attached near the roots of the 
hairs. It is by their contraction that the skin is made to assume the ap¬ 
pearance of goose-flesh. 

The Tendons. —In order to give the muscles strength and greater 
efficiency they are not usually attached directly to the bones with which 
they are connected, and in conjunction with which they give rise to the 
various movements of which the body is capable, but are united to them 
by means of tendons, which are white, glistening bodies composed of 
tough, inelastic, fibrous tissue similar to that which forms ligaments. 
Tendons are sometimes very short, but at other times are drawn out 
into long, thin cords, traveling some distance from the muscle before 
being attached to the bone. 

Form and Arrangement of Muscles.— The voluntary muscles 
are of various forms, as will be seen by reference to the accompanying 
cuts. Figs. 37, 38, 39, and 40. By this diversity of form they are adapted 
to all the different positions in which they are required to act. 



/ 



Plate 11 — THE MUSCLES. 

















































































































































































MUSCLES OF THE HEAD. 


77 



Fig. 37. Fusiform, or Spindle-Shaped Muscle, having a tendon at each end. 
Fig. 38. Pennate, or Feather-Shaped Muscle. 

Fig. 39. Fan-Shaped Muscle. 

Fig. 40. Circular, or Orbicular Muscle. 


The voluntary muscles, with few exceptions, exist in pairs, the two 
halves of the body being symmetrical. 


NAMES AND ACTION OF SPECIAL MUSCLES. 

Of the more than five hundred distinct muscles in the body we can 
mention but a very few of the most important. Indeed, the action of a 
large number of the smaller muscles is so obscured by others that it is 
hardly worth our while to attempt to study them closely. For the sake 
of convenience and brevity we will notice the action of each of the 
muscles named in immediate connection with its description, although 
this part more properly belongs to the physiology of the muscular 
system. See Plate II, and Fig. 41, for a general view of the muscles. 

Muscles of tlie Head. —See Figs. 42 and 43. The muscles of the 
head, including those of the face, are among the most interesting of all 
in the body. Of the large number of special muscles in this region 
only a few can be here mentioned by name. 

The Occipito-Frcmtalis .—This muscle is attached to the skull at the 
back part of the head, and by means of a long, thin, flat tendon is carried 
over the top of the head to the forehead, the other end being attached to 
the skin of the latter region. The scalp is closely adherent to the tendon 
of the muscle. By contraction of this muscle the forehead is wrinkled 
and the eyebrows elevated. In some persons the muscle is under such 
complete control that the whole scalp can be moved very freely. 





















78 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


The Corrugator Supercilii .—This might be called the frowning 
muscle. It is located near the inner and upper border of the eye. By 
its contraction the skin of the forehead is drawn down and wrinkled, as 
in scowlinof. 


Orbicularis Palpebrarum .—The little mus¬ 
cle which bears this long name is the circular 
muscle of the eye. Its fibres surround and aid 
in forming the eyelids, and by their contraction 
the eye is closed. There are several other mus¬ 
cles connected with the external parts of the eye, ■ 
which we have not space to mention. 

Auricular Muscles .—There are three little 
muscles connected with each ear, located just 
beneath the .skin, which seem to be designed 
to move the external ear in various directions ; 
but practically they are of no use in man. In 
lower animals these tiny muscles are developed 
into large and useful ones, as in the horse, dog, 
and rabbit. There may occasionally be found a 
person in whom these muscles are so well devel¬ 
oped that the ear may be moved at will, though 
so slightly that no advantage can be derived 
from the action. Darwinian philosophers tell 
us that theae rudimentary muscles are vestiges 
of the large, strong muscles possessed by man’s 
primeval ancestors, who may have been able to 
use their ears as fly-brushes for the protection 
of the face. 

Muscles of the Nose .—The soft parts of the 
nose are made up of muscles which compress its 
lower portion, elevate and depress and dilate the nostrils, each receiving 
a name descriptive of its particular function. One of the little muscles 
which operate upon the nose carries the most formidable name of any 
muscle in the body, being designated as the levator labii superioris 
claque ncisi, which translated means the elevator of the upper lip and 
of the nostril. 

Muscles of the Mouth .—Nine pairs of muscles operate upon the 
mouth and lips, them stationary ends being attached to the bones of the 



Fig. 41. 

of the Muscles 


General View 




MUSCLES OF THE HEAD. 


79 


face adjacent to the mouth, and their moving ends being connected 
by a circular muscle which surrounds the mouth, known as the 
orbicularis oris. The use of the last-named muscle is to aid in 



closing the mouth and to pucker the lips as in whistling. 


Muscles of Expression .— 
Most of the muscles connected 
with the mouth and lips are 
chiefly useful in giving ex¬ 
pression to the countenance. 
Through the action of these 
muscles, together with those of 
the external parts of the eye 
and nose, the face becomes a 
mirror of the mind. For in¬ 
stance, when feelings of joy or 
merriment are experienced the 
muscles of the upper part of 
the face contract in such a way 
as to drag the corners of the 
mouth outward and slightly 
upward, as in laughing or smil¬ 
ing. When opposite emotions 
are experienced, as in grief or 
sullenness, the corners of the 
mouth are drawn down, the 
muscles of the lower part of 
the face being contracted in 
such a way as to draw the lines 
of expression downward. All 
other emotions of the mind are 


Fig'. 42. 2 and 5. Occipito-frontalis; 3, 4, and 
6. Muscles of the Ear; 7. Orbicularis Pajpebrarum; 
8. Levator Labii Superioris Alaaque Nasi; 9. Com¬ 
pressor Naris; 10. Levator Anguli Oris; 11. Buccin¬ 
ator; 12. Zygomaticus Minor; 13. Orbicularis Oris 
and Zygomaticus Major; 14. Platysma Myoides; 15. 
Splenius; 16. Masseter; 17. Sterno-cleido-mastoid; 
18. Levator Scapula; 19. Scalenus Medius; 20. Tra¬ 
pezius. 


indicated with equal distinctness, so that a person of any degree of ex¬ 
perience in observing men and things can tell with almost absolute cer¬ 
tainty the general tenor of the thoughts of one to whom he is speak¬ 
ing. So close is the relation between the mind and the muscles of ex¬ 
pression that it is absolutely impossible for a person to be strongly af¬ 
fected by any emotion without in some degree exhibiting the same in 
the face. For example, it is not possible for a person to be merry in 
.mind and at the same time assume an appearance of grief upon the 
face which could not readily be detected as an attempt at deception. 


80 


AX ATOMY, PHYSIOLOGY, AXD HYGIEXE. 



( 


Tig. 43. This cut shows with 
greater distinctne-s some of the deep¬ 
er Muscles of the Face, and those of 
its lower part. 


Muscles of Mastication .—Besides the 
muscles of the face already mentioned, 
there is a set of muscles located at the back 
part of the cheek which are attached at 
one end to* the skull and upper bones of 
the face, and at the other to the inferior 
jaw-bone. These are quite strong mus¬ 
cles, and then- function is to move the lower 
jaw in talking, and particularly in masti¬ 
cation. The principal muscles for this 
purpose are the temporal and the rriasseter. 

Internal Muscles of the Eye .—The 
system of muscles by which the eye is 
moved is one of the most marvelous exhi¬ 
bitions of mechanism in the body. The 
motions of the eyeball are produced by 

six slender muscles which chieflv arise from 

%/ 

the bottom of the socket behind the eve, and are attached to its outer 
covering. Four of these produce the movements of the eye upward, 
downward, to the right, and to the left. The other two are ingeniously 
arranged in such a manner as to roll the eye and to move it in an oblique 

direction, hence they are known 
as the oblique muscles of the eye. 
One of these, the superior oblique, 
operates by means of a pulley ar¬ 
rangement, its tendon passing 
through a loop and changing its 
direction before being inserted into 
the eyeball. By the combined 
action of these several muscles, all 
the different motions are obtained. 
All acting in rapid succession qiuse the eye to roll in its socket in such 
a way as to enable the sight to describe a complete circle. In persons 
who are cross-eyed or wall-eyed, some of the muscles just described are 
affected. For illustration of muscles of the eye, see Fig. 44. 

Internal Ear Muscles .—Within the interior of the ear there are to 
be found three little muscles, the most delicate in the whole body, which 
operate upon the minute ear bones and other parts of the middle ear in 
regulating the function of hearing. ♦ 

O C C 



Fig. 44. Showing the Muscles of the Eye. 




MUSCLES OF THE TRUNK. 


SI 



Muscles of the Neck. —The muscles of the neck may be rudely di¬ 
vided into two sets; those in front, and those of the back part of the neck. 
The anterior muscles are useful in depressing the lower jaw, hi raising 
the bone of the throat, hi compressing the throat and controlling the or¬ 
gans used hi speaking and swallowing, and to bend the head forward. 

The muscles of the back part of the neck are chiefly useful for mov¬ 
ing the head. By their action the head may be thrown backward or to 
one side. They are quite strong muscles, and a re needed to enable a per¬ 
son to maintain the head 
in an erect position. A 
long, shm muscle which 
passes from the back 
part of the head to the 
upper end of the breast¬ 
bone, called the sterno- 
cleido-mastoid muscle, 
by contraction becomes 
the cause of wry neck, 
for which disease it is 
sometimes necessary to 
divide it by a surgical 
operation. 

Muscles of the 
Trunk .—These also 
may be divided into 
two groups, those found 
upon the front of the 
trunk, and those upon 
the back. The muscles 
of the front form the 
principal portion of the 
alxlominal walls. They are attached to the borders of the ribs and the 
breast-bone above, and to the edges of the pelvis below. They bend the 
body forward, and assist in keeping it erect. They are also exceedingly 
useful in respiration, and aid in several other vital operations. Between 
each two ribs there is a double set of muscles which assist in the contrac¬ 
tion and expansion of the thorax in respiration. The upper part of the 
chest also affords attachment to several large muscles which act upon the 
upper extremities. The muscles of the back are exceedingly numerous, 

6 


Pig - . 45. Showing Muscles of the Trunk 











82 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


being arranged in five distinct layers. They arise for the most part 
from the projecting points of bone which have been already described as 
being found in great numbers on the vertebrae which make up the 
spinal column. Some also arise from the skull, from the ribs, and from 
the pelvis. They hold the body erect, give to the trunk a great variety 
of movements, draw the head backward, assist in moving the arm, and 
aid in respiration. This is undoubtedly the most complicated part of the 
muscular system. For a view of the muscles of the trunk, see Fig. 45. 

Muscles within the Trunk. —Of the muscles within the trunk of 
the body the most important is the diaphragm, which is a broad, circu¬ 
lar muscle dividing the cavity of the thorax from that of the abdomen. 
Its outer border is attached throughout its whole circumference to the 
lower parts of the ribs and their cartilages and the upper lumbar verte¬ 
brae. The muscular fibres converge from the circumference and unite 
in the center in a large, flat, tendonous portion which forms the center of 
the diaphragm. In a state of rest, the muscle rises into the cavity of the 
thorax like a dome. By its contraction it becomes depressed to a more 
nearly horizontal position, thus aiding inspiration by increasing the size 
of the thoracic cavity. The diaphragm is one of the most important 
muscles of the body. Though voluntary in its structure and under con¬ 
trol of the will, like the other ordinary muscles of respiration it acts in¬ 
voluntarily, and thus carries on the process of respiration during sleep. 

The other muscles found within the trunk are connected with the 
lower extremities, arising upon the inner sides of the pelvis and passing 
out to be attached to the upper part of the thigh bones. They are use¬ 
ful for turning the limb so as to bring the toes outward, to aid in hold¬ 
ing the body erect and in bending it. 

Muscles of the Upper Extremities. —These comprise the muscles 
of the shoulder, arm, fore-arm, and hand. Most of the muscles of the 
shoulder assist the movements of the arm, and so do not require special 
notice. The arm proper is acted upon by eleven muscles, eight of which 
are attached to the scapula. The remaining three arise from the trunk 
of the body and the fore-arm. The most important of these are the 
deltoid, which covers the shoulder and raises the arm to a horizontal po¬ 
sition; the pectoralis major, which brings the arm forward upon the 
chest—this is the muscle chiefly used by birds in flying, being in them 
enormously developed; the lattissimus dorsi, a large muscle which 
arises from the trunk and is connected with the upper and back part of 
the arm, which it draws backward and to the side. 


MUSCLES OF THE HAND. 


83 


The movements of the fore-arm are freer than those of any other 
part of the body unless it be the hand. Its principal motions are 
flexion, bending upon the arm; extension, restoration to its straight 
condition after dexion; rotation inward, turning of the palm of the 
hand toward the body; rotation outward, movement in the opposite 
direction. These movements are accomplished by thirteen different 
muscles, most of which arise from the scapula and arm, and are at¬ 
tached to different parts of the bones of the fore-arm. The most im¬ 
portant of these are, the biceps, which is the principal muscle employed 
in flexion of the fore-arm ; the triceps, which extends the fore-arm, an¬ 
tagonizing the biceps; the pronator teres and pronator quadratics, 
which turn the arm inward; and the supinator brevis, which rotates 
it outward. 

Muscles of the Wrist. —The wrist is moved by sixteen different 
muscles, its chief movements being forward, backward, outward, and 
inward, movements in other directions being made by combinations 
of muscles operating in these different ways. The principal muscles 
of the wrist proper are, one which flexes it upon the ulna, another 
which flexes it upon the radius, and two muscles, a long one and a 
short one, which extend the wrist, antagonizing the flexors. 

Muscles of the Thumb and Fingers. —The thumb and fingers of 
each hand are operated by eighteen different muscles, half of which 
are capable of producing several different motions. It is this fact 
which gives to the human hand the wonderful dexterity which en¬ 
ables man to carry into execution the most subtle mechanical contriv¬ 
ances suggested by his active brain. It is claimed by some, and has 
not been contradicted that we are aware of, that the human hand has 
done almost as much to bring man to his present highly educated and 
civilized state as the brain itself, granting, of course, that the brain is 
the motive power. In no other known animal is there so great an in¬ 
dependence of action in the digits as in man. The power ff opposing 
the thumb to the four other digits is what gives the hand its greatest 
efficiency, enabling it to grasp very small objects between the ends of 
the fingers and the thumbs. The study of digits in different animals 
is an exceedingly interesting branch of knowledge. 

Muscles of the Lower Extremities. —The muscles of the inferior 
extremities are in a great degree analogous to those of the arms, cor¬ 
responding quite closely in number, relation, and function. 

Muscles of the Thigh. —These are chiefly large, strong muscles, aris- 


84 


ANATOMY , PHYSIOLOGY, AND HYGIENE. 


ing from the pelvis. The thigh is moved by twenty distinct muscles, 
the principal of which are the three glutei muscles which form the 
fleshy part of the hip, and the three adductor muscles which draw the 
limb forcibly toward the central line of the body. 

The Muscles of the Leg. —The leg is moved by ten muscles, the 
chief of which are, the biceps, by which it is flexed upon the thigh; 
the rectus femoris, by which the leg is extended or straightened—it 
is the lower end of this muscle which is inserted into the knee-cap 
or patella, which is in turn attached 1 >y a ligament to the upper part 
of the leg bone, or tibia; and the sartorius, or tailor’s muscle, which is 
used in crossing the legs beneath the body when sitting down in tailor 
fashion. 

Muscles of the Foot. —The ankle and toes are moved by twenty 
separate muscles, of which we will only mention the gastrocnemius 
and soleus which form the chief part of the calf of the leg. There is 
much less freedom of motion in the digits of the feet than in those of 
the hand, although the number and relations of their muscles are much 
the same. A considerable desree of control over the toes can be ob- 

O 

tained, however, by practice, as is shown in the case of persons who, 
being deprived of hands, have learned to write legibly with their toes. 

PHYSIOLOGY OF THE MUSCLES, 

The sole property of a muscular fibre is contractility. Muscular 
fibres are said to possess a natural irritability by means of which they 
respond to proper kinds of stimulation by contracting. The ordinary 
and most natural stimulus to muscular contraction is nerve force. 
Through the connection of the nerves with the muscles, nerve force 
generated in the living batteries of the system—the nerve cells of the 
brain and spinal cord—is communicated to the muscle fibres, which are 
by this means made to contract. Muscular fibres may also be made 
to contract by the stimulus of electricity, which in many respects very 
closely resembles the nerve force. Mechanical and chemical irritation, 
such as striking, tearing, or pinching the muscle, or applying an acid 
or some other irritant, has a similar effect. 

It was formerly supposed that muscles could be made to contract 
only through the medium of nerves. It is now known, however, that 
this view is incorrect, since by direct irritation muscular contraction 
can be produced when the nerves are completely paralyzed. 


HOW A MUSCLE CONTRACTS. 


85 


The contractile power of muscular fibres is not only always pres¬ 
ent while they retain their life, hut is always active. Contrary to the 
general supposition, the muscles are never quiet. They are always 
actively at work, and it is by means of this constant contraction that 
the symmetry of the body is preserved. A proof of this is found in 
the fact that when a single set of muscles is paralyzed, the part be¬ 
comes distorted by the contraction of the antagonizing muscles. This 
is often seen in the face in cases of paralysis of one side. A short 
time ago we had under treatment a patient in whom the extensor 
muscles of both fore-arms had been paralyzed, so that there was loss 
of power to straighten the hands. The fingers were all bent toward 
the palm. The patient could lift quite a heavy weight, but could not 
open the hand, and could scarcely move a finger except to close it 
tighter. By the application of proper treatment to the paralyzed 
muscles upon the outer side of the arm the patient recovered the power 
to control the hand and straighten the fingers. This peculiar property 
is called muscular tonicity. 

How a Muscle Contracts. —The contraction of a muscle, though 
very simple, is still interesting. If the arm be clasped with the hand, 
and the fore-arm be then bent, the hand being closed and a consider¬ 
able degree of force exerted, as in lifting a heavy weight, it will be 
observed that the arm becomes larger, seeming to swell out beneath 
the grasp. If a single muscular fibre were under examination be¬ 
neath a good microscope, as a live fibre just taken from a frog or a 
turtle, we might cause it to contract by a very feeble current of elec¬ 
tricity ; and should we do so, we should notice essentially the same 
thing; we should find that the fibre would become thicker, but at the 
same time it would become shorter. As already explained, a muscle 
is made up of a large number of fibres; and its contraction as a 
whole is due to the contraction of each one of the minute fibres 
which compose it. As each one of these thickens and shortens in 
the process, the whole muscle thickens and shortens. There is no 
increase in size in the muscle, but simply a change of form. This 
is the simple manner in which all motion is produced. 

Mechanical Action of Muscles. —As elsewhere remarked, the 
muscles use the bones as levers in executing their various movements. 
Not only the lever but also the pulley, another mechanical power, is 
illustrated in the action of the muscles. It will be both interesting 
and profitable to notice some of these exhibitions of vital mechanics. 


86 


ANATOMY, PHYSIOLOGY, AND HYGIENE 



A lever consists essentially of a rigid bar of some sort, a point of 
rest for the bar, which may be at one end or at any point between the 

ends called the f ulcrum, the pow- 
er, which is applied to some part 
of the lever away from the ful¬ 
crum, and the weight, the object 
to be lifted. There are described 
three kinds of levers, which are 
illustrated in Figs. 46, 47, 48. In 
the first kind, it will be noticed 
that the weight is upon one side of the rest, or fulcrum, and the power 
on the other side. In the second kind of lever, shown in Fig. 47, the 
weight is between the power and the fulcrum. In both instances 
there is a gain of power, because the force is applied at the long arm 
of the lever. In the third class, Fig. 48, the power is between the 
weight and the fulcrum. Now the power is applied at a disadvan¬ 
tage, as the weight is at the long arm of the lever. However, there 
is compensation; for what is lost in 
power is gained in speed or motion. 

Now, regarding the muscles as the 
power, the bones as the levers, the 
work to be done, that is, the objects 
to be lifted, carried, pushed, or oth¬ 
erwise moved by the muscles, as the 
weight, let us see how these different 
in the human body. 

The first kind of lever is rarely illustrated in the body. It is 
found, however, as in the action of the muscles of the back of the 
neck upon the head. The top of the spinal column is the fulcrum, 
the head itself the leva’, the muscles of the neck the power, and the 
front part of the head the weight to be lifted. 

Illustrations of the other two 
kinds of levers are very abundant. 
In the foot, employed in the ordi¬ 
nary act of walking, we have a good 
illustration of a lever of the second 
class. When the body is supported 
on tiptoe, the foot is the lever, the 
earth the fulcrum, the body the weight, and the muscles of the calf 
the power. See Fig. 49. 




USES OF MUSCLES. 


87 



Fig. 50 illustrates by the arm a lever of the third class. Here the 
fore-arm is the lever, the elbow is the fulcrum, the muscles of the 
fore-arm the power, and the dumb-bell lifted in the hand the weight. 
The power, being applied between the fulcrum and the weights, lifts 
the ball at a disadvantage, as it evidently re¬ 
quires more strength to hold the ball in posi¬ 
tion as shown in the figure than it would to lift 
it straight up with the arm by the side. 

It is not a mistake of nature that the muscles 
and bones of the arm are so arranged that the 
power is applied at a mechanical disadvantage, 
since what is lost in lifting power is gained in 
rapidity and extent of motion. By means of 
this arrangement the dexterity of the hands is 
very greatly increased, and they are far better .. F i 8 ’’ 49 ' In the ? bov , e cut 

J J J the foot, c, represents a lever 

fitted for the great variety of rapid movements with the fulcrum at r, the 

. n , , ,, ,, weight of the body lifted 

which they are required to execute than they through the bones of the leg, 

could otherwise be. joining the foot at W, and 

the power applied at P, the 

The pulley principle is beautifully and per- heel, through the contraction 
n <ii , , i • <» ,i i e ii of the muscles of the calf, a. 

fectly illustrated m one or the muscles ot the 

eye, as before mentioned, and also in a muscle of the neck called the 
di-gastric, from the fact that it has two bellies, or fleshy portions. As 
will be seen in the cut (Fig. 51), the middle and tendonous portion 

of the muscle is held by a loop 
through which it plays, the loop con¬ 
stituting a real pulley. Marvelous 
indeed are the works of the Creator, 
and “ fearfully and wonderfully 
made ” is his creature, man. 

Uses of Muscles. —Incidentally 
the muscles add symmetry to the 
body. They fill up the hollows and 
cover up the rough excrescences of 
the bones, and in numerous ways 
add to the beauty and roundness 
of the form. But the really im¬ 
portant function of the muscles is 
to produce motion. In this work the muscles are constantly en¬ 
gaged. Whether we sleep or wake, still the delicate muscular fibres 



Fig'. 50. The arm, representing a lever 
of the third class. 






88 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


of the body are employed in unceasing activity, performing their 
part in the various vital processes necessary to life. Locomotion, man¬ 
ual motion, and vocalization, or speaking, are among the most im¬ 
portant voluntary movements produced by muscular action; while 

respiration, digestion, and the circulation of the 
blood are equally or even more important proc¬ 
esses, largely dependent upon both voluntary 
and involuntary muscular action. 

It may be well for us to devote a brief space 
to the consideration of how these several proc¬ 
esses are performed. 

Locomotion. —The act of walking, or pro¬ 
gression from one point to another by means 
of muscular action, has been much studied by physiologists in both 
man and lower animals. Perhaps the simplest explanation of the act 
of walking would be that it is a continuous falling forward, the body 
being constantly saved from actually falling to the ground by the al¬ 
ternate placing forward of the feet to recover the equilibrium. The 
description of the several acts of walking, running, and leaping, are 
so admirably given by Prof. Dalton, one of the most lucid writers of 
the day on physiology, that we shall take the liberty to quote the fol¬ 
lowing paragraphs from his pen:— 

“ The movements of walking, running, leaping, etc., are performed 
as follows: When the body stands upright, the feet are planted flat 
upon the ground, bearing at once upon the heels behind and the ball 
of the toes in front, the weight of the body resting between the two, 
upon the middle of the arch of the foot. The body is maintained in 
this position, as we have seen, by the various muscles, which act in 
such a way as to keep its different parts carefully balanced, and to 
retain the weight of the whole suspended exactly over the ankle-joint. 

“ Now in walking, when a movement is to be executed in advance, 
the body is first made to lean a little forward, so that its weight no 
longer remains above the ankle, but is thrown forward so as to rest 
entirely upon the toes. The heel is then lifted from the ground by 
the action of the very strong muscles situated on the back part of the 
leg, called the gastrocnemius and soleus muscles.” 

“ At the moment that the body is raised and tilted forward in this 
way, the other foot is lifted entirely from the ground and swung for¬ 
ward so as to take a step in advance. As soon as the body has been 



MANUAL MOTION. 


89 


carried far enough in an onward direction, the second foot is also 
raised in the same manner as before, while the first is swuner forward 
in its turn to take another step. In this way the two legs act alter¬ 
nately, the weight of the body being carried forward first by one and 
\ then by the other; all the muscles, however, upon the two sides com¬ 
bining harmoniously in their action, so as to produce an easy, grace¬ 
ful, and continuous movement. 

“ In the act of walking, as above described, one foot is always upon 
the ground, and the weight of the body is mainly supported in this 
way by bearing upon the toes; it is only lifted forward alternately on 
the two sides by the leverage of the bones of the foot. Consequently 
no violent muscular exertion is required, and the movement can be 
kept up for a long time without fatigue. 

“ The act of running, however, instead of being a series of steps, is 
performed by a succession of leaps or springs, in each of which the 
whole body is thrown clear of the ground, and carried forward by the 
impetus which it has received. In order to accomplish this, at the mo¬ 
ment the heel is about to be raised by the action of the muscles above 
described, the knee and hip joints are first bent and then instantly 
straightened by the sudden contraction of their exterior muscles. 
The whole limb thus acts like a powerful spring, which, by its sudden 
extension, throws the entire body off the ground and carries it through 
the air in an onward direction. The opposite limb is at the same 
time thrown forward to receive the weight of the body and to per¬ 
form, in its turn, and with similar rapidity, the same movements. 
The speed of the runner depends on the vigor of the muscular con¬ 
tractions, and the swiftness with which the successive motions are 
performed. 

“ The act of jumping is accomplished in a similar way to that of 
running, except that the same motions are executed by both limbs to¬ 
gether, so that each leap is performed by itself, and is not combined 

with others in a continuous movement.” 

• 

- Manual Motion. —The great diversity of the movements of the 
hand admit of no general description. When we consider the large 
number of muscles which must be made to co-operate harmoniously 
in the production of a single movement of the hand, we are led to 
marvel at the wonderful degree of delicacy of touch and motion that 
is possible to a hand carefully trained to fine work. Jewelers, watch¬ 
makers, microscopists, and engravers exhibit this nicety of control of 


90 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


the muscles of the arm and hand in a remarkable degree. The differ¬ 
ence between a trained and an untrained hand is readily seen in com¬ 
paring the manual motions of a skilled artisan with those of a back¬ 
woodsman, whose finest tool has been an ax or possibly a chisel. 

In the dextrous use of the hand and arm, man is far superior to all 
lower orders. He may not be able to construct a bird’s nest exactly 
like the one found in the forest tree, but he can make that which is 
vastly more delicate and more beautiful. If we except the human 
brain, with its marvelous properties of thinking, feeling, and willing, 
thei'e is no more wonderful exhibition of creative skill than in the 
structure and functions of the human hand. 

Speaking. —While voice is not wholly the result of'muscular action, 
special organs being required to act in conjunction with the forcible ex¬ 
pulsion of air by the expiratory muscles, it is really one result of motion, 
since without muscular effort the most elaborate vocal apparatus in the 
world could accomplish nothing. The great share of created animals 
possess some form of speech, as well as man, and it is in all produced 
chiefly by muscular action. This is as true of the birds which whistle 
and carol in the trees, as of the tiny insects which chirp and hum amid 
the shrubs and flowers. 

Muscular Action ill Respiration.— As already stated, respiration 
is performed by muscles which are really voluntary in character, being 
under the control of the will, but which are so controlled by the nervous 
system that they are kept in constant motion. The wisdom of this ar¬ 
rangement will be readily seen. Involuntary muscles are very slow in 
their action, while voluntary muscles act promptly and with vigor. 
Respiration is a function which requires continuous, and often rapid, ex¬ 
ecution. In emergencies it is often necessary that air should be inhaled 
or expelled with great promptness, which can only be done by voluntary 
muscles. Airain, it is sometimes essential that the function of breathing 
should be suspended temporarily, as when the body is immersed in water 
or surrounded with smoke or noxious fumes, which could not well be 
done if it were performed by involuntary muscles. 

Muscular Action iu Digestion.— Prehension, the act of taking 
food, mastication, and the preliminary act of swallowing, are all performed 
by voluntary muscles; while the movement of the food along the ali¬ 
mentary canal, bringing it in contact with the various digestive j uiccs 
and the absorbents by which it is digested and taken up into the blood, 


MUSCULAR ACTION. 


91 


is wholly due to involuntary musclas which form a large part of the 
walls of the oesophagus anti the whole alimentary canal. The churning 
action of the stomach by which the gastric juice is as it were squeezed 
out and mingled with the food to be digested, is also due to muscular 
contraction. 

Muscular Action in the Circulation of the Blood. —The cir¬ 
culation of the blood, through the means of the heart and blood-vessels, 
is almost entirely due to muscular effort. The heart is itself nothing 
more nor less than a hollow muscle, and the arteries are simply muscular 
tubes. The contractile action of the heart is continued through the 
arteries, and thus the blood is forced out into the veins, through which 
it is urged along, both by the pressure from behind and by the squeez¬ 
ing action of the muscles as they bulge in contraction. 

Belation of Muscles and Nerves. —During life the muscular sys¬ 
tem is wholly controlled by the nervous system. Every contraction, 
whether of a voluntary or of an mvoluntary muscle, is instigated by an 
impulse sent out from the nervous system. Hence it will be readily 
seen that the muscles are wholly under the domain of the nerves, and 
must depend for their utility and efficiency upon the integrity of the 
source of their force and activity. The muscles may be in reality strong, 
being well nourished ; but if the nervous system is weak and exhausted, 
the muscles cannot manifest the force of which they are really capable. 

Fatigue. —Muscular action occasions muscular wear and waste. 
The most delicate contraction of the smallest muscle is accompanied by 
a definite amount of destruction of tissue. The greater the amount or 
intensity of muscular effort, the greater the amount of waste. Only a 
certain degree of destruction of tissue by action is possible. After the 
muscular tissues have wasted to a certain degree, they refuse to respond 
to the demands of the nerves. A violent effort of the will may secure 
a slight additional amount of work, but even the most powerful exercise 
of will cannot excite to action a muscular system which has been ex¬ 
hausted by prolonged activity. The sense of weariness, inability or in¬ 
capacity for action which follows violent or prolonged exertion, is called 
fatigue. Its cause we have already seen. The sense of fatigue is a de¬ 
mand of nature for rest, for time to repair the wasted tissues, an admoni¬ 
tion that the system must have rest. This provision nature has wisely 
made to oblige us to stop the vital machinery before it has become so 
much damaged that repairs cannot be made. This admonition comes 


92 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


with such force that it cannot be resisted for any length of time. Un¬ 
fortunately for the race, however, ingenious man has discovered that 
there are agents which will quiet or smother this warning voice, thus 
allowing the individual to go on destroying his tissues beyond the point 
of safety at which nature admonishes him to stop. Alcohol and tobaoco 
are among the most active and frequently used of these substances, and 
tea and coffee belong in the same category. Very strangely, too, these 
agents are employed and recommended for the very purpose which ren¬ 
ders them dangerous, and that, too, by men of learning and intelligence 
on most subjects, but who fail to see the folly of their action in this 
particular case. Alcohol, tobacco, tea, coffee, opium, hashish, and other 
narcotics and stimulants, will make a man feel well, and think he is 
not tired when he is exhausted; but they will not give him additional 
strength. By deceiving him they will enable him to get a little more 
work out of his muscles, to waste them a little more, but they do not 
supply him any force to use in the extra labor. A tired man is no more 
saved from the effects of overlabor, except in his feelings, by a glass of 
grog, a pipe or chew of tobacco, or a cigar, or a cup of tea or coffee, than 
a patient is saved from the results of the surgeon’s knife by being made 
insensible by an anesthetic. The action is precisely the same in both 
cases. The individual feels better, but only because his sensibilities are 
benumbed, because he is deceived, not because he is really better. The 
fact is that he is worse off. Statistics show that patients are less likely 
to make good recoveries from the effects of surgical operations when 
chloroform is used than when it is not used. Just so it is with the 
substances named; when taken to relieve fatigue or to enable a person 
to do more work, they really damage the individual more or less per¬ 
manently, because they make it impossible for him to recruit so well 
when the period of rest is obtained. The proper course to pursue is to 
stop work when nature says “ enough,” and rest. Stimulants only put 
off the day of reckoning for a little time, and they run up an enormous 
account to be answered for when the day of retribution comes. 

Muscular Electricity. —Experiments upon both human beings and 
animals have clearly demonstrated that the human body is a real elec¬ 
trical battery, generating appreciable quantities of electricity by every 
vital act. Every muscular contraction generates a current of electricity 
the exact quantity and quality of which can be determined by the 
proper instruments. There is no special electrical apparatus in the 
human body, as in certain fishes and other curious animals which pro- 


HYGIENE OF THE MUSCULAR SYSTEM. 


93 


duce this subtile agent in prodigious quantities, but the whole body de¬ 
velops it. livery breath we draw, every heart-beat, every wink of the 
eye, even every thought, generates the same element that darts de¬ 
struction from the thunder cloud, and flashes intelligence around the 
world. This interesting fact has an important bearing on the question 
which has occupied so many scientific minds, viz., the nature of vital 
force. The appearance would seem to be that the same force which in 
the living tissues is manifested as vitality, when the tissues are worn out 
and broken down appears as electricity or some other commonly known 
form of force. 

Muscular Seuse. —The muscles possess in but very slight degree, if 
at all, the general sensibility which belongs to most other tissues. They 
have little sensibility to pain. They may be pierced, cut, or even torn, 
without giving much pain. A peculiar pain is produced by cramp, or 
spasmodic contraction of a muscle. There is good evidence, however, 
that the muscles are compensated for the want of general sensibility by 
the possession of a sense peculiar to themselves, known as tloe sense of 
weight, or the muscular sense. It is by means of this sense that we 
appreciate resistance or judge of the weight of various bodies. 

Rigor Mortis. —The peculiar rigidity which comes on soon after 
death in man and animals is supposed to be due to coagulation of the 
muscular fibre. It is the beginning of decomposition, and indicates the 
death of the muscular fibres. It is observed that in persons who die 
suddenly in a state of comparative health, as from accident, rigor mortis 
does not appear for some hours after death, and then remains for some 
time. In persons who die from long-continued or wasting disease, the 
opposite in both particulars is true. 

HYGIENE OF THE MUSCULAR SYSTEM, 

The muscles, perhaps, more than any other organs of the body, 
depend for their health upon regular, systematic, adequate, and proper 
exercise. By exercise, the muscular fibres are made to contract, and 
in doing so, the old, stagnant, venous blood is squeezed out, and new, 
fresh, invigorating, vitalizing blood takes its place. By this means 
their vital activitias are quickened and their growth increased. There 
is evidence for believing that muscular fibres do not increase in num¬ 
ber in the voluntary muscles; but it is certain that they increase very 
materially in size and in firmness, and hence in strength. The 


94 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


strength of a muscle depends upon the individual strength of each of 
its fibres, as its strength is but the combined strength of its compo¬ 
nent parts. If each fibre becomes large, firm, and strong in conse¬ 
quence of use, the whole muscle becomes so; and that this is the case 
we have abundant evidence in the ponderous right arm of the black¬ 
smith, which outgrows the other in consequence of constant exercise 
in swinging a heavy hammer. The lower extremities of a ballet 
dancer become developed in a proportionately large degree, from the 
trying exercises to which they are accustomed. 

Effect of Disuse of Muscles. —Nature never attempts to maintain 
a useless organ, and almost as soon as an organ is not used she sets to 
work to demolish it; or at any rate she wastes no time in endeavor¬ 
ing to keep it in repair when it is not needed, or at least is not used. 
This is true all through the vital. economy, and is nowhere more 
clearly seen than in the muscular system. A disused muscle soon 
becomes thin, pale, relaxed, weak; and after a time a change begins 
which is termed fatty degeneration. Nature does not think it worth 
while to keep so much valuable nitrogenous matter lying idle, and so 
she sets to work taking the muscle to pieces and carrying it away little 
by little for use elsewhere, depositing in place of the muscle substance 
little particles of fat until the whole muscle is changed to fat. This 
change actually occurs in cases of paralysis; and when it has been 
completed, restoration of the function of the muscle is impossible. 

The Hindoo devotee who in blind zeal for his religion holds out 
his arm until the muscles shrink and shrivel up, leaving the arm but 
a useless appendage of the body, more dead than alive, is violating 
the law of nature which demands exercise for health no more than 
the student who shuts himself up with his books until his limbs grow 
lank and thin and his fingers bony with physical idleness ; and the lat¬ 
ter acts no more wisely in sacrificing himself upon the shrine of learn¬ 
ing, than the other in deforming himself to appease the wrath or win 
the favor of Buddha. 

How to Take Exercise. —It is not sufficient to simply take exer¬ 
cise indiscriminately and without reference to the object for which it 
is taken, the manner, time, etc. It must be taken regularly, sys¬ 
tematically, at proper times, and in proper quantity. ' Perhaps we 
cannot do better in treating this subject practically than to ask and 
answer some of the most important questions relating to this matter. 


WHEN TO EXERCISE. 


95 


1. When is the best time to exercise ? There is a popular theory 
extant that exercise taken early in the morning has some specific vir¬ 
tue superior to that taken at any other time. After careful observa¬ 
tion on the subject we have become convinced that this popular no¬ 
tion is a mistake when adopted as a rule for everybody. For many 
busy professional men, especially lawyers, editors, authors, clergymen, 
teachers, and others whose vocations keep them mostly indoors, the 
morning may be the only time when exercise can be taken conven¬ 
iently ; and if not taken at this time it is likely to be neglected alto¬ 
gether. Such persons, unless they are laboring under some special de¬ 
rangement of the health, as dyspepsia or some other constitutional 
malady, had better by far take the morning walk or other form of ex¬ 
ercise than to take none at all. However, we are pretty well con¬ 
vinced that for most persons the middle of the forenoon is a much 
better time to take any kind of active or vigorous exercise. In the 
morning the circulation is generally weakest and the supply of nerve 
force is the least abundant. In the forenoon, when the breakfast has 
been eaten and digestion has become well advanced, the system is at 
its maximum of vigor; hence, if the individual is at liberty to choose 
his time for exercise, this should be his choice. 

For poor sleepers, a half-hour’s exercise taken in the evening not 
long before retiring will often act like a soporific, and without any 
of the unpleasant after-effects of drugs. 

Vigorous exercise should never be taken immediately nor within 
an hour after a meal, and should not be taken immediately before eat¬ 
ing. Disregard for this rule is a very common cause of dyspepsia. 

2. What kind of exercise shall be taken ? The answer to this ques¬ 
tion must, of course, vary with the individual. Exercise must be mod¬ 
ified to suit the strength, the age, the sex, and even the tastes of the 
individual. As a general rule, persons who take exercise for health 
are apt to overdo the matter, the result of which is damage rather than 
benefit. For most persons there is no more admirable and advanta¬ 
geous form of exercise than walking; but many find walking simply 
for exercise too tedious to persevere in it regularly. Such will find ad¬ 
vantage in walking in companies, provided care Is taken to avoid ail 
such questionable diversions as walking matches or any kind of ex¬ 
ercise in which there will be a strife which will be likely to excite to 
excess. 

Horseback riding, for those who ride well and enjoy this form of 


06 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


exercise, may be of great benefit. It is not so well suited for ladies as 
for men, however, on account of the awkward and unnatural manner 
in which fashion compels them to ride. It is impossible for a lady to 
ride with the same degree of comfort, ease, and grace that her male 
companion may, on account of the one-sided way in which she sits in 
the saddle. In many other countries ladies ride in the same fashion 
as men; with them, of course, this objection does not hold. 

Horseback riding is an excellent aid to digestion, and often effect¬ 
ually relieves habitual constipation of the bowels. 

Carriage riding Is worth little as a form of exercise except for very 
feeble invalids, for whom the gentle swaying of the vehicle and the ex¬ 
citement of viewing objects seldom seen may be sufficient and appro¬ 
priate exercise. Riding in a lumber wagon over a corduroy road is 
about the only kind of carriage riding which is worth speaking of as 
exercise for people in ordinary health. 

Skating, rowing, racing, base-ball, foot-ball, dancing, and most other 
exercises of the sort, are more often harmful than otherwise, because 
carried to excess and associated with other evils of a pernicious char¬ 
acter. Performance upon the trapeze, boxing, and pugilistic training 
are open to the same objection. Calisthenics, for school-children and 
vounoj students, is a most admirable form of exercise. It is also well 
adapted to invalids who are unable to walk more than a short dis¬ 
tance at a time. Full directions for the use of calisthenics, or gym¬ 
nastic exercises, are given in a chapter devoted to the subject. In our 
opinion, every family ought to be fitted out with all the conveniences 
for parlor gymnastics. They afford not only healthful exercise but a 
laro;e amount of excellent amusement for the little folks. 

The health-lift is a form of exercise too important to be over¬ 
looked. We have carefully tested this form of exercise, and believe it 
to be an exceedingly valuable measure for those whose employments 
are sedentary and whose time for exercise is limited. However, we 
can indorse but a small portion of what has been claimed for it by 
persons who have made its use and sale a specialty. Again, we have 
no sympathy with the course which has been taken by most manu¬ 
facturers in charging an enormous price for a piece of apparatus which 
really costs but very little and could well be afforded for one-half the 
money charged. The chief benefits of the health-lift can be derived 
from a very simple form of apparatus which the reader will find de¬ 
scribed in the chapter on gymnastic exercises. 


x 


DEFICIENT EXERCISE BY STUDENTS. 


97 


For the majority of persons, no form of exercise is more highly 
beneficial health wise than some kind of physical labor. For ladies, 
general housework is admirably adapted to bring into play all the 
different muscles of the body, while affording such a variety of differ¬ 
ent exercises and such frequent change that no part need be very 
greatly fatigued. There are thousands of young ladies pining under 
the care of their family physician in spite of all he can do by the most 
learned and complicated prescriptions, for whom a change of air or a 
year’s residence in some foreign clime, or some similar expensive proj¬ 
ect, is proposed, when all in the world that is needed to make the 
delicate creatures well is to require them to change places with their 
mothers for a few weeks or months. Let them cease thrumming the 
piano or guitar for a time, and learn to cook, bake, wash, mend, scrub, 
sweep, and perform the thousand and one little household duties that 
have made their mothers and grandmothers well and robust before 
them. We made such a prescription once for a young lady who had 
been given up to die of consumption by a grayheaded doctor, and 
whose friends were sadly watching her decline, and in six weeks the 
young miss was well and has been so ever since; but we entailed her 
evei'lasting dislike, and have no doubt that any physician or other 
person who should adopt the same course in a similar case would be 
similarly rewarded. 

For young men there is no better or healthier exercise than saw¬ 
ing and chopping wood, doing chores about the house, working in the 
garden, caring for horses or cows, clearing walks, bringing water, or 
even helping their mothers in laundry work. Such exercise is light, 
varied, oft changing, and answers all the requirements for health most 
admirably. We can heartily recommend it, and from personal expe¬ 
rience, too. We advise all young men, who can possibly get a chance, 
to adopt this form of exercise as being the most certain of bringing- 
back the largest returns for a given expenditure of force of any which 
can be suggested. There is no gymnasium in the world which is bet¬ 
ter to secure excellent results from exercise than the kitchen, the 
washroom, the workshop, the woodyard, the barn, and the garden. 
These are nature’s gymnasia. They require no outlay for special 
appliances, and are always fitted up for use. 

Deficient Exercise by Students.—The common idea that study 
and brain work are harmful has chiefly grown out of the fact that 
students usually confine themselves too closely to their books, keep 

7 


98 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


late hours, and take as little as possible of active out-of-door exercise. 
There is no doubt but that the majority of students could do more 
work and better if they would devote at least two hours of each day 
to purely physical exercise. In ancient Greece, in the palmy days of 
that empire, physical training was considered as much a part of the 
necessary education of young men as their mental culture. Every 
inducement was offered to them to make themselves strong, vigorous, 
and athletic. Their schools were called gymnasia, on account of the 
attention given to gymnastics. The young women, too, were trained 
in physical exercises as well as the young men. Small waists and 
delicate forms, white, soft, helpless hands and tiny feet were not 
prized among the pioneers of civilization. The mothers of heroes and 
philosophers were not pampered and petted and spoiled by indul¬ 
gence. They were inured to toil, to severe exercise. Their bodies 
were developed so as to fit them for the duties of maternity and give 
them constitutions to bequeath to their children which would insure 
hardihood, courage, and stamina in the conflict with the world to ob¬ 
tain a subsistence, and with human foemen in the rage of battle. 
The women developed by this system of culture were immortalized in 
marble, and the beauty of their forms has been the envy of the world 
from that day to this; yet no one seems to think of attempting to 
gain the same beauty in the same way. It might be done: there is no 
reason why it cannot be; but the only way is the one which the Gre¬ 
cian women adopted,—physical culture. 

Overtraining. —The careful observation of results in large numbers 
‘of cases shows very clearly that there is such a thing as overtraining, 
and that excessive development of the muscular system is not only not 
advantageous but absolutely harmful. Trainers are not long-lived. Dr. 
Winship, who developed his muscles until he was able to lift over three 
thousand pounds, died when he should have been in his prime. The re¬ 
sult of overtraining or excessive development of the muscular system is 
the weakening of other vital parts of the body. Symmetrical develop¬ 
ment is the best for health and long life. This is what we plead for, not 
for extremes in any direction. Let the nerves and the muscles be de¬ 
veloped together and equably, and we shall have better results from both 
than would otherwise be possible. Mens sanci in corpore sano was the 
motto of the ancient Greeks; and the experience of every day shows 
that the man with strong muscles and good digestion, with fair intel¬ 
lectual abilities, is the one who wins the goals to-day in the strifes for 



EVILS OF TIGHT-LACING. 


99 


wealth and fame and all that men seek after. “ A sound mind in a 
sound body ” is as necessary for assured success in life in the nineteenth 
century as when the sentiment was first inscribed upon the gates of the 
temples in ancient Greece. 

Necessity for Unrestrained Action.— A muscle tied up is ren¬ 
dered as helpless as though it were paralyzed. It will be recollected 
that when a muscle acts it does so by swelling out in thickness, while 
contracting in length. From this it will be evident that if a tight band 
is put around a muscle in such a manner as to prevent its expansion or 
increase in thickness, it cannot possibly act. Hence, a fundamental 
requisite of healthful muscular action is entire freedom from constraint. 
Unrestrained action is indispensable to complete action and perfect de¬ 
velopment. When a broken arm is done up in a splint for a few weeks, 
upon removing the bandage it is usually found that the arm has 
shrunken in size ; the muscles have wasted, partly in consequence of 
pressure, and partly on account of the enforced inaction of the muscles. 
The very same thing happens wherever pressure is brought to bear upon 
the muscular tissues. A ring worn upon a finger causes atrophy, or 
wasting of the tissues beneath it. By placing an elastic band around 
soft tissues they may be absorbed altogether, in consequence of the 
pressure. This action has been taken advantage of for the removal 
of tumors in certain parts of the body. 

Evils of Tight-Lacing and Corset-Wearing. —See Figs. 52 to 55. 
The wearing of clothing drawn tight about the waist, either with a cor¬ 
set or without, is attended with most serious evil consequences. With¬ 
out dwelling upon the evils which result from the forcible displacement 
of important internal organs and the injury to the nervous system, 
the digestion, and sundry other evil consequences, we wish to call atten¬ 
tion to the fact that continuous pressure upon these parts may cause 
such a degree of degeneration of the muscles of the chest as to seriously 
impair the breathing capacity. Unused muscles waste away, as already 
observed; and when pressure is applied in addition, the wasting and 
degeneration become still more marked. This is exactly what happens 
with those who wear their clothing tight about the waist. This is the 
reason why ladies who have been accustomed to wear corsets declare so 
emphatically that they “ could not live without them,” that they feel 
when their corset is off as though they “ should fall down into a heap.” 

The evidence of injury is complete ; and it is so universal that few 


L. of C. 


100 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


women will venture to deny that the practice is harmful, but they try 
to shield themselves by declaring that they are sure their corset does 
them no harm, that it is very loose, etc., etc. We scarcely ever met a 
lady who would admit that her corset was tight, and we have had oc¬ 
casion to speak with hundreds of ladies on this point in making medical 



examinations. We read the other day in a newspaper of a young 
woman who actually broke a rib in the attempt to gain another half¬ 
inch on her corset string. She well deserved the accident, no doubt ; 
but the chances are ten to one that she would assert in the most positive 
terms, if expostulated with about the matter, that her corset was “ quite 
loose,” and to demonstrate the matter would show you how much more 
she could pinch up when she tried, or something of the sort. The fact 
is, ladies do not really know when then clothing is tight about the waist 
and when it is loose. The tissues have been so long under pressure that 
they have lost a good share of their sensibility, and clothing really seems 
loose to them which to a man would be so uncomfortably tight as to 
make him utterly wretched. 

Pantaloons made tight at the top are as harmful as tight dresses, as 
was well shown in the Russian army some years ago, when the evil of 
wearing the pantaloons held up by a belt about the waist became so 
serious among the soldiers as to require interference on the part of the 
government. The men had become unable to endure marches of any 



PULL-BACKS, LOW SHOULDERS , ETC. 


101 


distance; but upon being compelled to wear suspenders for tbe panta¬ 
loons, they speedily recovered. 

Elastics. —The clastic bands worn about the leg to keep the stock¬ 
ing in place, and sometimes used upon the arms to hold the sleeves up, 
are more harmful than is usually imagined. The long stockings worn 
by females bring the elastic just above the knee, 
where the large blood-vessels of the limb come 
near the surface and are in position to be com¬ 
pressed against the thigh bone in such a way 
as to impede the circulation. It is not to be 
wondered at that under these circumstances, in 
addition to the evil of thin stockings, and thin, 
tight shoes, there should seem to be a necessity 
for artificial calves, which we are informed on 
credible authority have actually been employed. 

The stockings, as well as the other articles of 
clothing, should be suspended from the shoulders 
either by means of separate suspenders or by at¬ 
tachment to a waist with broad shoulder-bearings. 

Pull-Backs, Low Shoulders, etc. —The following on this subject 
we quote from “Evils of Fashionable Dress”:—* 

“ Although the corset is the chief offender in constraining the healthy 
activity of the vital organs of the body, there are other modes of dress 
which deserve attention on account of their in¬ 
terference with some of the bodily functions. 

When the leaders of fashion decreed that the 
previously indispensable crinoline must be dis¬ 
carded, the sensible part of the world rejoiced, 
thinking that Dame Fashion was really about 
to reform her ways. But such hopes were dashed 
to the ground when the present fashionable style 
of dress appeared. Formerly, fashionable ladies 
sailed along the streets like animated balloons, 
monopolizing the whole walk with their wide- 
spreading skirts. Now they have reached the opposite extreme, and we 
see them wriggling along like competitors in a sack-race. Indeed, it 
, is a marvel how that locomotion is a possibility, so greatly hampered are 

*Good Health Pub. Co., Eattle Creek, Mich. 



Fig:. 55. Shows the dis¬ 
tortion of the ribs produced 
by corset-wearing. 



Fig - . 54. The ribs in their 
natural position. 








102 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


the limbs by numerous heavy skirts drawn tightly back and fastened at 
the sides. Anything like graceful ease in walking is impossible. A 
Chinese wriggle is the result of the best attempt. 

“ The motions of the arms are curtailed to an almost equal extent 
by the fashion of the garments about the shoulders. They are so 
made that it is next to impossible for the wearer to extend the hand 
an inch above the head. The arms are actually pinioned. Why not 
have the shoulders of ladies’ garments made like those of men, which 
allow perfect freedom of motion to the arms ? Some of the more re¬ 
cent fashions are adopting this style.” 

Tight Shoes. —We have already said so much on this subject in 
connection with the hygiene of the bones that we scarcely need add 
anything here, except to say that the muscles of the feet suffer equally 
with the bones, perhaps more seriously, being more soft and yielding. 
We cannot find words to express our views of this foolish and absurd 
custom. There seems not the slightest shadow of excuse for it, except 
that Fashion dictates that woman must have a small foot; and if Nat¬ 
ure has made such a terrible blunder as to give her one of decent size 
she must be tortured for the mistake for which she is not responsible, 
during the period of her natural—or rather her artificial—life. Fash¬ 
ion dictates a similar mandate in China, and the amount of suffering 
which the fashionable young women of that country are obliged to en¬ 
dure is even greater than in this country. Perhaps we cannot better 
impress our readers with the absurdity of this really barbarous fash¬ 
ion than by quoting from an interesting work entitled “ Oriental 
Women” the following graphic description of the extent to which the 
practice is carried in China:— 

“ It is supposed by many foreigners that this curious compression 
of the feet is accomplished by means of wooden or iron-bound shoes 
placed upon the feet in infancy, effectually dwarfing them by prevent¬ 
ing their growth altogether. But this is by no means the case. It is 
next to an impossibility for a foreign gentleman to secure the privi¬ 
lege of examining a foot thus deformed; but after more than a week 
of the most skillful diplomacy, in all of which I was aided and abetted 
by Miss Lucy H. Hoag, preceptress of the mission-school for girls in 
Kiu-Kiang, I succeeded in persuading a girl about fifteen years of age 
to allow me to be present when the gay covering was removed from 
her foot; afterward in Shanghai, by the liberal use of money, an el- 


DEFORMING THE FEET. 


103 


derly woman of the small-footed class was persuaded to gratify my 
curiosity by removing the bandage from her foot; and from the 
knowledge gained on those occasions and afterward I will briefly de¬ 
scribe the method of ‘ making the foot/ as it is called. 

“ The binding is rarely, if ever, commenced before the child is five 
years, and in most cases not until she is six or seven years old. This 
delay is to allow the 
limbs a 
start and 


vigorous 

growth, 



and the girl to learn 
how to walk firmly. 

The operators are 
usually women who 
make this their bus¬ 
iness, although fre¬ 
quently the mother, 
or some other female 
member of the 
household, takes the 
matter in hand. In 
the first place, all 
the toes, excepting 
the great toe, are 
folded down under 
the foot, the fleshy 
part of the heel is 
forced downward 
and forward, and a 
bandage (consisting of a strip of colored muslin four or five feet long 
and three inches wide) is wound back and forth in a figure of eight, 
over the folded toes, along the length of the foot, across the instep, 
and around the heel, pressing that toward the great toe to shorten 
the foot. The bandage is wound snugly at first, and then tight¬ 
ened a little at each succeeding operation. This gradually throws 
the instep up, and virtually breaks it, so that when the bandage is re¬ 
moved the front part of the foot may be moved like a door upon its 
hinges. Under this process the foot becomes attenuated until it is 
merely a mass of bones covered with tendons and skin. The develop¬ 
ment of the muscles of the calf is also checked, and the leg tapers from 


Fig. 56. Outline of Chinese lady’s foot and slipper, showing 
effects of bandaging. 






ANATOMY , PHYSIOLOGY, AND HYGIENE. 


104 

the knee downward, and the entire limb loses its elasticity, although 
no excessive weakness is observed. How the circulation is kept up 
through the extremities is more than I can understand. 

“ In the course of six or eight years, if daily attended to, the elon¬ 
gated bone of the heel, which is about all that is left of this part of 
the foot, is brought within a very few inches of the great toe; the 
broken instep and folded toes are bound together with the ankle in an 
ugly bunch bulging outward above what seems to be the foot, and the 
great toe and the heel alone aie thrust into the little embroidered 
shoe, and it is pronounced a perfect lady-foot. The heel is usually an 
inch or more higher than the toe, and a block of wood is placed in the 
back part of the shoe to support it. This gives the woman the ap¬ 
pearance of walking upon her tiptoes, as she wriggles along, stepping 
with nervous rapidity, and throwing out her arms to balance herself. 
A lady with very small feet is obliged to use a cane in walking, or to 
rest her hand upon the shoulder of a servant, which is a mark of es¬ 
pecial gentility. 

“ The wide and embroidered trousers conceal the unsightly bunch 
above the shoe, and the uninstructed observer supposes that he is 
looking upon a tiny but perfectly formed foot. The length of the 
shoe is really a mere matter of taste. The most fashionable length is, 
I think, about three inches, although I have a pair in my possession, 
once worn by a woman in Foochow, which are but two and one-half 
inches long on the bottom. Of course, so far as any heavy work is 
concerned, small-footed women are useless; and the housework in 
families where the women have small feet is always performed by 
males, or by female servants who have natural feet. 

“ At first the operation of bandaging is very painful. The band¬ 
age is removed every morning; the foot is cleansed, carefully inspected, 
and then rebound. Of course, before the foot is utterly * dead/ as it 
is termed, th e quickening of the circulation when the bandage is re¬ 
moved and the severe compression when it is again applied, cause ex¬ 
cruciating pain. In the early morning hours the traveler, in moving 
about a Chinese city, will hear from almost every house the cries of 
little girls undergoing their daily torture. 

“ A well-known missionary gives the following illustration:— 

“ ‘ I remember being greatly distressed one day by the crying of a 
child : “ O auntie, auntie, do n’t do so, it hurts ; it hurts so much ! ” 
And then followed a long, quivering, sobbing “ O-o-oh ! ” I tried not 


CHINESE COMPRESSION OF THE FEET. 


105 


to mind it at first, and kept on with my writing for a little while ; but 
I couldn’t stand it very long,—the sobbing was too piteous. So I laid 
down my pen, put on my hat, and went round the corner into the alley 
from which the sounds came. It was dirty enough and narrow enough, 
I can assure you; but that was nothing. I only wanted to ascertain 
what could be the cause of this most pitiful outcry, and what it was that 
“ auntie ” was doing. So I pushed open the door that led into one of 
the court-yards, and there I saw how the matter stood. On a high 
bench, with her feet dangling half-way to the ground, sat a little girl 
about five years old, her face swollen with crying, and the tears pouring- 
down her flushed cheeks; and near by, seated in a chair, was that 
dreadful “ auntie,” a fat, middle-aged woman, who held one of the child’s 
feet in her hand, while the other foot was hanging down bandaged very 
tight, and looking more like a large pear, tied round with blue cotton 
cloth, than a natural-shaped foot. There the old auntie sat, with 
one little bare foot in her hand, looking at it first on one side and then 
on the other, and particularly examining the parts where the little toes 
had been turned under and compressed by the bandages which had just 
been removed. She found these parts full of cracks and sores, and into 
these what do you think she put? Powdered saltpeter , to keep the 
sores from mortifying; and then she bound up the little foot again as 
tight as she could, and left the poor little sufferer, with streaming eyes 
and dangling feet, still sitting on the bench! ’ 

“ Girls often grow thin and spiritless during the first year after 
binding is begun. Often the skin cracks or (just over the instep) it 
bursts, and severe disease sets in, and not infrequently mortification or 
gangrene ensues; and as amputation is regarded as very dishonorable, 
and is, therefore, not allowed, of course the little sufferer soon dies. 

“ When three or four years have passed, if the operation has been 
carefully performed, the foot becomes, so far as feeling is concerned, 
lifeless, and ceases to give pain. But, all through life, the bandaging 
must be continued, to keep the foot in shape, and to enable the woman 
to walk at all. Unbandaged, the foot would have no firmness,—it 
would be a mere powerless mass upon the limb, with which it would be 
impossible to move. With the foot firmly bandaged, some of these poor 
creatures mince along at quite a respectable rate of speed, and strange 
as it may seem, some of them will even walk ten or twelve miles in a 
day on their way to and from some especially sacred temple, or in mak¬ 
ing visits to their friends. 


10G 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


“ Notwithstanding the severe pain resulting from this bandaging at 
first, mothers insist upon it, and little girls are often quite anxious to 
have it begun ; for it is the fashion, and, according to the average fe¬ 
male estimate in all lands, a little suffering, more or less, is of no conse¬ 
quence when contrasted with the disgrace of being ‘ out of fashion.’ Of 
course, the little girls are not always under the immediate eye of their 
mothers; and when, for a moment, the pain overmasters their pride, 
they will slyly loosen the bandage; but the fault is soon discovered, and 
the relieved member unmercifully brought back to its cruel bondage. 

“ So far as I can learn from those most familiar with the facts, com¬ 
pression of the feet is more inconvenient than dangerous, either to life or 
health ; and intelligent natives have frequently assured me, with all that 
superior wisdom which an educated Chinaman knows so well how to 
assume, that they did not regard it as half so pernicious as the custom 
our American ladies have at times adopted, of compressing their waists, 
since the former, at the worst, only endangers the individual, while the 
latter entails feebleness and suffering upon posterity. 

“ Some travelers in China profess to be greatly pleased with what 
they call the dainty little feet of the ladies, and go into ecstasies over 
their exquisitely wrought shoes ; but to me, especially after I became 
familiar with the modus ope rand I, it was a hideous and repulsive de¬ 
formity, all the more offensive since it was self-imposed. No amount of 
sentiment could reconcile me to the sight of those poor cripples hobbling 
along in momentary danger of falling,—the very picture of degraded 
helplessness. Perhaps in j ustice I ought to add, that some few China¬ 
men of advanced ideas whom I met, professed to regard this custom as 
useless and wrong ; but even while they were ready to admit its evils, 
they were no less emphatic in the opinion that there is no help for it. 
Custom is a law, which no one dreams of violating.” 

Bad Positions. —Certain parts of the muscular system suffer seri¬ 
ously from the results of bad positions assumed in the different attitudes 
which may be taken in lying, sitting, standing, and walking ; to these 
we wish to call especial attention. 

Bad Positions in Sleeping .—As we spend one-third of our time 
in bed,—at least most persons should do so,—it is of great importance that 
the right position should be assumed, so that no injury may be received 
through prolonged constraint in an injurious position. Another fact 
of importance which is worthy of consideration here is that the process 
of repair goes on much more rapidly during sleep than at other tunes, 


IMPROPER POSITIONS. 


107 


and since the greater share of deposit of new material takes place at this 
time it is obvious that any evil arising from an incorrect attitude will 
be rendered more or less permanent, the individual growing out of shape 
during sleep. 



W e regard the old-fashioned 

O 

bolster, not yet out of fashion 
we are sorry to say, as a mast 
injurious article. When sur¬ 
mounted by a pillow, as it in¬ 
variably is, the position designed 
for the head is elevated so high 
that the sleeper cannot possibly 

... . . . . . . , Fig-. 57. Improper position in sleeping. 

put himseix into a physiological 

position if he attempts to use them. If he lies upon his back, he is sit¬ 
ting half upright, and his spine is curved posteriorly. Fig. 57. If he lies 
upon either side the spine will be bent at a dangerous angle. Fig. 58. 
We have no doubt that thousands of cases of lateral curvature of the 
spine have been produced by sleeping with the head too much elevated. 

A correct attitude in sleep is with the head and spine as nearly as 
possible parallel with the central line of the body. If the individual 
lies upon the back, no pillow at all, or a very thin one at most, should be 
employed. If he lies upon his side, a somewhat thicker pillow may be 
used, but only of sufficient 
thickness to raise the head to 
the axis of the body. Under 
no circumstances should bol¬ 
sters be employed. The side 
seems to be the most natural 
position in which to lie in 
sleeping, and the right side 
should be chosen by preference, ...... 

^ L Fig-. 58. Improper position in sleeping. 

especially by those who eat late 

before retiring, as this position favors the passage of the food fiom the 
stomach through the pylorus. 



Improper Attitudes in Sitting. —This subject we have already 
considered in part under the head of Hygiene of the Tones, and w ould 
refer the reader to the remarks there made. It must be added, how ever, 
that the distortions of the spine produced by improper positions in sitting 
are only in part due to the changes produced in the cartilages of the 





























108 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


spinal column, which have been pointed out. At the same time that 
changes in the cartilage discs are being made, changes are also taking 
place in the numerous muscles of the spine. When the body is bent 
out of its proper shape, while certain muscles are contracted, others are 



Fig:. 59. 


Fig:. 60. 



stretched beyond their natural length. If the tension is maintained but 

«/ O 

a short period, the natural elasticity of the muscle restores it to its natural 
length again, and so brings the body into proper position; but if it be 
prolonged, the tonicity of the muscular fibres is in some degree lost. 
They give up their elasticity and become abnormally lengthened without 
power to return fully to their natural position. At the same time, the 
muscles which are contracted while the curved position is maintained 
become by the exercise stronger than their antagonizing muscles, which 
are at the same time being weakened by want of use and abnormal 
stretching. Thus the evil results are doubled, and the 
curvature which was at first a mere temporary evil 
becomes permanently fixed in the body by unequal 
muscular contraction. 

Figs. 59, 60, 61, 62, and 64, show positions 
which are very commonly assumed by students and 
others. The figures explain themselves at a glance. 
Many other bad positions are common, not a few of 
which are undoubtedly due to the improper construc¬ 
tion of chairs, sofas, school seats and desks. In many 
instances in schools, large students are placed in seats 
which are too low for them (see Fig. 60), and which 
require or at least strongly incline them to lean forward while engaged 
in their studies, making them round-shouldered and narrow-chested. It 



Fig'. 61. 





































IMPROPER ATTITUDES IN SITTING. 


1C9 


is piobable, however, that the opposite error is much more common, and is 
certainly much more injurious, viz., placing small students in seats which 
ai e too large and too high for them. W hen this is done, several evils 
result. The feet not being properly supported, the weight of the limbs 
constantly drags upon the spine, and requires that its muscles be kept con- 



Fig-. 62. Fig. 63. 


stantly in contraction, and at a disadvantage. The desk beino- too his-h 
in writing the arm must be lifted so high as to unavoidably produce 
curvature of the spine by elevation of the shoulder. Other evils are also 
almost certain to follow, among which are disturbances of vision from 
holding the book too near the eyes, disturbance of the circulation, espe¬ 
cially in the lower extremities, due to unnatural pressure on the under 
side of the limbs, and nervous affections from the unnatural strain upon 
the sensitive spine from the want of support to the limbs. 

Another evil very common in the construction of seats for school- 
children is placing the desk too far away from the seat (see Fig. 64), 
thus not only inviting but actually obliging the pupil to lean forward in 
writing, drawing, or ciphering. This evil is of no small consequence, 
and we are glad to see that it is being remedied by some manufact¬ 
urers. Still another common failure is neglect to so shape the backs 
of seats as to enable them to support the spine at its weakest point. 
This latter evil is probably as great a cause of curvature as any. The 
spine becomes tired from want of proper support, and the pupil leans 
over to get relief. We are glad to know that these difficulties, which 
have been recognized for several years, but have not been remedied on 
account of the failure of manufacturers to adapt their seats to the 
physiological wants of those who were to occupy them, need no longer 







110 


ANATOMY, PHYSIOLOGY , AND HYGIENE. 


exist on this account. An ingenious clergyman, who is also a professor 
in an educational institution, has, after several years of patient labor, suc¬ 
ceeded in producing a seat which seems to meet all the requirements of a 
perfect seat in a manner in which they have never been met before. It 
has been already introduced into hundreds of schools, and gives uni¬ 
versal satisfaction. We present in Fig. 65 a view of this seat* 



Fig\ 64. This cut shows the distorted anu unhealthful position which a student is almost 
compelled to occupy by the old-style school seat. 


Students, and others as well, often assume most improper attitudes 
while pursuing their studies at their rooms, tilting their chairs back and 
placing the feet against the wall, upon the top of the table, or in some 
other elevated place. Such a position cannot be long maintained with¬ 
out discomfort, and discomfort is simply an admonition of nature to 
take a different attitude, to change the position. 

As a rule which may be universally followed, we know of no better 
than the simple one, “ sit gracefully.” A graceful position is a natural 
one, and will be productive neither of inconvenience nor injury. We 
grant that there are great difficulties in the way, since very few chairs 
are constructed on physiological principles ; but this is a matter which 
should receive attention in purchasing furniture. It is possible to obtain 

*Any one who desires further information concerning it can obtain full particulars by 
addressing the inventor, Eld. U. Smith, Battle Creek, Mich. 


IMPROPER ATTITUDES. 


Ill 


chairs which are reasonably correct in construction. The principal 
points which need to be looked at are the following:— 

1. A chair should be so constructed that it will properly support the 
back, not by one or two slats placed crosswise, but by a uniform curve, 
corresponding as nearly as possible with the natural curve of the spine. 
The whole spine should be supported without requiring a person to 



Fig:. 65. This is a representation of the Automatic School Seat, which encourages 

a correct attitude. 


throw the shoulders forward in order to bring the lower or middle part 
of the spine in contact with the back of the chair. 

2. It is also important that chairs should be of proper height, so that 
the weight of the limbs may be supported by the feet set squarely upon 
the floor instead of hanging upon the front edge of the chair. Nearly 
all chairs are made too high, if not for the adult persons in the 
family, for nearly all the younger members, who most of all need seats 
properly constructed. There should be chairs of different heights for 
different members of the family; and the importance of the matter is 
sufficient to justify the incurment of the expense necessary to secure 
each member of the family against injury from this cause. 

While we are by no means inclined to be ultra upon the subject, we 
must enter a word of protest against the too common use of rocking- 










112 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


chairs. As usually constructed they induce an improper attitude in the 
occupant, one which limits the action of the lungs and produces round¬ 
ness of the shoulders. We seldom sit in a rocking-chair for a half-hour 
without finding it necessary to get up and walk about, expanding the 
chest and filling the lungs to relieve the feeling of oppression which re¬ 
sults from the confinement of the chest. We have frequently observed 
in patients suffering with lung troubles a careful avoidance of rocking- 
chairs, and upon making inquiry have found that what we say is true. 
They avoided the rocking-chan- because with their diminished lung ca¬ 
pacity they could not breathe well while sitting in it. 

While the rocking-chair is undoubtedly a comfort to thousands, we 
have no doubt that on the whole it has been a curse to the race, es¬ 
pecially to womankind. We may have easy chairs, made as soft and 
luxurious as possible ; but let them be made in accordance with physio¬ 
logical principles. Art has made the models for chairs rather than nat¬ 
ure. If we would follow art less and nature more in numerous ways 
we should be vastly better off. 

Bad Positions in 
Standing. —See Figs. 66 
and 67. While there 
need not be so much said 
on this subject as on the 
former, a few points de¬ 
serve attention. It should 
be remembered that the 
muscles are required to 
act while we are standing 
as well as when walking 
or making active move¬ 
ments. It requires a con¬ 
stant exercise of a large 
number of muscles, par¬ 
ticularly those of the 
Fig.ee. Improper po- trunk, to keep the body 

sition in standing, the 1 ^ J 

shoulders being thrown erect, to prevent it from 

forward. , ,. TT .. 

toppling over. Hence it 
is important, especially for those whose occupations require a standing- 
position much of the time,—as clerks, accountants, bank cashiers, etc.,— 
that correct attitudes should be preserved, so that the muscles may 




Fig. 67. A correct 
position in standing. 










HOW TO WALK. 


113 


act properly. It is a very common practice with many to throw the 
weight wholly upon one foot, alternating with the two feet. When 
this is done, the spine is curved, and parts are thrown greatly out of 
their natural position. The weight may he easily alternated without 
so great changes; and when this is done, all the benefit which can 
be derived from any change of the sort is obtained. The rule should 
be to always preserve the body erect, the shoulders well thrown 
back, the chest well expanded, and the spine as straight as nature has 
made it. It is possible to go to an extreme even in this, but such 
a defect is so rare that we need not utter any warning against it. 

How to Walk.—It may seem at first ridiculous to pretend to 
teach grown people how to walk, as though they had not leai’ned this 
in infancy. But we are willing to venture the assertion that not one 
person in twenty knows how to walk well. How few people are 
there who do not feel slightly embarrassed when obliged to walk 
across a large room in which are many persons seated so as to observe 
well each movement! How many public speakers there are who ap¬ 
pear well upon the platform so long as they remain standing still, or 
nearly so, but who become almost ridiculous as soon as they attempt 
to walk about. Good walkers are scarce. As we step along the 
street, we are often looking out for good walkers, and we find them 
very seldom. What is good walking? We answer, Easy, graceful, 
natural walking. Nearly all the good walkers there are, will be 
found among gentlemen, since fashion insists on so trammeling a 
woman that she cannot possibly walk well, can scarcely make a nat¬ 
ural movement, in fact. To walk naturally, requires the harmonious 
action of nearly every muscle in the body. A good walker walks all 
over; not with a universal swing and swagger, as though each bone 
was a pendulum with its own separate hanging, but easily, gracefully. 
Not only the muscles of the lower limbs, but those of the trunk, even 
of the neck, as well as those of the arms, are all called into action in 
natural walking. A person who keeps his trunk and upper extrem¬ 
ities rigid while walking, gives one the impression of an automaton 
with pedal extremities set on hinges. Nothing could be more un¬ 
graceful than the mincing, wriggling gait which the majority of 
young ladies exhibit in their walk. They are scarcely to be held re¬ 
sponsible, however, since fashion requires them to dress themselves in 
such a way'as to make it impossible to walk otherwise than awk¬ 
wardly and unnaturally. 

8 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


U4 


We cannot attempt to describe the numerous varieties of unnat¬ 
ural gaits, and will leave the subject with a few suggestions about 
correct walking. 

1. Hold the head erect, with the shoulders well drawn back and 
the chin drawn in. Nothing looks more awkward and disagreeable 
than a person walking with the head thrown back and the nose and 
chin elevated. 

2. Step lightly, with elasticity—not with a teetering gait—setting 
the foot down squarely upon the walk and raising it sufficiently high 
to clear the walk in swinging it forward. A shuffling gait denotes a 
shiftless character. But do not go to the other extreme, stepping 
along like a horse with “ string halt.” A person with a firm, light, 
elastic gait, will walk much farther without weariness than one who 
shuffles along. A kind of measured tread or rhythm in the walk also 
seems to add to the power of endurance, though, for persons who have 
long distances to travel, an occasional change in the time will be ad- 
vantageous. 

3. In walking, do not attempt to keep any part of the body rigid, 
but leave all free to adapt themselves to the varying circumstances 
which a constant change of position occasions. The arms naturally 
swing gently, but not violently. The object of this is to maintain the 
balance of the body, as also by the gentle swinging motion to aid in 
propelling the body along. 

Correct walking should be cultivated. It ought to be taught along 
with the arts and sciences. In our military schools it is taught; but 
these schools can be attended by but few. Invalids especially should 
take great pains to learn to walk well, as by so doing they will gain 
more than double the amount of benefit they will otherwise derive from 
the exercise. 

Relation of Food to the Muscles. —While this is not the proper 
place for a complete account of the subject of food as related to the 
muscles, we may well notice a few points. Experiments show very 
clearly that the muscles are wasted by work and exercise of all kinds 
requiring muscular effort. Equally careful and reliable experiments 
have determined the fact that the muscles need for their support, cer¬ 
tain elements of food more than others ; these are the nitrogenous ele¬ 
ments. The muscles are themselves nitrogenous substance, and hence 
they require elements of the same character. It is as impossible to 
nourish the muscles or sfipply them with force from starch, sugar, or 


RELATION OF FOOD TO THE MUSCLES. 


115 


fat, as it would be to make a brick house out of wood or straw. They 
need gluten, albumen, fibrine, caseine, and similar nitrogenous elements. 
It is not necessary to eat animal food to obtain these elements, though 
they are contained in greatest abundance in animal tissues. Vegetable 
food, such as oatmeal, peas, beans, and the unbolted meal of all the 
grains, contains a large proportion of this class of food elements. It is 
observed, in fact, that in the meal of wheat we have exactly the right 
proportion of all the food elements necessary to nourish the body and 
maintain it in health. This fact is also established by the dietetic cus¬ 
toms of various nations who use little or no animal food with the ex¬ 
ception of milk, and that in moderate quantities. Thousands of per¬ 
sons have been muscle-starved from the attempt to live upon fine- 
flour bread, which, contains very little more than starch, and has been 
proven by experiment to be incapable of supporting the life of a dog. 

The athletes of ancient Greece and Rome were not reared on fine- 
flour bread; and it is equally worthy of notice that prize-fighters, 
wrestlers, and all persons in training for feats requiring the highest 
physical development, avoid fine-flour bread, and make graham bread, 
oatmeal, cracked wheat, and such food, a large proportion of their 
diet. Thus fully does experience corroborate the conclusions cf 
theory in this matter. 


110 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


THE NERVOUS SYSTEM. 


ANATOMY OF THE BRAIN AND NERVES, 

The structure of the nervous system is the most complex and deli¬ 
cate of any part of the body. Many portions of it, indeed, are not yet 
perfectly well known, although many physiologists have devoted their 

whole lives to careful study of this 
part of the human organism. We 
shall not attempt to give any except 
the most thoroughly established facts, 
devoting little space to the considera¬ 
tion of complicated and disputed ques¬ 
tions connected with the subject. 

Structure of Nerve Tissue.— 

The microscopical characters of nerve 
tissue we have already considered. 
We found that there are two distinct 
elements in nerve tissue, cells and fi¬ 
bres. The essential element of both 
of these we found to be the same, the 
central part of the fibre being but a 
continuation of the cells, both being: 
composed of the great basis of all forms 
of living matter, protoplasm. 

These two elements cf the nervous 
system are differently distributed in 
the body. The cells are collected in 
groups in the central parts of the body, 
which are termed ganglia while the 
nerve fibres, associated in bundles, 
ramify to every part of the body. So 
completely is the whole body permeated by these delicate filaments 
occupied in transmitting sensations and volitions, that if all the other 
tissues were removed, the nerves would still present an exact outline 
of the body 



Fig:. 63. 

ous system. 


A general view of the nerv- 










DIVISIONS OF THE NERVOUS SYSTEM. 


117 


Divisions of the Nervous System.— Considered from the stand¬ 
point of function, the nervous system is divided into two classes, each 
of which has a distinct work to perform ; viz., the cerebrospinal sys- 




Figr. 70. A view of the upper surface of 
the brain, exposed by turning back the scalp 
and removing a portion of the cranium. 


tern, and the organic or sympathetic system. The 
first mentioned is at with which we have most 
to deal, because this is the one which chiefly dis¬ 
tinguishes man and animals from vegetables, and 
the higher functions of which distinguish man from 
lower orders of animals. The second class or sys¬ 
tem of nerves presides over the nutritive functions 
of the body, the ocesses of growth and repair, ex¬ 
cretion, secretion, etc., which are sometimes termed 
the vegetative functions because of their close anal¬ 
ogy to similar functions in vegetables, although in 
the latter class of existences there is nothing 1 analo- 

O 


Fie. 69. The Brain gous to a nervous system. 

au i spinal cord. Description of the Cerebro-Spinal System.— 
The cerebro-spinal system is made up of ganglia and nerve trunks* 
The ganglia, or groups of cells, are chiefly to be found in the skull 
and spinal canal, constituting the brain and spinal cord, the central 
axis of this system, the nerve trunks emanating from these two great 
centers and extending to all parts of the body. See Fig. G9. 







118 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 




Structure of the Brain .— 
See Figs. 70-73. The brain is 
the largest mass of nervous 
matter in the body, filling the 
entire cranial cavity. I ts 
weight is about forty-nine and 
one-half ounces in males, and 
forty-four ounces in females. 
It is inclosed by two mem¬ 
branes, the outer of which is 
closely applied to the inner 
plate of the skull, and from 
its toughness called the dura 
mater. This membrane 
abounds in blood-vessels, from 
which nourishment is supplied 

Fig. 71. A view of the under surface of the ^ biain and the skull, 

brain, showing the origins of the several pairs of and by means of which the 

blood-supply of the interior 
and exterior of the cranium is in communication. Next the brain is 
another delicate membrane chiefly made up of blood-vessels which run 
down into the substance of the brain. Between this membrane and 
the dura mater is still another membrane so delicate in its structure 
that it has received a 
name which describes 
it as being like a spi¬ 
der’s web. 

The membranes of 
the brain divide it in¬ 
to a larger and a 
smaller portion. The 
larger portion, located 
in the upper and front 
-part of the skull, is 
called the cerebrum > 
the smaller portion, 
located in the back 
and lower part of the 
skull, is called the 


Fig. 72. The left half of the brain, showing the convolutions 
of the cerebrum, one lateral ventricle, the arbor vital of the cere¬ 
bellum, etc. 






THE CEREBBO-SPINAL SYSTEM. 


119 




cerebellum , or little brain. Each of 
these principal portions of the brain 
is subdivided by a fold of the mem¬ 
branous coverings into two lateral 
halves, each of which furnishes 
nerves to the opposite half of the 
body. 

When the membranes of the 
brain are removed, its surface is 
found to be marked by numerous 
and quite deep depressions, which 
are due to the convolutions or fold¬ 
ings of its outer layers. The gray 
color of the mass is also noticeable. 

When cut, it is found that the gray 
substance extends but a little way 
into the mass of tissue, the central 
portion being white. Examination 
with a microscope shows that the 
gray substance is composed of nerve cells, while the white portion is 
made up of fibres, which are connected with the cells. 

At the base of 
the brain, or its 
under side and cen¬ 
tral portion, are 
found a number of 
collections of gray 
matter or nerve 
cells, called the 
central ganglia of 
the brain. 

At the lowest 
portion of the 
brain, just at its 
junction with the 
spinal cord at the 
foramen magnum, 

Fig - . 74. A view of the Cranial Nerves, with their points of origin 
in the brain. 

known as the 


is a rounded body, 


Fig - . 73. A horizontal section of the brain 
through its middle portion, showing the rela¬ 
tion of the white matter to the gray, with 
many other points of interest. 




120 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


medulla oblongata, which may really he considered as the enlarged 
upper end of the spinal cord. 

In the central portion of the brain is found a curious little organ 
about as large as a pea, the pineal gland, which the great philosopher 
Descartes supposed to be the seat of the soul. It is now known to be 
simply a gland. 

From this exceedingly brief description it will be seen that the brain 
is really a collection of ganglia within the skull, and consists of sev¬ 
eral distinct groups of cells. Each group has its particular function 
to perform, its particular part of the work of the vital economy to 
control or direct. From each one go out nerve fibres which terminate 
in different ways, according to the functions to be performed. 

The Spinal Cord .—The spinal cord, or marrow, as it is sometimes 
called, is really a continuation of the brain down through the spinal 
canal. It extends through the whole length of the canal, and at its 
lower extremity spreads itself out like the tail of a horse, whence it 
is in this region called the cauda equina. The spinal cord is really a 
series of cell groups, or ganglia, ranged one above another, but so closely 
joined together as to make them practically inseparable. Like the 
brain, the cord is invested by membranes designed for its protection 
and nourishment. Like the brain, also, it is divided into two lateral 
halves, each half being further divided into anterior and posterior col¬ 
umns. All along its course the cord sends off branches, which have 
two roots, one of which arises from the anterior column, and the other 
from the side of the cord, branches being sent off symmetrically from 
both sides. 

The Cerebro-Spinal Nerves. —The nerve branches which are sent out 
by the brain and spinal cord number forty pairs in all, of which nine 
pairs originate in the brain, and thirty-one in the spinal cord. See 
Figs. 71 and 69. 

The thirty-one pairs of nerves which are derived from the spinal 
cord are distributed chiefly to the trunk and extremities, all parts of 
which they supply with nerves of sensation and of motion. The nine 
nerve branches from the brain, arising chiefly from the central gan¬ 
glia at its base and from the medulla oblongata, are distributed to the 
face, the organs of special sense located in the head, and the vital or¬ 
gans of the chest and abdomen. 

The manner in which nerves and nerve cells are connected is now 
pretty well understood, though it has been but recently that the exact 


THE SYMPATHETIC SYSTEM OF NERVES. 


121 



mode of connection has been determined. It will be recalled that 
nerve cells are provided with peculiar appendages, some possessing but 
one, others two, three, or even as many as a dozen or more. It ap¬ 
pears from careful investiga¬ 
tions that have been made 
of this subject that these 
poles or branches are for the 
purpose of connecting to¬ 
gether individual cells; and 
also, that nerve fibres are 
simply prolongations of these 
same appendages. By this 
means the minute cells of 
the brain and spinal cord 
are actually extended into 
the most remote portions of 
the body; and the millions 
of cells which make up the 
gray matter of the brain and 
cord are connected by the 
same means. 

The Sympathetic or 
Or gaiiic System of Nerves. 

—Fig. 75. This system is 
made up of a series of small 
ganglia found in the head 

O O 

and on either side of the 

spinal column within the 

cavities of the trunk. The 

ganglia are all connected 

by small fibres, so that 

they are sometimes spoken 

of as being a single nerve, 

the great sympathetic. Their 

fibres follow the blood-ves- * ie - 75 -, A of the Sympathetic or Organic 

Nervous System. 

sels in great numbers, start¬ 
ing with them as they go out from the heart. A large collection of 
the nerves of this system, found in the abdomen just back of the 
stomach, is known as the solar plexus- This system is closely con- 




122 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


nectecl with the cerebro-spinal system of nerves by means of commu¬ 
nicating branches. 

General Properties of Nerves. —Nerves possess, during life, the 
power to do two things: to conduct nerve force, and to conduct im¬ 
pressions received from without. Both these properties are not pos¬ 
sessed by the same nerve fibres at the same time. For doing the two 
kinds of work there are two classes of nerves. They do not differ in 
the least in structure, but totally in function. One carries impressions 
into the brain and spinal cord; the other transmits nerve force in the 
form of impulses outward. As there are many varieties of impres¬ 
sions to be received, there are several kinds of nerves which have 
power to transmit impressions only of one certain kind. These are 
called nerves of special sense. This property of nerves is known as 
nervous irritability. Each nerve of special sense possesses only its 
own kind of irritability. For instance, the nerve of sight transmits 
impressions of sight, but not of hearing, smell, taste, or any other kind 
of impression. So with each of the others. The nerves which travel 
outward from the nerve centers end in the muscles,—where they are 
called motor nerves,—in membranes, glands, and in all parts requiring 
the aid or control of the nerves. 

PHYSIOLOGY OF THE BRAIN AND NERVES. 

The chief organ in the nervous system is the brain. This is the 
great center from which emanates the nerve force which vitalizes and 
energizes every part of the body. It is the seat of government in the 
vital domain, the nerves being its servants through which it receives 
information of the external world, and by means of which it is able to 
execute its mandates in all parts of its province, even extending be¬ 
yond itself and the limits of the body, and operating upon external 
things through the medium of its instruments. 

As before stated, the brain is made up of a series of ganglia, each 
of which has special duties to perform. We can only understand the 
functions of the brain as a whole by studying the functions of each 
of the separate groups of cells which compose it. This has been done 
with the greatest care, and very recently results have been obtained 
which throw great light on this hitherto most complex and mysteri¬ 
ous subject. So far as we know, these results have not yet been em¬ 
bodied in any treatise on the subject, being only to be found in sci- 


FUNCTIONS OF TIIE MEDULLA OBLONGATA. 


123 


entitle periodicals. An eminent writer* in a leading English scien¬ 
tific magazine, the Nineteenth Century, has summarized these late re¬ 
sults so admirably and succinctly that we cannot do better than to 
quote a portion of his article, as follows:— 

“ The most important step in modern research, and which may be 
said to have ushered in a new period in our knowledge of brain func¬ 
tion, was the application of electricity to the hemispheres of the brain 
of living animals, and the observation of the effects caused by such 
stimulation. The first successful experiments of this kind were made 
by two German observers, Fritsche and Hitzig, of Berlin, who were 
soon followed by Ferrier in this country. A secure base was thus 
given to one of the most important doctrines of the present day, viz., 
the localization of the several cerebral faculties; and if vivisection had 
done nothing else for science, it would simply on account of this have 
a claim on our gratitude. But vivisection is only one of the means 
which have been employed toward the elucidation of our subject. 
The clinical features of the several diseases of the brain have been, 
and are now, more attentively than ever studied by hospital physi¬ 
cians ; the symptoms observed during life are compared with the re¬ 
sults of post-mortem examinations; and by simultaneously bringing 
anatomy, experimental physiology, clinical medicine, and pathology to 
bear upon this gTeat question, the present doctrine of brain-function 
eventually became established. 

Functions of tlie Medulla Oblongata.—" We may subdivide the 
brain into five principal parts, which greatly differ in general configu¬ 
ration, and which, although they are in the most intimate connection 
with each other, yet are invested with thoroughly different functions. 
They stand in the relation of higher and lower centers, the lowest be¬ 
ing the medulla, and the highest the gray surface of the hemispheres. 
The functions of these parts will now be considered seriatim, begin¬ 
ning with the lower centers. 

“ 1. The medulla forms the connecting link between the spinal 
cord and the brain. It is a small cord, about an inch long, and weigh¬ 
ing no more than two drachms; yet it must be looked upon as the 
most vital part of the whole system, for injury to it proves immedi¬ 
ately fatal. The most important function of the medulla is to cause 
and to regulate the respiratory movements, and the point in which 


*Dr. Julius Althaus. 


124 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


this respiratory center is situated is called the vital knot. Death by 
hanging results generally from injury to this special point in the me¬ 
dulla, through dislocation or fracture of the upper portion of the 
spine; the criminal therefore dies of asphyxia, or cessation of respira¬ 
tion. The entire brain above the medulla may be removed in an ani¬ 
mal, and the latter may yet continue to breathe; but destruction of 
the medulla asphyxiates it at once. The same organ also regulates 
the heart’s action. It is true that the pulsations of the heart are not, 
like the respiratory movements, at once arrested by destruction of the 
medulla, for they may continue for some time after death from hang¬ 
ing. Indeed, the rhythmic beating of the heart is effected by means of 
small nerve cells which are situated in its muscular substance, and 
which may retain their energy for some time after death. The influ¬ 
ence of the medulla upon the heart is therefore a secondary one, that 
is, to retard or accelerate its action. The medulla is never at rest as 
long as life lasts; for respiration and the heart’s action continue during 
sleep as well as in the waking condition in a typical manner. 

“ The medulla is likewise the center of action for the blood-vessels. 
These are not always equally distended by the circulating liquid, but 
may contract and dilate, as is seen in sudden blushing and pallor, un¬ 
der the influence of diverse mental emotions. The insensible perspira¬ 
tion of the skin, which, like respiration, is also going on constantly, is 
likewise under the influence of the medulla. 

“ A pointed illustration of these facts is given by the symptoms of 
the peculiar disorder known as sun-stroke. This affection occurs more 
particularly in the tropics, but is occasionally observed in hot weather 
in the temperate zone, in persons who are exposed to the direct rays 
of the sun, and who have at the same time to undergo exertion. It is 
therefore chiefly seen in soldiers marching during the heat of the day, 
or in agricultural laborers who are at work in the fields; yet it has 
been known to come on at night, in persons sleeping in the pestilential 
atmosphere of overcrowded and badly ventilated barracks or cabins, 
and in children shut up in a stifling bedroom after having been ex¬ 
posed to great heat during the day. It would therefore be more ap¬ 
propriate to speak of heat-stroke, for the disorder really consists of a 
great and sudden rise in the temperature of the blood, which in this 
state acts as a poison on the medulla. The perspiration of the skin is 
suddenly arrested, and as the evaporation of sweat on the surface of 
the body is intended to produce cold, and thus to neutralize the effects 


FUNCTIONS OF THE MEDULLA OBLONGATA. 


125 


of the external heat, the closure of this safety-valve causes a further' 
rise of temperature, which paralyzes some or most of the centers in 
the medulla. The worst kind of heat-stroke is that in which the cen¬ 
ters for respiration and the heart’s action are affected, as fatal asphyxia 
or syncope is the result. A person who may be walking in the street 
or working in a field is seen suddenly to drop down as if shot or 
struck by lightning, and dies in a minute or two. A fatal issue is in 
such cases so rapid that there is no chance for any treatment to do 
good, more especially as the means which would be of the first im¬ 
portance, viz., ice and plenty of cold water, are usually not at once at 
hand. 

“ The second kind of sun-stroke is owing to paralysis of the center 
for the blood-vessels in the medulla, whereby apoplexy is caused. In 
such instances the symptoms are not quite so sudden, and death may 
often be averted. The illness begins with mental disturbance—there 
are delusions and hallucinations, followed by mania, and the patient 
may commit suicide or homicide. This stage of excitement lasts for a 
short time, and is succeeded by a period of depression. The patient 
becomes sleepy, insensible, and may die in a state of profound apo¬ 
plexy. Life is, however, often saved by drenching the body with cold 
water, and applying ice to the head. The overheated blood is thereby 
cooled, and the medulla roused from its torpid condition. 

The movements of swallowing, which require for their proper ex¬ 
ecution a co-ordinated action of the lips, tongue, palate, and gullet, are 
likewise under the immediate influence of the medulla. The same or¬ 
gan contains a center for the physiognomical play of the muscles of 
the face, and another for articulate speech, that is, the pronunciation 
of vowels and consonants in such fashion as to form words. These 
facts are well illustrated by the symptoms of a peculiar disease which, 
although it has no doubt always existed, has only recently attracted 
the attention of the medical world, and which consists in a wasting 
away of those nerve cells in the medulla which preside over the func¬ 
tions just mentioned. This affection, which has received the eupho¬ 
nious name of f labio-glosso-pharyngeal paralysis,’ commences with ap¬ 
parently insignificant symptoms. It is found that speaking, eating, 
and swallowing require an effort. The tongue feels heavy; the lips 
do not move properly; the patient experiences difficulty in pronounc¬ 
ing certain letters, such as b, p, o, and u ; he cannot whistle or blow 
out a candle. As time goes on, the tongue becomes more powerless ; 


12G 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


more letters of the alphabet are lost; the soft palate does not act 
properly, and the voice acquires a nasal twang. The vocal cords be¬ 
come paralyzed, the voice is completely lost, and the patient is only 
able to grunt. He cannot blow his nose, clear his throat, cough, or 
swallow. In attempting to eat, the tongue fails to form a proper 
morsel of the food taken, and to push it on to the gullet. The food 
remains, therefore, between the teeth and the cheeks, and can only be 
pushed farther on to the throat by the aid of the fingers. It is apt to 
get into the windpipe and cause choking. On attempting to drink, 
the liquid returns through the nose. The unfortunate sufferer thus 
dies a slow death from starvation, the torments of which can only in¬ 
adequately be relieved by medical aid. On making a post-mortem 
examination, wasting of certain nerve cells in the medulla is discov¬ 
ered to be the cause of this terrible malady. 

“ All these different functions of the medulla which we have con¬ 
sidered are automatic or mechanical, that is, independent of volition, 
intelligence, or any other of the higher mental processes; and they 
may therefore continue where the higher centers in the brain have 
been either experimentally removed, or disorganized by disease.” 

Functions of the Pons and Optic Lobes.— “ 2. The next great 
division of the brain which we have to consider consists of the pons, or 
bridge, and optic lobes, and is the center for still more complicated ac¬ 
tions than those over which the medulla presides. The functions of 
these parts have been chiefly made known by experiments on living 
animals. A pigeon which is left in possession of these parts, but from 
which the higher portions of the brain have been removed, is still able 
to respond to a stimulus, but, if left alone, will show complete indiffer¬ 
ence and loss of initiative. There is no desire, no impulse to any spon¬ 
taneous action, and apparently no recollection of any former events. 
Such an animal will remain, day by day, sitting quietly on its feet, with¬ 
out giving any signs of life, and, unless artificially fed, will ultimately 
die of starvation, without feeling the pangs of hunger and without suf¬ 
fering in any way. As soon, however, as its repose is disturbed, it will 
give signs of life. If laid on the back, it will struggle until it has re¬ 
gained its previous position on the feet. If pinched, it will walk 
away. If thrown into the air, it will flap its wings, and come down 
to the ground in the ordinary manner. If a light be held to the eyes, 
the pupils will contract. If ammonia be applied near the nostrils, the 
animal will draw back with signs of disgust. If a shot be fired close 


FUNCTIONS OF THE PONS AND OPTIC LOBES. 


127 

to it, it will jump up and open its eyes; and if food be put into its 
mouth, it will swallow it. 

“ In frogs and fishes the phenomena are almost identical with those 
observed in pigeons, being only slightly modified by the different me¬ 
dia in which the animals live. In the fish, for instance, the contact 
with the water acts as a constant external stimulus on the mechanism 
of swimming. A fish from which the higher portions of the brain 
have been removed, will therefore not sit still, like the pigeon, 
but will go on swimming until it reaches an impediment to its pas¬ 
sage. It follows a headlong and apparently irresistible impulse, yet 
will show some method, inasmuch as it will avoid obstacles, and turn 
aside when prevented from going straight on. While a fish in its nor¬ 
mal condition will, as may daily be seen in an aquarium, stop on its 
way, sniff about, pursue a prey, etc., the unbrained fish sails heed¬ 
lessly along, without ever stopping or taking nourishment, until it 
dies of exhaustion. In a similar manner an unbrained from when 
thrown into the water, will move on until it reaches terra Jirma, but, 
as soon as it has found a resting-place, will remain in the same state 
of death-like repose as the pigeon. 

“ In the mammalia the results differ somewhat from those obtained 
in the lower animals. In them the different portions of the brain are 
so intimately connected, and so dependent upon one another, that re¬ 
moval of the higher parts appears to disorder the entire mechanism, 
and causes such a degree of exhaustion as to interfere greatly with the 
independent action of the lower centers. Nevertheless, the functions 
of these latter are identical with those of the same parts in the lower 
animals, which we conclude from their homologous structure, and also 
from observations made in disease of these centers. 

“ The expression of the affections, such as fear, terror, pleasure, 
pain, etc., is likewise under the influence of the second division of the 
brain. Frogs, in which the higher portions of the brain have been 
destroyed or removed, will still croak when stroked across the back; 
and croaking in the frog is the expression of satisfaction and comfort. 
In ourselves, laughing and crying, and othe'r expressions of the affec¬ 
tions, are generally quite involuntary, and independent of reflection. 
It is true, that we may, by an effort of the will, restrain or inhibit 
such expressions; but this is done by a special exertion of the inhib¬ 
itory influence of the higher centers, which can only come into play 
after a long course of training, and which is quite absent in children 
and uneducated persons.” 


128 


ANATOMY ; PHYSIOLOGY , *4AT) HYGIENE. 


Fimctious of the Cerebellum. —“ 3. The cerebellum , or little 
brain, which is intimately connected with the preceding and following 
divisions, was formerly believed to be the seat of the reproductive 
faculty and desire; but this view has recently been shown to be in¬ 
correct. Nor has the cerebellum anything to do with reason, volition, 
or consciousness; for animals which are deprived of the higher cen¬ 
ters, yet left in possession of the cerebellum, do not show any spon¬ 
taneity of desire or action, and will, for instance, die of starvation 
with the utmost indifference. If, however, the cerebellum be re¬ 
moved, the animal will move about as if it were drunk. It is not 
paralyzed, and will endeavor to carry out certain movements, but 
there is an utter want of precision; and even the most desperate ef¬ 
forts do not succeed in steadying the body. The cerebellum is thus 
shown to be the organ of equilibration of the body; and this conclu¬ 
sion from physic logical experiments has been corroborated by observa¬ 
tions of disease of the organ in man. It is likewise known that the 
different portions of the cerebellum have different parts allotted to 
them in this respect. One part prevents us from falling forward, an¬ 
other from falling sideways and from constantly turning round in a 
circle, while a third is intended to secure us from falling backward.” 

Functions of the Central Ganglia. —“4. The central ganglia, 
which constitute the fourth great division of the brain, have the func¬ 
tion to render certain complex movements which are intimately con¬ 
nected with sensations, and which are, in the first instance, only ex¬ 
cited by volition and consciousness, gradually, as it were, mechanical 
and automatic. The object of this contrivance is to save time and 
trouble to the highest portion of the brain, viz., the gray surface of 
the hemispheres. It is intended that these latter should only be oc¬ 
cupied with the most important manifestations of life. The central 
ganglia may therefore be said to be the confidential servants or pri¬ 
vate secretaries f the hemispheres, and undertake a good deal of 
drudgery, in order to leave the gray surface at liberty for the finer 
and more difficul inds of the work which falls to our lot in life. 
Thus we have, in childhood and youth, to learn the actions of walk¬ 
ing, talking, writing, dressing, dancing, riding on horseback, decent 
eating and drinking, singing, playing of musical instruments, etc., by 
countless conscious efforts on the part of the hemispheres; and full 
attention is necessary in the beginning in order to enable us to carry 
out such movements in a proper manner. But the older we grow, the 


FUNCTIONS OF THE CENTRAL GANGLIA. 


129 


more frequently we have directed our minds to all these forms of ac¬ 
tivity, the less effort will eventually be necessary on the part of con¬ 
sciousness and volition; and ultimately all such movements will be 
performed mechanically, and without much, if any, attention to them 
on the part of the gray surface of the brain. A man who is in the 
habit of writing much never thinks of the way in which he forms his 
letters on the paper, over which his pen seems to fly quite mechanic¬ 
ally. The same holds good for the various kinds of needlework, em¬ 
broidery, playing on the piano, the violin, etc. If, each time we do any¬ 
thing of that sort, a conscious effort were necessary for all the differ¬ 
ent parts of which the action is composed, the time at our disposal 
would not suffice for the hundredth part of the work which we actu- 
ally get through in life; and some forms of activity, such as finished 
piano and violin playing, would be utterly impossible. 

“ A key is thus furnished for the comprehension of many singu¬ 
lar occurrences which would otherwise be quite inexplicable. A pian¬ 
ist, for instance, finds himself playing one of Rubinstein’s sonatas by 
heart, and is perhaps thinking all the time of his coming trip to Switz¬ 
erland, or something else which may happen to engage his attention; 
that is, the central ganglia play the sonata, while the hemispheres 
are busy elsewhere. A very worthy country parson told me some 
time ago that, when he reads prayers at church, he does so quite as 
an automaton, for his mind keeps wandering in a totally different 
direction. A man who knows London well may walk from his house 
through a maze of streets with the greatest precision to his club, 
where he arrives without having given the slightest attention either 
to the act of walking or to the direction he took, but having been 
quite in another world of thoughts all the time he was on his way. 

“ Somnambulism and other automatic conditions, which are observed 
in certain states of derangement of the nervous system, may be similarly 
explained. The lower centers are habitually under the absolute control 
of the highest, that is, the hemispheres ; yet this balance of power may 
be temporarily disturbed by illness or exhaustion of the gray surface, 
and the central ganglia may then begin to act in their own fashion. 
What may take place under such circumstances may be aptly compared 
to certain occurrences which are not uncommon when the family is out 
of town, and the servants are left in charge of the house. Supposing 
the hemispheres to have lost their control over the lower centers, elabo¬ 
rate actions may take place which may have all the appearance of delib- 
9 


130 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


erate intention, and yet for which the person who commits them can no 
more he held responsible than the absent master of the house for the mis¬ 
doings of his servants. The somnambulist who falls from the roof of a 
house and is killed is no more a suicide than a man who in the state of 
epileptic vertigo commits robbery, arson, or murder, can be called a truly 
responsible criminal. The legal mind has not yet been able to grasp the 
full significance of these facts, as shown by convictions to penal servitude 
of persons who should have been sent to hospitals or asylums.” 

Functions of the Cerebrum. —“5. The highest development of 
brain-matter is found in the hemispheres, convolutions, or gray surface 
of the brain, which is the material base of all mental and moral activity. 
This portion of the brain ***** is not 
a single organ, as was formerly supposed, but consists of a number 
of thoroughly differentiated organs, each one of which possesses certain 
functions, yet is in the closest possible connection with all the others. 
To define all these various organs with accuracy, to determine their inti¬ 
mate structure as well as their individual energy, and to trace the phys¬ 
iological and pathological alterations which they undergo during the 
natural processes of development, maturity, and decay, and in diseases 
to which they are subject, is the greatest problem for the anatomy and 
physiology of the twentieth century ; and when this problem is solved, 
a complete revolution in psychology must be the result. At present, 
however, we are only on the threshold of this inquiry, which is perhaps 
the most difficult and complicated of any which may present themselves 
to the human mind. 

“ I cannot attempt, in the limits of the present paper, to enter at all 
fully into the labyrinth of these convolutions, but must be satisfied with 
a rapid survey of what is best known with regard to the functions of 
some of them. One of the most suggestive results of recent researches 
has been to show that the faculty of intelligent language, as distinguished 
from simply articulate speech, is situated in that portion of the hemi¬ 
spheres which is called the third left frontal convolution, and its imme¬ 
diate neighborhood. We have already seen that the pronunciation of 
letters and words is effected in the lowest portion of the brain, viz., the 
medulla ; but this and all the other inferior organs concerned in speak¬ 
ing form only as it were the instrument, on which that small portion of 
the brain’s surface which I have just named is habitually playing. 
Lower centers are able to hear spoken words, and to see written words ; 
but the intelligent appreciation of the connection which exists between 


FUNCTIONS OF THE CEREBRUM. 


131 


words and ideas, and the faculty of expressing thoughts in sentences— 
that is, what the Greeks called logos —only resides in the third left 
frontal convolution. This discovery was foreshadowed by Gall, hut 
actually made by Broco, who likewise found that the left hemisphere is 
altogether more important for intellectual manifestations than the right, 
and is chiefly trained for talking as well as most of the finer kinds of 
work which we have to perform in daily life. This appears to be owing 
to the following circumstances : The left hemisphere is originally heavier 
than the right; the convolutions are more abundantly developed in the 
left; and finally, the left is more abundantly provided with blood, on 
account of the larger caliber of the blood-vessels which supply it. Most 
people therefore train chiefly the left hemisphere for talking, writing, 
etc.; they are left-brained as they are right-handed. A preponderance 
of the right over the left hemisphere, on the other hand, seems, accord¬ 
ing: to the most recent researches, to be characteristic of certain forms of 
insanity. 

“ Physiological experiments on animals point to the convolution I 
have just named as being concerned in language; for when electricity 
is applied to the part in the living monkey or rabbit, the animal opens 
its mouth, and alternately protrudes and retracts the tongue. But far 
more convincing proofs have been furnished by numerous cases of dis¬ 
ease in which there was loss of language during life, and where after 
death a lesion limited to the part just named was discovered. 

“ A boy, aged five, who was a great chatterbox, fell out of the win¬ 
dow and injured the left frontal bone, which was found depressed. 
There was no paralysis, but the boy had entirely lost his language. The 
wound healed in twenty-five days ; but the child, although intelligent, 
remained dumb. A year afterward he was accidentally drowned, and 
at the autopsy it was found that the third left frontal convolution had 
been destroyed by the inj ury he had received. 

“ A man fell with his horse, but got up, took hold of the reins, and 
was going to jump into the saddle, when a doctor who happened to ac¬ 
company him expressed the wish to make an examination. It was then 
found that he could not speak, but had to make himself understood by 
pantomime. A small wound in the left side of tne forehead v as found, 
with depression of bone ; but there was no paralysis. Inflammation set 
in, the patient died, and at the post-mortem examination it was found 
that a fragment of bone had penetrated into the third left fiontal con¬ 
volution, which had become softened. 


132 


ANATOMY, PHYSIOLOGY, AND HYGIENE . 


“ Talking, writing, drawing, etc., are habitually done by the left 
hemisphere alone, while both hemispheres have to be trained for musical 
performances. Pianists educate them both equally, while violinists and 
violoncello-players have to train them dissimilarly; and this is probably 
the reason why it requires more practice, and is more difficult, to play 
well on string-instruments than on the piano. 

“ A man who has by disease or injury lost the faculty of talking, is 
generally also unable to write ; and it is only in exceptional cases that 
one of these functions persists while the other is in abeyance. Cases of 
this latter kind show, however, that there are really two separate centers 
for the two faculties which are lying very close together, and there¬ 
fore generally suffer at the same time. If the disease affecting them be 
still more extensive,the faculty of intelligent pantomime or gesticulation 
is likewise abolished. Persons who have entirely lost their language 
may still be able to play chess, backgammon, and whist; and they have 
been observed to cheat at cards with some ingenuity; they may also 
be sharp in business matters,—facts tending to show that speech and 
intellect do not run in identical grooves. 

“ Those portions of the hemispheres which correspond to the pareital 
region or crown of the head, and which are called the pareital lobes, 
constitute the true motor region of the brain’s surface, and, being in in¬ 
timate connection with another portion which is the material base of the 
intellect and mind, have been called psycho-motor centers, in order to 
distinguish them from the lower motor centers in the medulla, the cen¬ 
tral ganglia, etc. The special functions of these psycho-motor centers 
have been studied by the application of electricity, by destroying them 
in the living animal, and also by observation of certain symptoms at the 
bedside; and it has been shown that each one singly serves some defi¬ 
nite purpose, as, for instance, clenching the fist, swimming, grasping 
something, raising the hand to the mouth, etc. Destruction of these 
centers causes paralysis of such movements, while irritation of them 
leads to a peculiar form of epilepsy, in which the convulsions affect only 
one (the opposite) side of the body, and where there is generally no 
loss of consciousness. 

“ The next great division of the brain’s surface is that which cor¬ 
responds to the temporal region of the skull. These temporal lobes 
of the hemispheres are intended to act as centers for sensory percep¬ 
tions. This is likewise shown by galvanizing them in the living ani¬ 
mal, and by localized destruction of the same. One portion of the 


FUNCTIONS OF THE CEREBRUM. 


133 


temporal lobe is the center of the sense of hearing. If it be de¬ 
stroyed, deafness on the opposite side is the result; on the other hand, 
if it be electrified, the animal is seen to prick up its ears and to as¬ 
sume the attitude of listening, just as it does when a sudden noise is 
made close to its ear. In those animals whose habits of life render 
their safety dependent upon the keenness of their sense of hearing, 
as, for instance, the wild rabbit and the jackal, galvanization of that 
part causes not only pricking of ears and listening, but also a quick 
jump to the side, as if to escape from some danger which would be 
announced by a loud or unusual noise. 

“ The center for the sense of smell is situated close by. If it be 
electrified, the animal begins to sniff, as if it smelt something strong, 
just as it does when odoriferous substances are placed to its nose. De¬ 
struction of this center causes loss of smell. It is particularly devel¬ 
oped in animals which are endowed with a keen sense of smell, such 
as dogs, cats, and rabbits. A center for the perception of taste is in its 
immediate neighborhood. Other portions of the temporal lobes are 
intended for the sense of touch, and there is also a visual center, de¬ 
struction of which causes blindness of the opposite side. All these 
centers are symmetrically arranged on both sides, the left in the brain 
serving for the right side of the body, and vice versa. 

“ A third portion of the hemispheres which we have to consider are 
the posterior or occipital lobes, which correspond to the back of the 
head. Their structure differs greatly from that of the parts more in 
front, and they receive their blood supply from quite a different set 
of blood-vessels. Electricity has apparently no influence upon them, 
and destruction of their substance causes neither paralysis nor loss of 
sensation. Animals from which these lobes have been removed con¬ 
tinue to see, hear, touch, taste, smell, and move about just as usual. 
They generally, however, refuse to eat, and succumb rapidly. W e 
are inclined to look upon these lobes as specially connected with the 
digestive tract, more especially the stomach and liver, and also with 
the reproductive organs; yet the symptoms of disease of these lobes 
are contradictory and perplexing, and our knowledge concerning them 
is as yet in its infancy. 

“The last and most important portion of the hemispheres consists 
of the anterior or frontal lobes, which correspond to the forehead. 
They are the actual seat of the intellect. Injury or disease of these 
lobes does not cause any impairment of motion or sensation; and large 


134 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


portions of brain-matter have occasionally been lost through wounds 
in these parts without any very striking symptoms, such as paralysis, 
etc., following, more especially if the lesion was confined to one side. 
Patients have now and then recovered from the most fearful injuries 
to the anterior lobes, and yet been able to go about and to attend to 
the ordinary routine of certain occupations; but it has always been 
shown, on close examination, that there had been a profound change 
in the character and behavior of such persons, and that their temper 
and their mental and moral faculties had become deteriorated. In 
a very marked case of this kind, which occurred some years ago in 
a previously steady and clever workman, there was, after recovery 
from the injury, such a change in the mind of the man that his em¬ 
ployers had to discharge him. The balance between his intellect¬ 
ual faculties and his animal propensities had evidently been de¬ 
stroyed. He had become capricious and vacillating, fitful, impatient, 
obstinate, and, as far as intellectual capacity was concerned, appeared 
to be a child, which, however, had the animal passions of a strong 
man. In consonance with such cases is Ferrier’s experience with 
monkeys in whom he had destroyed these lobes. The animals did not 
appear to have lost the power of motion or sensation, but there was 
ail alteration in their character. While previously to the operation 
they were actively interested in their surroundings, and pried into 
everything which came within their sphere, they had after it become 
dull and apathetic, readily dozed off to sleep, or wandered to and fro 
in a listless manner; so that it was evident that they had lost the 
faculty of attentive and intelligent observation. 

“ The anterior lobes have therefore to be looked upon as the or¬ 
ganic base of the highest intellectual and moral faculties. The prin¬ 
cipal part of the work done in life consists of certain movements or’ 
actions, which are the more or less immediate consequence of sensa¬ 
tions and desires which we experience; but apart from the power of 
performing such actions, we possess the faculty of restraining or in¬ 
hibiting them in spite of being urged to their performance by sensa¬ 
tions or desires. This inhibitory action is again most intimately con¬ 
nected with the power of concentrating attention, without which none 
of the higher intellectual operations are possible. The anterior lobes 
are therefore inhibitory centers, intended for the highest kind of 
mental work and moral control. They are small in idiots and the 
lower animals, larger in monkeys, largest in man; and their pecul- 


FUNCTIONS OF THE SPINAL COED. 


135 


iarly large and abundant development is found to coincide with the 
highest development of intellectual power. 

“ It is probable that a special evolution of certain parts of these 
lobes will be found to coincide with the presence of certain special apt¬ 
itudes and talents in individuals; but of this nothing definite is 
known, and there is in this direction an immense field still open for 
patient and intelligent inquiry.” 

The Functions of the Spinal Cord.— The spinal cord contains 
both gray and white matter, the gray matter consisting of nerve-cells 
and the white matter of nerve fibres. The function of the nerve- 
cells seems to be to have charge of certain automatic movements which 
are performed independent of the will, or involuntarily. These move¬ 
ments are generally termed reflex, since they are supposed to originate 
in external impressions which cause an impulse to be carried to the 
spinal cord by a sensory nerve, the impulse being reflected to the 
muscles by a motor nerve. This is well seen in a frog which has been 
decapitated. If a little sulphuric or acetic acid be applied to the inner 
portion of the thigh of a frog which has just been deprived of its 
head, it will immediately put up the other foot to remove the irritat¬ 
ing substance. If the acid is applied to the belly instead, both feet 
will be raised, and vigorous movements will be made to remove it. If 
placed upon its feet, such a frog will remain perfectly quiet if wholly 
undisturbed; but so soon as any sort of irritation is applied, as tick¬ 
ling with a stick, pricking, or even jarring of the object on which it 
rests, it will leap forward as though alive. These movements are 
said to be reflex because they are supposed to originate in the manner 
described, from the gray matter of the cord. There are eminent phys¬ 
iologists who maintain that experiments of this kind prove that the 
cord as well as the brain is the seat of mind, even going so far as to 
assert that mind exists wherever gray matter is found, being a prop¬ 
erty of nerve-cells. 

The spinal cord also acts as a conductor of sensations to the brain, 
and of volitions from it. The nerves of general sensibility convey to the 
spinal cord impressions received in various parts of the body, when they 
are carried up to the brain by means of the gray matter of the cord. 
The brain then wills the performance of an act, and the force necessary 
to excite the muscles to contract is sent down the spinal cord and thence 
out through some of its nerve branches to the part from whence the 
impression came. For instance, if a pin is thrust into the finger, the sen- 


136 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


sation which we call pain is transmitted by means of a sensory nerve to 
the cord, which passes it up to the brain, where the sensation is really 
felt, the brain itself being not sensitive, since it may be cut and torn 
without pain, though it appreciates inj uries done to other parts of the 
body. The cord is thus seen to be both a conductor of nerve force and 
a nerve center or force generator. 

The reflex action of the cord is often seen in human beings in cases 
of paralysis in which there is loss of power to control the lower extrem¬ 
ities. We have frequently met with such patients, in whom the limbs 
could be made to twitch with considerable force by titillation of the soles 
of the feet, though the muscles would not act in obedience to the will on 
account of some inj ury in the nerve centers having charge of that part 
of the body or in the nervous communication between the two. 

Functions of the Spinal Nerves. —The thirty-one pahs of nerves 
which originate in the spinal cord are each double. This might be easily 
surmised from the fact already stated, that each nerve has two roots, 
one of which arises from the posterior portion of the cord, the other from 
the anterior portion. It has been found, by experiments upon annuals, 
that the fibres which come from these two roots differ from each other 
in function, the anterior roots being nerves of motion, and conveying 
nerve force from the cord to the muscles, and those which are connected 
with the posterior root conveying impressions from various portions of 
the body to the cord. Hence the anterior root and fibres arising from 
it are termed motor, the posterior root and its fibres being called sensory. 

A curious fact discovered by physiologists is that both the motor 
and sensory fibres, which, as we have seen, communicate with the brain 
through the cord, cross over to the opposite side from that on which 
they enter the cord before passing into the brain. The sensory fibres 
pass over or decussate soon after entering the cord, while the motor fila¬ 
ments cross over in the medulla oblongata, or at the base of the brain. 
The consequence of this is that if an injury happens to these nerve fibres 
in the brain or the cells in which they terminate or originate, the inj ury 
will be manifested upon the opposite side of the body. Thus, paralysis of 
one side of the body may be taken as evidence that the opposite side of 
the brain has been injured. 

Functions of the Cranial Nerves. —The functions of the nine 

cranial nerves are far less simple than those of the spinal nerves j ust de¬ 
scribed. In some instances a nerve has both motor and sensory func¬ 
tions, but in several others a nerve has but a single function. Several 


SYMPATHETIC SYSTEM—THE MIND. 


137 


of the cranial sensory nerves, instead of possessing general sensibility, have 
peculiar sensory properties, from which they are termed nerves of special 
sense. The optic, or nerve of sight, auditory, or nerve of hearing, the 
olfactory, or nerve of smell, and the gustatory, or nerve of taste, are 
those which possess special sensory properties, and these possess little or 
no general sensibility. 

The fifth nerve should be specially noticed as the great sensory nerve 
of the face, since it is disease of this nerve which is the occasion of so 
much suffering in tic douloureux, or facial neuralgia. A branch of this 
nerve supplies the teeth, and hence it is that decayed or diseased teeth 
are so frequent a cause of facial neuralgia. 

Functions of the Sympathetic System.— The name of this sys¬ 
tem of nerves very well indicates its general character. Besides having 
charge of the nutrition of the body, its vegetative or organic functions, 
it connects or associates together the different parts of the system, so 
that when one member suffers, the others suffer with it. A good illus¬ 
tration of the action of this system is seen in a simple experiment per¬ 
formed by Dr. Brown-Sequard. He observed that when he placed one 
foot in cold water, the other became warmer. In one instance the tem¬ 
perature of the foot not immersed rose seven degrees. The reason of 
this is that nature makes an effort to resist the effects of the cold ap¬ 
plied to one foot, by increasing the supply of heat; and through the 
sympathy of the other foot, its heat is increased also. 

The very common phenomena of “taking cold,” and numerous 
other instances of sympathy of one part with another, are due to the 
action of the sympathetic nerves. 

The Mind. —Whatever may be the correct doctrine respecting the 
nature of the human soul, about which science can really say very little, 
it seems very clear from what has been proven respecting the nature of 
the brain and its processes, that mind ls nothing more nor less than brain 
action. It is everywhere granted that the brain is at least the organ of 
the mind. It is certainly relevant to inquire, then, Is not the relation 
between the mind-organ and the mind analogous to the relation known 
to exist between the organ of digestion and digestion ? Digestion is a 
process, thought is a process. Digestion is the result of the action of the 
digestive organs : there is abundant reason to believe that thought 
or mind is the result of brain action. This view need not interfere 
with any theological views concerning the nature of the soul, since it 


138 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


is evident that whatever the soul is, it is something more than mind; 
it must be greater than mind, since mind is only a result, from what¬ 
ever standpoint we look at it. Whatever there may be behind which 
we do not understand, and there is doubtless a great deal, mind is 
still the same, but a result; and it may as well be considered as 
the result of brain action as of the action of any other cause. If we 
deny this regarding man, we must do the same respecting the brute, 
since he also lias a mind, and is capable of thinking, willing, and reason¬ 
ing to a certain degree. Perhaps we cannot do better than to quote the 
following paragraph from one of the foremost thinkers of the age, and 
one of the most distinguished writers on this subject, Dr. Henry Mauds- 
ley, of London :— 

“ It must be distinctly laid down that mental action is as surely de¬ 
pendent on the nervous structure as the function of the liver confessedly 
is on the hepatic structure ; that is the fundamental principle upon 
which the fabric of a mental science must rest. The countless thousands 
of nerve cells which form so great a part of the delicate structure of 
the brain, are deemed to be the centers of its functional activity ; we 
know right well from experiment that the ganglionic nerve cells scat¬ 
tered through the tissues of organs, as, for example, through the walls of 
the intestines, or the structure of the heart, are centers of nerve force min¬ 
istering to their organic action; and we may fairly infer that the gan¬ 
glionic cells of the brain which are not similarly amenable to observation 
and experiment, have a like function. Certainly they are not inexhaust¬ 
ible centers of self-generating force ; they give out no more than what 
they have in one way or another taken in ; they receive material from 
the blood which they assimilate, or make of the same kind with them¬ 
selves ; a correlative metamorphosis of force necessarily accompanying 
this upward transformation of matter, and the nerve cell thus becoming, 
so long as its equilibrium is preserved, a center of statical power of the 
highest vital quality. The maintenance of the equilibrium of nervous 
element is the condition of latent thought—it is mind statical ; the man¬ 
ifestation of thought implies the change or destruction of nervous ele¬ 
ment. The nerve cell of the brain, it might in fact be said, represents 
statical thought, while thought represents dynamical nerve cell, or, more 
properly speaking, the energy of nerve cell.” 

Almost any amount of testimony might be added on this point, 
but this will suffice. It is readily granted that there are some diffi¬ 
culties, even with this view of the nature of mind; but it is claimed 


THE MECHANISM OF THOUGHT. 


189 


that the difficulties with this view are much less than with any other, 
and that they are not insurmountable. The view deserves attention, 
at least; since if it be true, it is destined to overturn many of the old 
philosophies in psychology. Indeed, it may almost he said that the 
old philosophies are already abandoned by the majority of the clear¬ 
est thinkers, on account of the great numbers of difficulties which at¬ 
tended them. 

The Mechanism of Thought. —Explained in accordance with the 
scientific theory of mind, the mechanism of thought loses much of its 
complexity, as we may be able to see. According to this view, thought 
really originates in the external world. The eye, ear, organs of touch, 
smell, and taste, and other sense organs, receive impressions from the 
external world, each carrying to the brain the particular kind of im¬ 
pression which it is fitted to convey. The eye conveys impressions 
of light, the ear of sound, etc. These impressions are received through 
the medium of the nerves by certain groups of cells lying at the base 
of the brain which are designed for this purpose. One group receives 
impressions of light, and of all the sensations 'which can be received 
through the eye. It can receive these kinds of impressions, and no 
others. The same may be said with respect to each of the other 
senses. The special organs, or ganglia, which receive these impressions, 
transmit them through connecting branches to the intellectual part of 
the brain in the cerebrum, where they are recognized as light, sound, 
odor, etc., and this is thought. In this way, ideas respecting the size, 
form, color, and other properties of objects, are formed. If the gan¬ 
glia at the base of the brain convey to the cerebrum the impressions 
which they are in the habit of doing, without being excited to do so 
by the external agents upon which they are dependent, the result is 
the same. If action of the ganglia which presides over the organ of 
sight is excited and the cerebrum informed of the fact, the individual 
will receive the perception of light even if no light is really seen. 
Action of this sort may be excited in a variety of ways, as by me¬ 
chanical irritation or by the use of electricity. Every one who has 
received a severe blow upon the head, as by a fall upon the ice, is 
aware of the fact that concussion of the head will cause a person to 
see flashes of light. A story is told of a man who in an English court 
testified to having seen a man who assaulted him in the dark by the 
light produced by a blow on the head which he received from his as¬ 
sailant. It is not stated whether the testimony was received or not 


140 


ANATOMY , PHYSIOLOGY, AND HYGIENE. 


Of course it could not be true, since light thus produced is not real, 
having no existence except in the brain. We have many times pro¬ 
duced the same phenomena by the application of a current of elec¬ 
tricity to the head. Distinct flashes are seen, though the eyes are 
closed. From this it appears that the impression we call light is in 
the brain due to action of certain nerve cells. The same experiment 
may be made with all the other organs with a like result. Ordinarily, 
seeing is the reception of light-waves through the medium of the eye, 
which is an organ specially constructed to receive them, by which 
means the optic nerve is made to convey an impression of a certain 
sort to the cells in the brain set apart for the reception of such impres¬ 
sions, which are thereby induced to act, which action is recognized by 
the cerebrum, the seat of the intellect, as light. If the optic cells are 
made to act in any other way the result is the same, as we have seen. 
It is very evident, then, that so far as the external world is concerned, 
all knowledge respecting it comes to the brain through the organs of 
sense, the only avenues of communication between the brain and the 
outer world. A careful analysis of our stock of knowledge will show 
that it all relates to things of which we have gained information by 
means of our senses; that is, all our knowledge is made up of, or derived 
from, data collected for us by the eye, ear, touch, and other sense or¬ 
gans. If this is not clearly seen at once, it will be by the supposition 
of a case. Let us imagine a person born into the world without a 
single one of the seven senses. It is inconceivable that such a person 
could have a single thought. The life possessed would be but a vege¬ 
tative one. The brain would necessarily be an utter blank, since it 
would be without the most simple materials for thought; there would 
be no means by which the intellectual machinery could be set in 
motion. 

We have not space to elaborate this subject further, and here leave 
it for the consideration of the reader, hoping that those who are pre¬ 
pared to appreciate the questions at issue will continue their investiga¬ 
tion of the nature of mind and the relation of mental activity to the 
brain and nerves. 

The Will. —That power of the mind by which the voluntary acts 
of the body are determined or controlled is termed the will. This is 
undoubtedly the highest function of the brain, since all other of both 
the bodily and mental functions are in some degree subject to it, either 
directly or indirectly. While this is probably the most obscure of all 


TIIE NATURE OF THE WILL. 


141 


the questions connected with the physiology of the brain, there are 
some very interesting facts known concerning it which are well worthy 
of consideration. 

First, as to the nature of the will. This has been the subject of 
lively discussion among physiologists and metaphysicians for centuries. 
We hear much about free will; yet when we come to study the mani¬ 
festations of volition we find that they are far from possessing that 
degree of freedom which the generally accepted doctrines on the sub¬ 
ject would lead us to suppose. If we carefully analyze an act of vo¬ 
lition, we shall find that desire is the prompting impulse in most if 
not all cases. When we act, it is because something which we regard 
as valuable to ourselves or some other being is to be gained by so do¬ 
ing ; in other words, we act because it is desirable to do so, or seems 
to us to be desirable. We always do what at the moment seems to be 
best, whatever its ultimate consequences may be, and irrespective of 
our knowledge of the consequences. When we refrain from action, it 
is because we desire to do so. Thus will may be manifested in two 
ways, positively and negatively, in acting and in refraining from ac¬ 
tion ; but in both instances the prompting of will is desire. This fact 
seems so clear that we apprehend no one will dispute or disagree with 
it who will stop to reason candidly on the subject. 

If we examine into the nature and origin of desire, we shall find that 
it grows out of a complex combination of circumstances and influences; 
first of which may be mentioned, inheritance. Our mental and physical 
constitution is largely the result of the habits and education of our par¬ 
ents and ancestors for many generations back, together with special cir¬ 
cumstances governing our early development. As Dr. Oliver Wendell 
Holmes has very well said, “Each of us is only the footing up of a 
double column of figures that goes back to the first pair. Every unit 
tells, and some of them are plus, and some minus!’ The proofs of this 
are too numerous to need citation here. 

Again, our desires are in a great degree the result of our education. 
Our tastes change vuth changes in our circumstances. They are modi¬ 
fied by age, and by our associations and social surroundings. Our de¬ 
sires are influenced by those of our friends, by the books we read, by the 
food we eat, by the condition of our bodily health, and by a great vari¬ 
ety of circumstances. It is obvious, then, that as the will is excited to 
action by desire it is far from being wholly f ree, since it is indirectly so 
dependent on other influences and circumstances. 


142 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


We are well aware, also, that the will is greatly modified by disease. 
A person who in health is active, energetic, positive in all his move¬ 
ments, becomes while suffering from some indisposition, the very reverse. 
A fit of sickness, a pecuniary loss, or other misfortune, will not infre¬ 
quently change a person’s disposition and the character of his will man¬ 
ifestations, for life. 

A careful study of the relation of the will to the body will show that 
its domination is far less complete than usually supposed. It has no 
power over the functions of organic life, as of the heart and blood-vessels, 
the stomach, intestines, and other vital organs, and it is fortunate for us 
that it has not, as the uncertain action of the will—it being so readily 
affected by a great variety of causes—would be fatal to the healthful 
and harmonious action of the vital machinery. Even the power of con¬ 
trol of the so-called voluntary movements is only acquired by degrees 
and after a protracted effort. In this respect, man is inferior to some 
lower animals. The little child learns to walk by painful and laborious 
efforts. At first it cannot control the muscles necessary to effect locomo¬ 
tion. It can readily understand what movements must be made, long 
before it can acquire the power to make them. The beginner in piano- 
playing fully appreciates the difference between knowing how to do, and 
doing. The will calls upon certain muscles to act, but they will not un¬ 
til they have been trained to do so. This fact is further seen in the 
great difficulty of making separately movements which have by habit 
been associated, as for example, closing one eye while keeping the other 
open; or moving one hand back and forth in a horizontal plane while 
the other is being moved in a vertical plane, both palms looking down¬ 
ward. It is, indeed, sometimes impossible for us to control our mental 
operation's by the will. We cannot think of what we wish to. We 
cannot on all occasions concentrate our minds upon the subjects of which 
we desire to think. The mind will wander into other fields; other and 
widely different subjects of thought will occupy its attention in spite of 
the most vigorous efforts of the will to the contrary. We cannot com¬ 
mand the brain to stop thinking. It will not obey if so commanded. 
We cannot even compel it to stop thinking upon any special subject 
which may be occupying it except by displacing it by some other idea, 
which may be in turn again displaced by the original thought before we 
are aware of it. 

Without further argument it must be evident that the will is by no 
means wholly free, but that it is, in a very large degree at least, the re- 


THE NATURE OF MEMORY. 


143 


suit of the operation upon us of the various external influences with 
which we are surrounded. 

Physiologists have never been able to locate the will in any partic¬ 
ular organ of the brain. It is probable that it exists in immediate con¬ 
nection with each of the various cerebral centers; in other words, that 
each group of cells which receives nerve fibres from the outside of the 
body and sends back motor fibres possesses its own volition, the will being 
the sum total of action of all these volitionary centers. 

Memory. —Memory is that faculty or property of the brain by 
means of which we are enabled to accumulate knowledge. To say that 
all of the problems involved in a complete explanation of memory may 
be easily solved, would be claiming too much. This much seems pretty 
certain, however, viz., that memory is due to the fixing of impressions in 
the structure of the brain. This view harmonizes perfectly with all the 
known facts relating to this most valuable function of the mind. Every 
impression received, occasions an action of certain parts of the brain. As 
changes of substance are constantly taking place in the brain, it is but 
natural to suppose that cells which are acting will be modified in accord¬ 
ance with the particular manner in which they are acting, their struct¬ 
ure being thus modified by their action. If this were the case it would 
follow that the longer the action were continued the more intense would 

O 

be the impression made upon the structure of the cells acting, and the 
more lasting. This is exactly what does happen. The longer an object 
is viewed, the longer the memory of it remains. The things and places 
which are often seen and become very familiar to us are seldom forgot¬ 
ten. 

Again, if this theory is correct it would follow that the larger the 
number of cells brought into action by an impression as associated with 
it, the more intense and lasting would be the impression. This, too, is un¬ 
doubtedly true. We much better recollect things that we both see and 
hear, than those which we simply see or hear. Objects that we not only 
see and hear but are also able to touch, taste, smell, and otherwise inves¬ 
tigate, we retain in mind the most accurately and the longest. In fact, 
the great secret of a good memory is concentrated attention and associa¬ 
tion of many senses and faculties in observation. By this means we 
gain the advantage of the memory of several different organs or cell 
groups by which to recall the object or fact which we wish to remem¬ 
ber. 

This theory also explains the phenomena of habit. By frequent ac- 


144 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


tion in a certain way the structure of the nerve cells which command 
the action becomes so modified that they act more readily in that 
particular way than in any other. This fact, if it be true, and there 
seems hardly a chance to doubt it, is certainly very suggestive of 
the importance of cultivating right habits of thought, speech, and action, 
since the task of remodeling a deformed and distorted brain is an exceed¬ 
ingly difficult one. 

Blushing. —The sudden reddening of the cheeks known as blush¬ 
ing, is due to the influence of certain emotions upon the vaso-motor 
center, that is, the part of the brain which controls the blood-vessels of 
the body. In some persons, blushing is wholly confined to the cheeks, 
while in others it extends to the forehead, and in still others to the neck 
and shoulders. Through the influence of mental emotions the walls of 
the blood-vessels become relaxed, causing an unusual afflux of blood to 
the part, which imparts the characteristic redness. An experiment 
sometimes performed by physiologists upon white rabbits illustrates the 
phenomena of blushing and explains its mechanism. In the white rab¬ 
bit the skin is white, and so transparent that changes in the blood-vessels 
can be as readily noted as in human beings. Placing the animal under 
the influence of ether, the experimenter divides the nerve which controls 
the circulation in the ear. The result is that the ear immediately be¬ 
comes flushed; in fact, it blushes. If the nerve is prevented from 
uniting, by removal of a portion of it, the flushing will continue, and, 
in consequence, in the course of a few months it will be found that the 
ear affected by the operation has grown to be appreciably larger than 
the other, in consequence of its larger supply of blood. 

Pain and its Uses. —Pain is simply a mollification of general sen¬ 
sibility. It arises from excessive irritation or stimulation of the nerves. 
Thus, the same irritation which in moderate degree, or when of short 
continuance, is agreeable, giving pleasure, when rendered more intense, 
or even if long continued, becomes exceedingly painful. For example, 
the sense of contact of bodies with the skin is not unpleasant, and is 
often very agreeable; but when the contact is made in a peculiar man¬ 
ner, as in titillation, it may become painfully unpleasant. Light is 
pleasant and grateful to the eye in a moderate degree, but becomes very 
painful and unbearable when we attempt to look at the sun. 

Pain is useful as a warning of impending evil. It puts us on our 
guard by informing us that the tissues are in danger of being injured in 
some way. Although unpleasant to bear, and often an unwelcome vis- 


PAIN AND ITS USES. 


145 


itant, pain is a guardian, a faithful sentinel. If it were not for the 
warnings and admonitions we receive from this source, we would 
speedily subject the delicate organism to such violence as to impair its 
functions, if not entirely destroy its utility. This fact is well seen by 
the accidents to which persons are exposed who are in any way de¬ 
prived of this means of warning. For instance, a person who had 
through disease lost the sense of feeling in his lower extremities, in tak¬ 
ing a foot bath put his feet into water so hot that the feet were badly 
burned, being actually parboiled. A gentleman of our acquaintance 
who had lost the sense of feeling in one arm bv an accident in which the 
sensory nerves of the arm were divided, while at work on a cold day 
unconsciously froze the fingers of the affected hand so badly that death 
of the tissues took place and considerable portions were lost. Other 
similar instances might be cited. The warnings of pain should always 
be heeded. Nature makes no unnecessary complaints. While it is not 
wise for a person to be on the lookout for pains, magnifying every un¬ 
comfortable sensation, it is important that the timely admonitions of be¬ 
ginning disease should be carefully heeded. Neglect of this often sacri¬ 
fices useful lives which might easily be saved with timely attention. 
Pain, then, should be looked upon as a beneficent provision of nature 
rather than as an enemy. 

The great physiologist, Magendie, makes the following interesting 
remarks concerning the nature of pain:— 

“ Though it may appear like sophistry to say that pain is the shadow 
of pleasure, yet it is certain that those who have exhausted the ordi¬ 
nary sources of pleasure have recourse to causes of pain, and gratify 
them by their effects. Do we not see in all large cities that men who 
are debauched and depraved find agreeable sensations where others ex¬ 
perience only intolerable pain ? ” 

We have seen old topers whose sensibilities had become so depraved 
and benumbed that the strongest liquors failed to excite them, fill a wine¬ 
glass with peppersauee, and quaff the liquid fire as though it were a 
glass of milk or the mildest claret. 

Numerous experiments and observations show that the capacity for 
pain increases with the fineness of the organization. It is pretty clearly 
settled that lower animals suffer much less from the same injury than 
man. Indeed, it is maintained by some that in the lowest orders, as* in 
worms and reptiles, there is little if any sensibility to pain, the contor¬ 
tions arising from injury, being really reflex in character. It is notice- 

10 


14 G anatomy, physiology, and hygiene. 

able that savages, as a rule, are less sensitive to pain than civilized 
persons. 

Sleep. —Sleep is a physiological condition in which there is cessation 
of activity of the upper lobes of the brain. When a person goes to 
sleep, the blood leaves the brain, the membranes becoming pale and the 
activity of the nerve cells ceasing in consequence. Upon waking, the 
blood returns again very quickly. This fact has been observed not 
only in animals, but in human beings in whom large portions of the 
skull have been removed by accident. During perfectly sound sleep 
there is no action of the thinking cells of the brain. There may or may 
not be some degree of activity of the central ganglia, the sensational 
centers, so-called, at the base of the brain, but there will be no degree of 
activity in the cerebrum. 

Dreams never occur in perfectly sound sleep. They are an indica¬ 
tion that there is not complete cessation of activity in the cerebrum. 
The will being dormant, the various faculties act in an irregular, dis¬ 
orderly manner, giving rise to a great variety of absurd, grotesque, in¬ 
consistent mental pictures. It has been remarked that dreams are the 
best index to a person’s character, since they are really but the echoes 
of our waking thoughts. The superstitious confidence which many 
persons put in dreams is in the highest degree unphilosophical, and has 
not a shadow of evidence in its favor. Late eating and deficient phys¬ 
ical exercise are the most common causes of bad dreams. 

Somnambulism. —The habit of walking about while asleep is one 
of the most curious of all the phenomena of nervous action. The som¬ 
nambulistic state is simply an exaggeration of the state of dream. It is 
a condition in which the intellectual faculties are dormant, while many 
parts of the brain seem to be even more active than usual. While in 
this curious state, persons will accomplish feats which would be impos¬ 
sible for them while awake. 

Many remarkable instances of somnambulism are recorded. For 
example, a story is told of one Cortelli, who “ was found one night 
asleep in the act of translating from a dictionary. When his candle 
was extinguished, he arose and went to seek another light. When 
any one conversed with him on any subject on which his mind was 
bent at the time, he gave rational answers, but he seemed to hear 
nothing that was said to him or near him on other subjects. His eyes 
also seemed to be only sensible to those objects about which he was 
immediately engaged, and were quite fixed; so much so, that in read¬ 
ing he turned the whole head from side to side instead of the eyes.” 


MESMERISM. 


147 


Another very remarkable case is related by the Archbishop of 
Bordeaux in the “ Encyclopedia Methodique.” “ It was concerning a 
young priest at the Catholic seminary, who used to rise in his sleep 
and write sermons. Having written a page, he would read it aloud 
and make corrections. ‘ I have seen,’ says the Archbishop, ‘ the be¬ 
ginning of one of his sermons which he had written when asleep ; it 

was well composed.’.He continued to write, although 

a card was held between his eyes and the paper. Did the history stop 
here, we should have a well-authenticated case of vision without the 
aid of the eyes. But the collateral circumstances show that this writ¬ 
ing was accomplished, not by sight, but by a most accurate mental 
representation of the object to be attained. For after lie had written 
a page requiring correction, a piece of blank paper of the exact size 
was substituted for his own manuscript, and on that he made the cor¬ 
rections in the precise situation which they would have occupied on 
the original page. A very astonishing part of this report is that which 
relates to his writing music in this sleeping state, which it is said he 
did with perfect precision. He asked for certain things, and saw and 
heard such things, but only such things, as bore directly upon the sub¬ 
ject of his thoughts.” 

There seems to be a very close relation between the somnambulistic 
and the mesmeric states. In both there is voluntary action, though the 
will does not seem to be fully dominant, since movements appear to be 
in a considerable degree automatic. 

Mesmerism. —The secret of mesmerism appears to be in getting 
the will of the subject inactive, and then putting his sensational 
centers in operation through the medium of the senses. We cannot 
imagine that a person could be mesmerized who could neither hear, 
see, nor feel. From a somewhat careful study of the nature and phe¬ 
nomena of mesmerism we are convinced that at least the greater share 
of the manifestations, if not the whole, can be explained in this way. 
At least, we have never seen manifestations which could not be thus 
explained, without the supposition of any occult force. When a per¬ 
son is to be mesmerized, he is placed under conditions the best calcu¬ 
lated to make the will dormant. There must be silence. The subject 
is usually told to direct his eyes upward, either looking at his hand or 
at some small, indifferent object which presents few details to furnish 
fund for thought. After a certain length of time, longer or shorter, 
according to the individual, in some persons the mind will become va- 


148 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


cant of thought, the will inactive. The mental organs are then in a 
condition exactly analogous to that of a scale beam evenly balanced. 
It is ready to act just according as the impression shall be made, and 
so nicely adjusted is the balance that only a very slight impression is 
necessary to turn the scale. The operator then closes the eyes of the sub¬ 
ject or tells him to do so, perhaps placing his fingers upon his eyes for 
a moment. Then he will say to him in a very positive manner, “ \ ou 
cannot open your eyes.” The operator does not ask the subject if he 
can open his eyes, but assures him that he cannot. If he finds that 
the eyes are not opened, he then feels quite sure that his subject is in 
a condition to be influenced. Then when he tells him to open his eyes, 
they are opened. He wishes him to appear to be engaged in fishing. 
He puts into his hands something slightly resembling a fishing-rod, it 
may be a ruler or a cane. Then he puts into his mind the desired 
idea by telling him that the object he holds is a fishing-rod. He offers 
him something and calls it a line, pretends to find the hook and to 
put a worm upon it, then points in an appropriate direction and says, 
“ There are the fish, see them ! throw in your line and catch one.” 
Thus the mind of the subject is influenced by what is said and done 
to him, what he sees, hears, feels, and otherwise appreciates through 
his senses. All persons cannot be influenced in this way, simply be¬ 
cause their positive mental organization will not allow the mind to 
become vacant and the will dormant. Persons who are easily mes¬ 
merized are those who are naturally easily influenced, whose imagina¬ 
tions are easily excited. A condition very similar to the mesmeric 
state can be induced in animals as well as in human beings. 

The most popular and successful mesmerist at present exhibiting 
in this country said to us a few months since in a conversation on 
the subject of mesmerism, in answer to the question whether the sub¬ 
ject was not affected wholly through the medium of the senses, “Yes, 
chiefly so.” He endeavored to maintain that there was some degree 
of direct action of mind upon mind, but was utterly unable to pro¬ 
duce an instance in which this was done, even when full credit was 
given to his own testimony. There is evidence for believing that the 
cases which seem to illustrate this power of mind are cases of fraud. 

Animal Magnetism. —So much has been said upon this subject of 
late years that we cannot refrain from offering a word upon it, es¬ 
pecially as there exist such wide-spread errors concerning it. 

The doctrine of an occult force by which one person may operate 


ANIMAL MAGNETISM. 


149 


upon another, or by which one mind may affect another otherwise 
than through the medium of the senses, seems to have originated in 
Paris, in the latter part of the last century, with a pretender whose 
claims were investigated by a committee appointed for the purpose by 
the French Academy. Benjamin Franklin, who then resided in Paris, 
was a member of the committee. After a careful and thorough ex- 
animation of the claims of the pretender, they were pronounced to be 
utterly unfounded, it being decided that the phenomena apparently 
due to the operation of some unseen force, were wholly attributable to 
the imagination of the subjects rather than to magnetic or any other 
form of force communicated by the operator. 

We firmly believe that this simple explanation was the correct one 
then, and is correct still. We have never yet seen nor heard of any 
phenomena of the sort in question which were not fairly attributable 
either to the imagination or to some tangible cause which could be 
easily pointed out. A few years ago while studying the medical uses 
of electricity with one of the most eminent physicians of New York 
City, who was at that time in charge of the department of nervous dis¬ 
eases at the great Demilt Dispensatory of that city, we had abundant 
opportunity of testing the matter, and were fully satisfied with the 
results. 

The physician referred to was at that time engaged in a series of 
experiments in what he termed mental therapeutics. Under the guise 
of animal magnetism he was experimenting upon the imagination of 
the patients who came under his care. Not a particle of medicine was 
used, nor any other remedial agent. The patient was simply made to 
believe that he was being treated by means of a powerful magnetic 
current; yet, as the Doctor frequently remarked, tlce results were as 
good as under any method of treatment he had ever employed. The 
same method was not adopted in all cases, but was varied according 
to individual peculiarities, the same general principles being followed, 
however, throughout the course of experiments. In some instances 
the patient was allowed to think that the magnetic virtue had been 
imparted to a certain very bad tasting but inert liquid of which he 
was, with much solemnity, directed to take exactly one drop once in 
twenty-four hours, just as the clock was striking twelve, and on no 
account to take a larger quantity, or to take it at any other time, as 
the consequences might be something terrible. The effect of infinites¬ 
imal doses was under these circumstances decided enough to gratify 


150 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


the most enthusiastic advocate of high potencies. A solution of noth¬ 
ing in reality but a bad taste, potentized by the imagination of the 
patient, wrought wonders of which the most successful “magnetic 
healer ” would be proud to boast. Yet there was no chance for the 
operation of any other force than the minds of the patients themselves. 
To the influence of the mind upon the body must be attributed all the 
so-called magnetic cures. 

A careful study of the nervous system and of the nature of nerve 
force makes it very apparent that the only way in which one mind 
can operate upon another is through the senses. From all we know 
of the mind, its only avenues of knowledge are the seven senses. 
These may receive impressions from external objects and transmit 
them to the brain; but there is no other means known by which 
knowledge of any sort can be imparted. The idea that nerve force 
can be communicated through any other medium than nerves is not to 
be entertained for a moment by scientific physiology. The simplest 
experiments demonstrate the fact that nerve force, volition, mind im¬ 
pulses, or whatever the force may be called, can travel on nothing but 
nerves. For instance, suppose the nerves which control the hand be 
divided. The most powerful effort of the will possible is now utterly 
powerless to cause the hand to move or to show any sign of obedience 
to the mind. The ends of the divided nerve may be united by mus¬ 
cular fibre or other living tissue, but still the channel over which nerve 
force is wont to travel with such -rapidity is wholly interrupted. The 
best conductors of electricity, a force more closely allied to nerve or 
mind force than any other, may be used to splice the divided ends, 
but still the result is the same. The divided nerve ends may be 
pressed together as closely as mechanical contact can be made, and yet 
there will be no transmission of force beyond the point of division. 
Before the connection between the brain and the hand can be restored, 
the ends of the nerve must grow together, there must be a restoration 
of the continuity of structure which was broken down in the severing 
of the nerves. When this is done, the nerve resumes its function. 
The nerve force travels over it with the same facility as before, and 
the hand is again under the domination of the will. The deduction 
is a very clear one that if the mind cannot control or in any way in¬ 
fluence an organ which is actually a part of the body, through which 
the same blood flows which circulates in the brain, and the muscular 
and membranous and bony tissues of which are one with the rest of 


ANIMAL MAGNETISM. 


1 51 


the body, the only difference being the division of some of the nerves 
or force conductors,—if under these circumstances the mind or will is 
powerless to opei'ate, then how can it be possible that it should have 
power to aflect by mere volition objects which are remote from it, or 
even objects which may be touched by the outer surface of the body ? 
There can be but one answer to this question. The brain can only 
operate through the medium of nerves. 

But we shall be asked to answer several questions. Perhaps the 
most frequent query will be, “ If this view be correct, how do you ac¬ 
count for the magnetic influence which some persons seem to possess 
by which they can influence an audience so wonderfully, swaying their 
feelings at will ? ” We answer, there is no evidence that any person 
possesses such magnetic power. Individuals often possess wonderful 
powers of influence, and people differ much in this respect. One man 
will hold a large audience spell-bound for hours, while another can 
scarcely keep a half-dozen in their seats until he has finished. The 
difference consists, not in the possession of magnetism by one and its 
want by the other, but in the different manner in which the two per¬ 
sons address their hearers. Let the most powerfully “magnetic” 
speaker stand before an audience of persons who are both blind and 
deaf, and how much influence could he have over them ? Not a whit. 
He might exert himself to his utmost, he might imagine himself a 
powerful generator of magnetism, and suppose himself to be throwing 
out oceans of magnetic force, but the result would be wholly negative. 
If a force of the kind supposed really existed, the persons situated 
under the circumstances described would feel its influence as really 
and as intensely as though they could both see and hear. This simple 
experiment would settle conclusively the question of magnetism in 
public speakers, and would make evident the fact that what is termed 
magnetism in these cases is simply the sum total of the qualities 
which go to make up a good speaker, especially the gestures, the ex¬ 
pressions of the face and attitudes of the body, the quality and inflec¬ 
tions of the voice, the personal appearance of the speaker, and like 
qualities, all of which appear to the senses and depend for their influ¬ 
ence wholly upon the impressions thus made. 

“Magnetic rubbers” effect their cures in two ways: by means of 
exciting the imagination of the patient, and by means of the vigorous 
rubbing to which they frequently subject their patients. It is partic¬ 
ularly noticeable that this class of quacks never cure any organic dis- 


152 


ANATOMY , PHYSIOLOGY , AiV£> HYGIENE. 


ease. In many instances the maladies which they seem to expel as by 
magic are imaginary ills which do not really exist at all, except in the 
mind of the patient, or trivial functional disorders which are readily 
controlled by the mind when the patient is made to believe himself 
well. As a means of curing diseases through mental influence, the 
myth, “ animal magnetism,” is unrivaled, and as such it has done a 
great amount of good ; but on the other hand the belief in this fallacy 
has done a vast deal of harm by diverting the minds of the credulous 
away from the true principles of hygiene and the healing art. Hence 
we believe that it ought to be thoroughly exposed and condemned. 
Whatever good there may be in appealing to the imagination as a 
means of cure can be utilized without resorting to any such quackery 
as is universally connected with the practice of “ magnetic doctors.” 

Mind-Reading. —The recently developed phenomena of mind¬ 
reading, so called, have been taken by many as positive evidence of the 
existence of some hidden means by which one mind may communicate 
with another otherwise than through the medium of the senses. We 
have been much interested in the phenomena exhibited by persons 
professing to have this power, and have taken some pains to investigate 
them; We enjoyed the opportunity of being present, by invitation, 
at a meeting of scientists, clergymen, physicians, and lawyers, held for 
the purpose of testing the claims of the first mind-reader who ap¬ 
peared before the public, a few years since. The operation called 
mind-reading consisted in the operator’s taking the hand of the person 
whose mind was to be read and pressing it firmly against his forehead, 
after having been securely blindfolded, and then leading him to some 
place in which the individual had previously secreted some object 
without the knowledge of the operator. In nearly every case this 
was done successfully, no matter how distant the spot nor how cir¬ 
cuitous the route taken in secreting it. The operator claimed to put 
his mind in communication with that of the person with whom he 
was operating, and to learn by this means the location of the object. 
The result of the investigation was to show very clearly that the pre¬ 
tended mind-reader could not read the mind of any one but himself, 
and that he had no means of getting information except through the 
senses; but that he possessed an uncommonly fine sense of touch by 
which he could appreciate very slight, and to the individual operated 
with, involuntary, muscular movements. It was always necessary that 
the subject should keep* his mind intently occupied with the object 


PHRENOLOGY. 


153 


during the whole experiment, otherwise it was never successful. This 
would naturally incline the individual to make the slightest resist¬ 
ance when moving in the direction of the object. This is undoubtedly 
the correct explanation of the mind-reading mystery. Dr. Geo. M. 



^emeration { 




tOEALTY / SUB HUITY q 


OEST R\jCTi 


lANJUAOE 


Fig. 76. A diagram showing the position of the various mental organs or “bumps” 

as located by phrenology. 


Beard, of New York, and other eminent scientists, have carefully in¬ 
vestigated the same phenomena, and have arrived at essentially the 
conclusions stated. 

Phrenology. —Probably no psychological theory originated in 
modern times has had so great an influence upon the minds of the 
civilized people of the globe as has the theory originated by Gall and 
Spurzheim, known as phrenology. Taken together with physiog- 



























154 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


nomy, this theory attempts to determine a man’s character by the ex¬ 
ternal configuration of his skull and face. With the exception of a 
very few points which may be considered as quite well established 
by physiological and pathological observations, the theory must be 
considered as strictly empirical in character. As such, it must be sub¬ 
ject to great changes. Since it cannot be said to have an anatomical 
basis, as all settled theories relating to the brain and nervous system 
must have, phrenology is certainly liable to great and very considera¬ 
ble changes, as the structure and functions of the brain are more 
thoroughly worked out by scientific research. 

While there is much that is good in phrenology as taught by its 
ablest exponents, it is capable of being made an agent for great in¬ 
jury; and we have sometimes questioned whether almost as much 
harm as good was not done by it as it is generally used. Attracted 
by its novelty, thousands have studied it sufficiently to get a very 
slight smattering of the names and locations of the “bumps,” and 
then, supposing they possessed all the requisites to make them com¬ 
petent to delineate the characters of their fellows, point out deficien¬ 
cies and merits, etc., they have set themselves up as phrenologists, 
head-examiners, bump-feelers,—blunderers would be a much more 
proper term to attach to them,—when in fact they hardly possessed 
intelligence and mother-wit enough to become first-class barbers. 
The amount of trash which has been retailed about the country, es¬ 
pecially in the rural districts, under the name of phrenology, is ap¬ 
palling. The harm that these charlatans do is incalculable. They 
fumble the heads of those who visit them, assume a wonderfully wise 
look, and then proceed to deal out to them a character according as 
their fancy dictates, or as will the best serve their purpose. Even 
when a man has sufficient information and experience to enable him 
to form a nearly correct estimate of a person’s character, he may still 
be utterly unqualified to give the proper advice to individuals re¬ 
specting the best course to pursue to remedy their defects. The busi¬ 
ness of giving advice to people concerning the work of reforming de¬ 
praved characters, or correcting natural deformities of mind, mental 
and moral, is certainly second to no other in which a human being 
could be engaged, and ought to be attempted only by one who is in 
the most eminent degree qualified for the work. The problems 
which come before a physician who deals with the sick and disor¬ 
dered body are the simplest possible compared with those which pre- 


PHRENOLOGY. 


155 


sent themselves for solution to those who profess to be the physicians 
of the mind. Bad advice given by such an individual may do an in¬ 
calculable amount of harm, as we have had occasion to observe in 
more than one instance. We have known cases in which persons 
who had lived happily for some time in the relation of husband and 
wife have suddenly discovered that they were wholly uncongenial 
and incapable of being happy together after going to a phrenologist 
and being told that they were not adapted to each other. Not long 
since a young man rushed into our office in most precipitate haste, 
having hurried much as he knew we were about leaving to make a 
professional visit. He carried on his face a look of the most profound 
anxiety. There was evidently a real trouble on his mind. As we 
were about going out he begged us to stop just one moment. We in¬ 
quired if he was sick. “Oh, no,” he said, “but I must see you just 
one moment.” “ Is some one else suddenly taken ill ?” we asked, 
really feeling some little alarm, as he appeared so solemn and anxious. 
“No one is sick, he replied, “but I want to see you a moment to find 
out what I am good for.” We were puzzled and*asked for an expla¬ 
nation, which he promptly made by saying that he had just made a 
visit to a phrenologist who informed him that he had made a mistake 
in choosing the life-work for which he was fitting himself, the gospel 
ministry, and that he should prepare himself for a physician instead. 
The young man was much agitated in reflecting that so much time 
had been lost, and wanted to begin at once in his proper sphere if he 
could do so. We quieted his fears when we learned the cause, advised 
him to pay no attention to the counsels of his unwise adviser, and to 
pursue the even tenor of his way as before. He was manifestly un¬ 
fitted for the work of a physician, though he had a great love for 
books, delighted in the study of language, was highly conscientious, 
and very desirous of doing good to his fellow-men. His lack of power 
to adapt himself to circumstances, and especially his want of ingenu¬ 
ity either mechanical or otherwise, clearly indicated that almost any 
other calling would be better fitted to him than that suggested by his 
adviser, who charged him a half-dollar for counsel which would have 
made his life a failure had he followed it. Upon inquiry we learned 
that the self-styled phrenologist had condemned his plan to fit himself 
for the ministry on account of his not possessing the phrenological sign 
of large language, although in fact he had a most excellent memory of 
words, having already acquired good command of three modern lan- 


156 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


images. The work of such men is damaging to the world, and far 
more so than they have any idea themselves. 

We believe that phrenology in the hands of those who make it a 
specialty has been carried to an extreme; that claims are made by its 
advocates of powers which they do not and cannot possess. It is this, 
in fact, which has made the art,—it can hardly be called a science as 
yet,—obnoxious in the eyes of the great mass of scientists. Seeing that 
some claims are preposterous, they have neglected to investigate or 
give credit to any part of what is claimed. The many investigators 
who are now at work upon the cerebrum, examining its structure with 
the closest scrutiny of the microscope, and its functions by means of 
experiments upon living animals the nearest like man in their anatom¬ 
ical structure, will undoubtedly develop in time some facts bearing 
on this subject which will place what is true of the present phreno¬ 
logical doctrines upon a strictly scientific basis, and will add to them 
such elements as they lack of the completeness and definiteness which 
is required for a thoroughly symmetrical system of psychological 
science. • 

HYGIENE OF THE BRAIN AND NERVES. 

As the brain and nerves are the controlling parts of the system, it is 
evident that upon the preservation of their health must depend in a very 
great measure the health of the whole body. A man whose brain and 
nerves are diseased cannot be healthy otherwise; neither is a person 
whose nervous system is in a healthy condition likely to be diseased oth¬ 
erwise. The marked increase in nervous affections of late years has be¬ 
come so noticeable that almost every medical writer calls attention to it, 
and this fact makes especially important the consideration of the laws 
which relate to the healthy action of this part of the body. The nerv¬ 
ous structures are the most delicate of all the elements of the body; 
and when we consider the additional fact that they are subjected to more 
constant use than any other set of tissues, it certainly is not surprising 
that they should be specially subject to disease; but the great depend¬ 
ence of all other parts of the body upon the nerves makes it still more 
important that their integrity should be preserved. 

Necessity for Mental Exercise— Nerves as well as muscles re¬ 
quire exercise to promote their growth and insure their development. 
That both brain and nerves are capable of development by exercise, and 
that development of these structures is largely dependent upon proper 


NECESSITY FOR MENTAL EXERCISE. 


157 


exercise, are facts too well established to require proof by systematic evi¬ 
dence in this connection. Every-day experience convinces us of the fact. 
In the sharp contests of mind with mind in the battle for existence and 
the strife for fame, riches, and worldly honors, the mind which has been 
the most carefully trained to efficient action, which has by mental gym¬ 
nastics learned to exercise to advantage its powers, always comes off vic¬ 
torious. It is not essential that the training should have been given in 
a school, or that the mental exercise should have been practiced in an 
academy or a college ; the farm, the workshop, the forest, or the coal-pit 
may have been the training-school or the gymnasium, but the work 
was done, and in such a manner as to secure a satisfactory result, and 
that is all that need be asked. 

Mental exercise lies at the foundation of mental growth and mental 
health, and indirectly, we believe, it furnishes a firmer basis for mus¬ 
cular and general physical health than can be attained without it. The 
commonly received notion that mental work is harmful and incom¬ 
patible with physical health we believe to be a gross and pernicious error. 
Our college students, male and female, who break down in health just 
as they have finished their studies, or before they have completed their 
course, are not victims to mental overwork, as a general thing. The 
same may be said of the great army of valetudinarian clergymen, law¬ 
yers, merchants, and others whose occupations are sedentary while in¬ 
volving considerable brain-work. In the great majority of instances, 
the failure of health in these cases is the result of flagrant violations of 
the commonest laws of health, such as deficient muscular exercise, bad 
food, late hours, fashionable dissipation, and, most of all, mental worry. 
The student hives himself up in his close study, probably smokes from 
three to a dozen cigars a day, lives upon the poorest boarding-house 
fare, and takes only just such little muscular exercise as he is compelled 
to do in going to and from his classes. Soon he finds his head dull, and 
he begins to worry because he is troubled to master his lessons. Now 
instead of gaining mental strength by his daily exercise, he is each day 
wearing out the vitality and wasting the very substance of his poorly 
nourished brain. Mental worry is corroding his intellectual powers, and 
he will sooner or later break down, a chronic invalid, and mental work 
will get the credit. In a similar way the clergyman, the lawyer, the 
politician, the merchant, breaks himself down. Thousands suffer with 
what is called “softening of the brain,” when that organ is wholly in¬ 
tact except so far as it suffers through sympathy with other diseased 
organs, the whole trouble being in the stomach and liver. 


158 


ANATOMY, PHYSIOLOGY, AND IIYGIENL. 


This subject is so generally misunderstood that we deem it worth 
while to devote considerable space to it, and hence we will call attention 
to a few facts in support of these views, which we have for several 
years advocated in various ways, chiefly in lectures and through the 
journal of which we have had the editorial charge. 

1. There is nothing in mental work which should make it especially 
liable to break down the constitution. On the other hand, it is well 
calculated to insure the highest degree of health. Since all the force 
manifested in the body originates in the nerve centers, chiefly in the 
brain, it is evident that the more vigorous the brain, the more vigorous 
the manifestations of force in the organs dependent upon it. And this 
is^just the condition produced by mental labor. The brain grows in 
strength and vigor under exercise, and hence becomes capable of send¬ 
ing out more vigorous impulses to the various parts of the body depend¬ 
ent upon it for supplies of force. 

Mental exercise is also agreeable to those who devote themselves to 
it. Authors, philosophers, poets, lawyers, enjoy their work, if successful 
in it; and only those who are successful, at least in a moderate degree, 
continue these pursuits. The same cannot be said of the mere mechanic 
or artisan who toils almost as mechanically as the machines which he 
employs. The poet loves his work and is loth to leave it. The hod- 
carrier gladly drops his hod and rejoices that his daily task is ended 
when the work bell announces the time at which he is allowed to stop. 
The muscle laborer seldom works unless necessity demands it; while the 
brain-worker keeps on toiling as arduously as ever long after the accu¬ 
mulation of a competency makes his labor wholly unnecessary. We 
speak now, of course, of pleasant mental pursuits which are not dis¬ 
turbed by mental worry. The harrowing anxiety of the stock-broker or 
the gambler is not conducive to health, mental or physical. 

2. Brain-workers are long-lived. This statement will be almost 
certain to be disputed, and so we must fortify it with incontrovertible 
facts, which, fortunately, we are well able to do. Quite a little re¬ 
search has been made upon this question within the last few years, and 
with most decided results in favor of mental workers. 

According to an eminent French writer, Gorgias the rhetorician 
lived to the age of one hundred and eight years, “ without discontinuing 
his studies and without any infirmity.” Epimenides, one of the seven 
“ wise men,” lived to the great age of one hundred and fifty-four. Hip¬ 
pocrates, the father of medical literature, who was a diligent student 


NECESSITY FOR MENTAL EXERCISE. 


159 


and wrote voluminous works, many of which are still extant though 

V o 

penned more than twenty centuries ago, lived to the ago of ninety-nine ; 
and his master, Herodicus, attained the age of one hundred. Galen, 
one of the most celebrated physicians of antiquity, wrote three hundred 
volumes, many of which are consulted as authorities at the present day, 
and lived to be nearly a hundred years of age. Cornaro lived to the 
age of one hundred, though of a frail constitution, and did vigorous 
mental work for seven or eight hours a day until his death. The great 
Stoic, Zeno, a diligent student, lived to the great age of ninety-eight, 
when he put an end to his life while in the full possession of his facul¬ 
ties because he had received what he took to be an admonition that his 
time to die had come. Socrates was murdered at seventy-one in the 
prime of life. Pythagoras, Pindar, Quintilian, Chrysippus, and Thu¬ 
cydides lived to the age of eighty or upwards. Polybius and Plato died 
at eighty-one. Xenophon, Diogenes, and Carneades died at ninety. Eu¬ 
ripides lived to the age of eighty-five. Anaxagoras died at seventy-two, 
and Aristotle at sixty-three. All of these men were hard-working stu¬ 
dents of nature and philosophy. They were the representative men of 
their times. They did work which has resisted the ravages of time and 
come down to us through the Dark Ages, in many respects work which 
cannot be surpassed in excellence, and often is unapproachable in its per¬ 
fection. Yet all of them lived to almost double the present average 
length of life. Their average length of life is more than ninetv-one 
years, which certainly does not militate against mental work as con¬ 
ducive to longevity. 

Dr. Madden, in an able work on the “ Infirmities of Genius ” gives 
twelve tables of noted men of twenty names each, which sum up as fol¬ 
lows :— 


AVERAGE AGE. 

Twenty Natural Philosophers, . . . . . .75 

(( 

Moral Philosophers, ...... 

70 

cc 

Sculptors and Painters, ...... 

70 

cc 

Authors on Law, etc., ..... 

G9 

cc 

Medical Authors, ....... 

68 

cc 

Authors on Religion, ...... 

67 

CC 

Writers on Language, ...... 

66 

CC 

Musical Composers,. 

64 

cc 

Miscellaneous Authors, ...... 

62 

cc 

Dramatists, ....... 

62 

cc 

Writers on Natural Religion, ..... 

62 

CC 

Poets, 

57 

Average of these Two Hundred and Forty Brain-Workers, . 

66 


160 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


That the unusual longevity of the brain-workers already referred to 
was not due to the fact that they lived at an earlier age of the world is 
evidenced by the fact that the same characteristic is noticeable among 
mental workers of the present day, as is shown by the following table, 
which is made up of men who have lived in recent times :— 


Bacon, Boger, 

78 

Young, 

84 

Buffon, 

81 

Ferguson, 

92 

Galileo, 

78 

Kant, 

80 

Copernicus, 

70 

Reid, 

86 

Lowenlioeck, 

91 

Goethe, 

82 

Newton, 

84 

Crebillon, 

89 

Whiston, 

95 

Goldoni, 

85 

Erasmus, 

69 

Watt, James, 

83 

Bentham, 

85 

Hobbes, 

91 

Mansfield, 

88 

Locke, 

72 

Le Sage, 

80 

Stewart, D., 

75 

Wesley, John, 

88 

Yoltaire, 

84 

Hoffman, 

83 

Cumberland, 

80 

Pinel, 

84 

Southern, Thomas, 

86 

Claude, 

82 

Coke, Lord, 

85 

Titian, 

96 

Wilmot, 

83 

Franklin, 

85 

Rabelais, 

70 

Halley, 

86 

Harvey, 

81 

Rollin, 

80 

Heberden, 

92 

Waller, 

82 

Michael Angelo, 

96 

Chalmers, 

83 

Handel, 

75 

South, Dr., 

83 

Hayden, 

HI 7 

i ( 

Johnson, Dr., 

75 

Ruysch, 

93 

Cherubini, 

82 

Winslow, 

91 

Herschel, 

84 

Morgagui, 

89 

Laplace, 

77 

Cardan, 

76 

Linnceus, 

72 

Fleury, Cardinal, 

90 

Metastasio, 

84 

Auguetel, 

84 

Milton, 

66 

Swift, 

78 

Bacon, Lord, 

65 

Watts, Dr., 

74 


The average age of all the above-named persons, sixty in all, is a lit¬ 
tle more than eighty-two. 

It is very evident that experience is decidedly against the commonly 
received notions on this subject. Though further evidence n scarcely 
needed, we may add the following from a recently published paper by 
Dr. Geo. M. Beard, of New York, well known as an eminent electrician 
and neurologist:— 

O 



PROPER DEVELOPMENT OF CHILDREN’S MINDS. 


161 


“ I have ascertained the longevity of five hundred of the greatest 
men in history. The list I prepared includes a large proportion of the 
most eminent names in all the departments of thought and activity. 

“ It would be difficult to find more than two or three hundred illus¬ 
trious poets, philosophers, authors, scientists, lawyers, statesmen, gen¬ 
erals, physicians, inventors, musicians, actors, orators, or philanthropists 
of world-wide and immortal fame, and whose lives are known in suf¬ 
ficient detail, that are not represented in this list. My list was prepared, 
not for the average longevity, but in order to determine at what time of 
life men do their best work. It was, therefore, prepared with abso¬ 
lute impartiality; and includes, of course, those who, like Byron, Ra¬ 
phael, Pascal, Mozart, Keats, etc., died comparatively 3 -oung. Now the 
average age of those I have mentioned, I found to be 61.20. 

“ The average age at death at the present time, of all classes of those 
who live over twenty years, is about fifty. Therefore the greatest men 
of the world have lived longer, on the average, than men of ordinary 
ability in the different occupations, by fourteen years ; six years longer 
than physicians and lawyers ; nineteen or twenty years longer than 
mechanics and day-laborers; from two to three years longer than 
farmers ; and a fraction of a year longer than clergymen, who are the 
longest-lived in our modern society.” 

Dr. Beard states among other conclusions at which he has arrived as 
the result of his investigations,— 

“ 1 . That the brain-working classes—clergymen, lawyers, physicians, 
merchants, scientists, and men of letters—live very much longer than 
the muscle-working class. 

“'‘2. That those who follow occupations that call both muscle and 
brain into exercise, are longer-lived than those who live in occupations 
that are purely manual. 

“ 3. That the greatest and hardest brain-workers of history have 
lived longer on the average than brain-workers of ordinary ability and 
industry. 

“ 4. That clergymen are longer-lived than any other great class of 
brain-workers.” 

Proper Mode of Developing the Minds of Children. —That 
there is a right way and a wrong way of dealing with young minds in 
order to develop them so as to fit them for their highest usefulness in 
after-years, is patent not only from the nature of things, but from the 
unsuccessful results to be seen in the illy developed minds of thousands 
11 


102 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


of men and women whom we daily see trying in vain to make their 
way well in the world against the numerous obstacles placed in their 
pathway, the most insurmountable of which are the results of bad 
training. 

O 

In a great many instances, perhaps in the greater share of cases, 
the process of education is a process of perversion from first to last. 
The child, when put to school at an age altogether too early, instead 
of being led along the path marked out by Nature for him to walk 
in, in his pursuit of knowledge, is set to work, or gone to work 
at, in a manner the most remotely removed from the natural order. 
Instead of beginning where Nature does, with the development 
and training of the perceptives, the sources of knowledge, thus teach¬ 
ing the learner at the outset how to observe thoroughly and accu¬ 
rately, in nine cases out of ten the teacher begins by giving the child 
instruction which can have no other influence than to lessen his reli¬ 
ance upon his own powers of observation and perception, and lead him 
to take such information as is dealt out to him unquestioningly, and 
without being able to see any natural relations between the knowledge 
imparted and that which it is supposed to represent. Thus his edu¬ 
cation continues, Jjis mind being dwarfed by improper methods, and 
his body injured by unnecessary and harmful confinement, until the 
child either dies, becomes an educated dolt, or perchance, from natural 
brilliance of intellect, breaks away from the fetters forged around him 
and begins to think for himself at last, and then really begins to learn. 

The majority of children do not enjoy school-life. It is irksome 
to them. It is actually repulsive, and naturally so. Learning is made 
hard work, when for them it ought to be made play. Children do 
not generally like work, but they do love play; and if instruction 
could be imparted to them through methods which would be to them 
play, a great gain would be made. The efforts of the managers of 
Kindergartens in this direction are certainly commendable, and we 
hope they will be successfully introduced into every city and village 
in the land. We heartily concur in the following observations on this 
subject made by Hr. Iiichardson, one of the most eminent medical sci¬ 
entists of Europe:—• 

“ For children under seven years of age the whole of the teaching 
that should be naturally conveyed should be through play, if the body 
is to be trained up healthily as the bearer of the mind. And it is 
wonderful what an amount of learning can by this method be at- 


SCHOOL CRAMMING. 


1G3 


tamed. Letters of languages can be taught; conversations in differ- 
ent languages can be carried on; forms of animal life can be classified; 
the surface of the earth can be made clear; history can be told as 
story; and a number of other and most useful truths can be instilled 
without ever forcing the child to touch a book or read a formal lesson.” 

School Cramming. —Nothing could be more unscientific nor more 
unphysiological than the popular methods of instruction in vogue in 
most of our schools for youth as well as in those for small children. 
The idea of education entertained by the average teacher is that it 
consists in infusing into the mind of the pupil the largest possible 
amount of knowledge which it can be made to contain. Little is 
thought of the necessity for thorough and systematic discipline of the 
mental faculties. Consequently, it is generally the case that the stu¬ 
dent’s entire experience at school or college is one continual course of 
perversion. Instead of being taught how to think and study to the 
best advantage, how to investigate for himself, how to originate ideas 
and to become mentally independent, the student is continually dis¬ 
couraged by the methods employed by his instructors, from any at¬ 
tempt at originality or independence of thought, and thus becomes a 
dogmatic mental dwarf. AYe sincerely hope that the day will come 
when our educators will regard the primary object of schools to be 
culture and training of the human body, mentally, morally, and 
physically. 

No system of education can be complete which does not give due 
prominence to the pupil’s culture morally and physically, as well as 
mentally. The acquisition of knowledge should be regarded not as 
the primary object of education, but as a useful incidental result, ne¬ 
cessitated by the nature of the discipline to be acquired. 

Students should be thoroughly imbued with the idea that the ob¬ 
ject of their school-work is not so much to impart to them a knowl¬ 
edge of facts, as to teach them how to acquire facts, how to investi¬ 
gate, how to compare, how to reason, how to utilize knowledge after 
it has been acquired. The methods of education generally followed 
in our colleges, fill young men with facts, and pack their craniuins 
with the ideas of men who lived two thousand years ago, and then 
Graduate them and send them out into the world destitute of even a 
modicum of practical knowledge, without the ability to use the facts 
which they have gained. Such men have much knowledge, but are 
unable to use it to practical advantage; and a score of them are of 


164 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


less real use to the world than one practical man whose fund of in¬ 
formation is almost infinitely smaller, but who possesses the faculty of 
utilizing knowledge. There is great need of reform in our educa¬ 
tional institutions, and we are glad to see some evidences of improve¬ 
ment in this direction. The times call for practical men, and the pub¬ 
lic mind is being aroused to ascertain why there is so great a scarcity 
of men of this class. We hope the inquiry will continue, and that 
the agitation of the question which has begun, will increase until con¬ 
servatism, prejudice, and dogmatism, which are the chief obstacles 
against educational reform, are swept away by the rising tide of pub¬ 
lic opinion in favor of progress in this direction. 

Unsymmetrical Mental Development.— A marked tendency of 
the times is toward the selection of specialties, not only in the profes¬ 
sions, but in all departments of life. This seems to be necessary on 
two accounts: 1. The accumulated facts in the various departments 

of human knowledge is so great that a single mind cannot hope to grasp 
all. The best an individual can do is to become thoroughly conversant 
with one or two arts or sciences. Human life is not long enough, even 
if the capacity of the brain were sufficient, which there is reason 
to doubt, to master all that is known in the various subjects of study. 
2. Some persons are born with a peculiar fitness for certain pur¬ 
suits, mental or muscular, or both, and hence they will be most likely 
to succeed in those particular pursuits. This tendency, although it 
seems to be a natural outgrowth of the present state of society and of 
the world, and a necessary result of a high grade of culture, is never¬ 
theless detrimental to the individual. While it benefits society as a 
whole, making it more perfect than it could otherwise be, the gain of 
society is at the expense of its individual members, or of some of 
them at least. By the undue development of certain faculties to the 
neglect of others, the sum total of brain force is weakened, and the 
brain becomes a monstrosity, and the mind a distortion. It is more 
than probable that this specialization of labor and of mental develop¬ 
ment is one of the causes which induce, at first eccentricity and after¬ 
ward actual insanity, which is but one step removed from well-marked 
eccentricity. It is far better for each individual to acquire as equable 
a development as possible, mentally, physically, and morally; each 
one should endeavor to acquire as much as possible of this equable 
culture, as it will add force and endurance to the mind, even should 


STIMULANTS AND NARCOTICS. 


165 


the individual afterward become a specialist in some branch of 
knowledge. 

O 

Evils of Excessive Brain-Labor.— While a proper amount of 
brain-labor is in the highest degree wholesome and conducive to lon¬ 
gevity, as already shown, too much mental work is harmful in a high 
degree. The brain wears rapidly, and requires abundant time for 
rest and repair in sleep; when this is supplied, almost any amount of 
work may be performed which is possible to the individual. Brain- 
worry wears much faster than work, and to it should be attributed 
much that has been charged to brain-work. Physiologists have shown 
that three hours of severe mental labor exhausts the system as much 
as ten hours of severe physical labor, which leads to the conclusion 
that less time should be spent in mental labor than is usually spent in 
muscular labor between the intervals of rest. The student or profes¬ 
sional man who goads his brain into activity when it is exhausted by 
want of sleep or long and severe labor, commits a crime against him¬ 
self. The strongest mind will eventually break down under such 
usage. When the brain is weary, and thought is laborious, rest is re¬ 
quired, and it should be secured. 

Pernicious Effects of Stimulants and Narcotics.— Brain-work¬ 
ers are of all classes the most strongly tempted to make use of ex¬ 
citants to enable them to obtain from their tired nerves a little more 
work than they are capable of doing with safety. Alcohol, tobacco, 
tea, coffee, and chocolate are all used for this purpose, and with ap¬ 
parent advantage in some cases, temporarily at least. But the ad¬ 
vantage is only apparent. These drugs, and all others which operate 
in a kindred manner, are deceptive; they make a person believe he is 
not tired, when he is exhausted; they make him think he is warm, 
when he is really cold. They make him believe he is strong, when he 
is weak. Their use is most pernicious in its effects, since it more than 
doubles the danger from overwork. When in a natural condition, a 
man can tell by his feelings when he has gone to the full limit of his 
powers of endurance; but when his nerves are stupefied by alcohol or 
tobacco, or exhilarated with tea or coffee, he has no landmarks; he is 
at sea, and ls certain to meet with disaster and shipwreck unless he 
change his course. This subject is more fully considered in a chapter 
devoted to the subject, to which the reader’s attention is invited. 


166 


ANATOMY, PHYSIOLOGY , AAD HYGIENE. 


THE ORGANS OF SPECIAL SENSE. 


In such low forms of life as the mussel and the earth-worm, what 
little sensation is present is of a very simple kind. As we rise higher 
in the scale of being, the general property of sensibility is modified to 
meet the wants of the higher order of existence, and special properties 
are developed. In man, in whom is found the highest type of sensi¬ 
bility, there are, in addition to the general sensibility which pervades 
the whole body, seven varieties of sensation, termed the special senses. 
Formerly there were enumerated but five, hearing, seeing, smelling, 
tasting, and feeling; but two others have been added within a few 
years, the sense of temperature, and the muscular sense, or the sense of 
weight. Each of the first five of these requires a special organ for its 
manifestation ; to the study of these organs of the special senses and 
their functions we will now give our attention, considering the simpler 
organs first, and so gradually approaching the more complicated, which 
are undoubtedly the most wonderful exhibitions of delicate organiza¬ 
tion and perfect adaptation of means to ends in the body. 

THE SKIN. 

The skin contains the organs of touch, but cannot itself be called 
the organ of touch, as it performs several other functions, some of which 
are fully as important as this. The mucous membrane of the mouth 
and nose also possesses tactile sense. The skin is composed of two 
principal layers, which are easily separated, after death, by maceration 
in water. The inner of the two is the true skin, or cutis vera, in 
which are located all the organs and elements to which the functions 
of the skin are due. The basis of the structure of the skin is a dense 
network of elastic fibres, among which are closelv interwoven minute 
blood-vessels, nerve filaments, and lymphatic or absorbent vessels. The 
skin also contains little pockets, or follicles, from which the hair 
grows, each hair from a single follicle. Closely connected with the 
hair follicles are small glands, the function of which is the production 
of fatty or sebaceous matter. Here are also found the perspiratory or 
sweat glands, which will be more accurately described elsewhere. 
Another interesting element of the true skin is involuntary muscular 
fibre, the contraction of which draws the skin into the peculiar condi¬ 
tion known as goose-flesh. 






Plate I V. THE S'KIN. 


Showing a Vertical Section of the Skin, greatly magnified. a. a. Hairs m 
their follicles, connected with which are the Sebaceous Glands ; c. Sweat Gland 
with its duct; d. d. Blood-Vessels. 



















THE SENSE OF TOUCH. 


1G7 


The cuticle, or epidermis, is wholly made up of cells, which are pro¬ 
duced by the true skin beneath. As the cells grow older they become 
shrunken and dead, and are gradually pushed out to the surface, becom¬ 
ing dried and falling oft’ as new cells are pushed out beneath. These 
dead cells give to the epidermis a horny character, and when viewed 
with a microscope its outer layers are seen to be composed of delicate 
little scales, which are the dead cells referred to. The lower part of the 
epidermis contains colored cells, upon which the color of the skin in dif¬ 
ferent persons and different races depends. In the negro these cells are 
abundant, giving to the skin a black color. In the lighter races they 
are less abundant, there being very few in the skin of the Caucasian, 
and none at all in the albino, whose transparent epidermis shows very 
clearly the red color of the living tissues beneath, with their abundant 
supply of blood-vessels. 

The thickness of the cuticle varies in different parts of the body and 
in different persons. Its use is to protect the true skin beneath. 

The structure of the skin is very well shown in Plate IV. 

The nerves of touch terminate in the true skin, in a variety of ways. 
It is probable that in the majority of instances they end in the hair fol¬ 
licles already mentioned; but in the parts of the body in which the 
sense of touch is most acute, as the hands, a special arrangement to give 
the greatest possible delicacy is provided. This consists of what is 
known as tactile corpuscles, which are cone-shaped, corpuscular, resist¬ 
ing bodies located in the papillaa of the skin, as shown in the plate. 
The nerve fibi'es which convey tactile impressions terminate in these 
bodies, after coiling two or three times among them. The resistance 
which the corpuscles afford, adds greatly to the delicacy of the sense 
of touch. It is their presence in large numbers at the ends of the fin¬ 
gers which gives to tins part of the skin such accuracy of touch. More 
than one hundred of these corpuscles were counted in a space near the 
end of a finger -fa of an inch square, which would make more than 
200,000 to the square inch. 

The Sense of Touch. —Of the seven special senses this is undoubt¬ 
edly the most simple; yet through it we learn many of the most im¬ 
portant facts which we possess concerning external objects. We learn by 
it such properties of objects as size, form, and character of surface as to 
smoothness or roughness. The sense of touch greatly assists the other 
senses in acquiring correct ideas of the nature of bodies. We are rarely 
fully conscious of our real dependence upon this sense, or of the degree 


168 


ANATOMY, PHYSIOLOGY , AND HYGIENE. 


to which it may be developed, until deprived of some of the other senses, 
especially sight. Numerous examples are given of persons who, upon 
losing their sight, have been enabled to develop their sense of touch to 
such a degree as to be really marvelous. Probably one reason for this 
remarkable increase in the delicacy and efficiency of touch is the concen¬ 
tration of the attention upon it when the sight is absent from birth, or 
has been destroyed. 

The sense of touch differs greatly in delicacy in different parts of the 
body. The acuteness of the tactile sense in any part may be readily 
tested by observing the distance at which two pin points may be placed 
from each other without being recognized as two distinct objects. For 
example, two points applied in this way to the hand, will be recognized 
as two when but a slight distance apart; while upon the back they 
may be removed some considerable distance without being distinguished 
as more than one object. In this way the ■whole skin has been tested, 
the results showing that of all parts, the tip of the tongue is the most 
sensitive, recognizing points which are not more than one-twenty-fifth 
of an inch apart. The tips of the fingers rank next in sensibility, dis 
tingulshing objects which are no nearer to each other than one-seven¬ 
teenth of an inch. From the tips of the fingers the acuteness of touch 
rapidly diminishes as we recede, being represented by a distance of one- 
seventh inch at the portion of the finger next the palm of the hand, one- 

third on the back of the fingers, 
three-fifths on the back of the 
hand, two-thirds on the skin of 
the throat, one and one-half 
inches on the sternum, and two 
inches at the middle of the back. 
The cheek is much more sensi¬ 
tive than the back of the hand, 
recognizing objects at one-third 
of an inch. Objects are recog¬ 
nized on the dorsum of the foot 
at a distance of one inch. 

The sense of touch may be regarded as one of the most reliable of all 
the senses ; yet we are liable to deception by it if impressions are re¬ 
ceived in a manner different from that in which they usually are. This 
fact is illustrated by an experiment the origin of which dates back to 
Aristotle. If two fingers be crossed as shown in Fig. 77, and a small 






THE MUSCULAR SENSE. 


1G9 


object placed between the ends, the impression will be that two objects 
are felt. The reason of this evidently is that by crossing the fingers 
the two sides of the fingers opposed are such as have been taught to dis¬ 
tinguish separate objects, and they tell the same story which they have 
been educated to tell, notwithstanding it does not agree with the 
facts. This shows clearly that the action of the nerves as well as that 
of the brain is largely the result of education. An illustration of the 
same fact is bo be found in a surgical operation sometimes performed for 
the restoration of a nose which has been destroyed by accident or dis¬ 
ease. In this operation the skin of the forehead is brought down and 
made to grow into the form of a nose ; but the sense of touch still re¬ 
tains the old position, so that when the new nose is touched, the impres¬ 
sion is conveyed to the brain that the forehead has been touched. After 
a few' months, however, the sense of touch is educated to recognize its 
new r position, and the difficulty is overcome. 

So with persons who have suffered amputation of a limb ; they con¬ 
tinue to feel the fingers or toes for some time. Persons have even 
claimed to feel actions which really occurred in amputated limbs. 
Such claims are, however, wholly based on the imagination. The phe¬ 
nomenon is due to the fact to v'hich attention has j ust been called, that 
the nerves form the habit of carrying impressions from certain points, 
and whenever irritated in any way, carry the same impression even if 
they are no longer connected with the original points. The deception 
gradually fades av'ay, the nerves by degrees becoming accustomed to 
their new condition, so that the amputated limb seems to grow' grad¬ 
ually shorter and shorter until its real condition is correctly recognized 
by the nerves. 


THE MUSCULAR SENSE, 

The sense by w'hich weight is appreciated, or the muscular sense, is 
supposed to be located in the muscles. It is evidently distinct from 
the sense of touch, because the tactile sense may be wholly obliterated by 
disease while the muscular sense remains. 

It is this sense which enables a person to j udge of the weight of an 
object, and to adjust his outlay of strength to the object to be lifted. If 
it w'ere not for this sense our movements w'ould be very irregular and 
spasmodic. 


170 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


THE SENSE OF TEMPERATURE. 

This sense bears a close relation to the tactile sense, but is aLo proven 
to be different because it often exists when the sense of touch has been 
lost by disease, and Is sometimes lost while the tactile sense remains intact. 
By means of this sense we are able to determine degrees of temperature 
within certain limits. When an object w T hich is very hot is brought in 
contact with the skin, the sensation is of pain, rather than of heat. It is 
a curious fact that the effect upon the nerves of sense as well as upon the 
tissues is essentially the same whether the object be very hot or very cold. 

The thermal sense is not an accurate measure of heat, since, as with 
all other forms of sensibility, its impressions are relative rather than 
positive. This is well shown by a simple experiment. Place in three 
vessels a quantity of water of different temperatures, making that in 
the first vessel very cold, that in the third very hot, and that in the sec¬ 
ond intermediate between the two. Place one hand in the cold water 
and the other in the hot, holding them in the water one or two min¬ 
utes. Then put first one hand and then the other into the middle vessel 
of water at the medium temperature. The curioffs fact will be ob¬ 
served that each hand tells a different story about the temperature of 
the water in this vessel. The one which has been in the hot water says 
it is cold, while the other hand, which was removed from the vessel of 
cold water, declares that it is warm. From this experiment it is clear 
that our ideas of temperature gained through the thermal sense are only 
relative. 

It is also worthy of notice that the apparent temperature of ob¬ 
jects depends in a great measure upon their character. An object 
which is a good conductor of heat seems to possess a much higher 
temperature than one which is a poor conductor, although the abso¬ 
lute temperature of both may be exactly the same. It is this fact 
which causes metals and liquids to seem warmer at a given tempera¬ 
ture than gases and solid objects composed of such poor conductors as 
wood, straw, hair, and similar substances. Liquids of a higher tem¬ 
perature than 120° can be borne but for an instant, while vapor of 140° 
or 150° can be endured without pain, and the whole body may be im¬ 
mersed in hot air at a temperature of 250° and upward with impu¬ 
nity. We have remained some minutes in a room of this temperature 
without the slightest injury; and persons have been known to en¬ 
dure a very much higher temperature in perfectly dry air. 


THE SENSE OF TASTE. 


171 


THE SENSE OF TASTE, 

The sense of taste, or gustatory sense, is located in the mucous 
membrane of the tongue, being attributable to two nerves, one of 
which is distributed in the anterior portion of the organ, and the other 
in the mucous membrane of the back part of the tongue and mouth. 
The terminal filaments of these nerves seem to end in little promi¬ 
nences with which the membrane is closely studded, which are known 
as 'papillce. The larger of these are supposed to be devoted to the 
sense of taste, while the smaller contain nerves of touch and of the 
thermal sense, both of which forms of sensibility are possessed by the 
tongue in a high degree, especially by its tip, which possesses the most 
delicate tactile sense of any part of the body. This portion is not 
quite so sensitive to taste as the posterior portion of the organ. 

The sense of taste, like the senses of touch, weight, and tempera¬ 
ture, is exercised only upon bodies which come in immediate contact 
with it. In the case of taste, however, mere mechanical contact is not 
sufficient. An object to be appreciated by the gustatory sense must 
be dissolved, so that it may come in direct contact with the nerves of 
taste by penetrating the papillie in which they terminate; hence, any 
substances placed upon the tongue when dry, will not be tasted until 
dissolved, if at all; and insoluble substances evidently can possess no 
gustatory properties. When the tongue becomes* “ coated ” or “ furred,” 
as it often does in sickness, the sense of taste is greatly lessened in 
acuteness, which accounts in a great degree for the insipidness of 
foods and drinks so often complained of at those times. 

Physiological experiments seem to show that the sense of taste is 
confined to the tip, edges, and back portion of the tongue, and the 
back portion of the roof of the mouth and the soft palate, being ab¬ 
sent from the lips, gums, middle of dorsum or back of tongue and its 
under side, and from the front part of the roof of the mouth. 

Tastes are classified as acid, saline, bitter, and sweet, though it is 
evident that there are many flavors which are not included in this 
classification, and which cannot be accurately described. Of these 
different tastes it is curiously observed that those of a saline and bit¬ 
ter character are best appreciated by the back portion of the tongue, 
and sweet and acid flavors by the anterior portion. Some physiolo¬ 
gists claim that acids are best appreciated by the sides of the tongue. 
All of these various tastes seem to he increased by friction of the 


172 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


tongue against the roof and sides of the mouth, which is probably due 
to the diffusion of the sapid substance. 

Taste Aided by other Senses. —Many of the properties of sub¬ 
stances appreciated in the mouth prove, upon careful examination, 
to be recognized by other senses than that of taste, although credit is 
given to the latter. For instance, people often speak of astringent, 
oily, mealy, watery, smooth, burning or pungent, and cool tastes, when 
in reality these are not tastes at all, but are properties recognized by 
the senses of touch and temperature. So, also, substances are spoken 
of as having strong tastes when they have very little taste indeed, 
but are simply smelled when in the mouth. Sight is also an aid to 
the sense of taste by exciting agreeable anticipations. 

The Uses of Taste.—Besides being a source of gratification, the 
sense of taste is useful as a guide in the selection of food. As a gen¬ 
eral rule, substances which are unpalatable, repugnant to the taste, 
are unwholesome. There are, it is true, cases of individual idiosyn¬ 
crasy in which the sense of taste rejects articles which are really 
wholesome; but even in these cases the taste may many times be a 
correct guide, as the digestive organs are in close sympathy with the 
gustatory sense and might resent the usually wholesome aliment on 
account of the same unexplainable peculiarity. 

The taste is susceptible of education in a very high degree. Even 
the most repugnant substances may by degrees be made acceptable. 
Tastes vary greatly in different countries, one nation considering as a 
delicacy what would be most loathsome to others. For instance, noth¬ 
ing could be more repulsive to the palate of a Frenchman than the 
putrid flesh considered as a delicacy by some nations; and it is quite 
likely that the latter would consider equally disgusting the asafetida 
which the former sometimes employs as a flavor in his dainty dishes. 

Electrical Excitement of the Sense of Taste. —The sense of 
taste may be excited by a current of electricity as well as by sapid 
substances. A very simple experiment will illustrate this fact. Place 
upon the upper side of the tongue a piece of brightly polished zinc, 
and upon the under side a large copper penny or a silver half-dollar, 
bringing the edges of the two metals together at the tip of the tongue. 
In a few seconds a very strong metallic taste will be experienced. If 
the positive pole of a battery be touched to the tongue, while the other 
is held in the hand, an alkaline taste will be experienced ; and the ap¬ 
plication of the negative pole will produce a strongly acid taste. We 


THE ORGANS OF SMELL. 


173 


have frequently observed in practice that excitation of the nerve of 
taste is often felt by patients during the application of galvanism to 
other parts of the body. 

THE ORGANS OF SMELL. 

The organ of smell, or the olfactory sense, is located in the upper 
part of the nasal cavity, the mucous membrane of which part receives 
the branches of the olfactory nerve which are sent down from the ol¬ 
factory bulbs—a portion of the brain located just above—through a 
large number of very small openings in the floor of the skull, provided 
for this purpose. The balance of the mucous membrane of the nose is 
supplied with branches from the general sensory nerve of the face, 
and has nothing to do with the sense of smell. The ends of the ol¬ 
factory nerves are not imbedded in the mucous membrane as are the 
nerves of taste and the sensory nerves, but are exposed with a very 
slight covering of epithelium, so that they may receive more delicate 
impressions. Smell is produced by the actual contact of odorous par¬ 
ticles with the nerve filaments. It seems also to be necessary that 
these particles should be brought to the nose suspended in the air; 
since the nasal cavity may be filled with rose-water, the odor of which 
is very marked, without exciting the sense of smell in the slightest 
degree. Although a certain degree of moisture is necessarily main¬ 
tained, the presence of a large amount of fluid interferes with the 
function of smell altogether. In ordinary breathing, the air taken in 
through the nose passes only through its lower passages, and does 
not come in direct or immediate contact with the nerves of smell in 
the upper portion of the cavity; but odorous particles in the air reach 
the nerves of smell by diffusion of the air upward. By the act of 
sniffing, however, which is instinctively performed when we wish to 
intensify the sense of smell, the air is forcibly drawn up into the up¬ 
per part of the nasal cavity, and thus brings a larger number of parti¬ 
cles in contact with the olfactory nerve than in ordinary respiration. 

We are able, by means of the olfactory sense, to appreciate a very 
great variety of odors, the number of which is so great as to make 
almost utterly impossible any attempt to classify them. These odors 
can not only be distinguished when presented separately, but also 
when mingled they can be recognized individually. The quantity of 
material necessary to excite the sense of smell is exceedingly minute. 
A single grain of musk will fill a room with its odor for many years 
without appreciably diminishing in weight. 


174 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


It is a curious fact that mental impressions and associations are 
more closely connected with smell than with any other sense. Many 
persons are so susceptible in this regard that a very slight excitation 
of the sense with certain odors will cause them to faint. 

Uses of the Sense of Smell. —In addition to affording a great 
amount of pleasure by enabling us to recognize the numerous del¬ 
icate and pleasing perfumes which abound in nature, especially in the 
botanical world, the sense of smell apprizes us of unwholesome con¬ 
stituents in the air, and of our proximity to sources of injury to 
health. The olfactory sense thus protects not only the lungs and 
other respiratory organs, by enabling us to avoid irritating gases 
which might cause serious injury to the whole system, but it is also 
useful to enable us to judge of the properties of food, and to stimulate 
the appetite and the action of the organs of digestion. It is not true 
that all harmful substances possess bad odors, but it is almost univer¬ 
sally true that substances possessing an unpleasant odor are not 
wholesome. The sense of smell is a valuable sentinel to the citadel 
of life, and ought to be carefully guarded and protected. It may be 
educated to a great degree of delicacy. 

As a general rule the lower orders of animals possess this sense in 
a much more acute degree than man. Wild animals will scent their 
prey or their enemies at a great distance. The keenness of scent in 
the dog is marvelous. This doubtless depends largely upon the fact 
that in animals of this class the olfactory nerve is spread over a much 
larger space than in man. In barbarous tribes the sense seems to be 
much more highly developed than in civilized man. Humboldt, the 
great naturalist and traveler, states that the natives of Peru can dis¬ 
tinguish in the dark between different races by this sense. 

HEARING: THE AUDITORY SENSE, 

The organ of hearing consists of three parts: 1. The external ear, 
a trumpet-shaped portion for collecting sounds; 2. The middle ear, 
or tympanum, a cavity separated from the external ear by a mem¬ 
brane resembling a drum-head in its character and use, and contain¬ 
ing several delicate bones, or ossicles, which play an important part 
in the action of the ear; 3. The internal ear, or labyrinth, which con¬ 
tains the terminal filaments of the auditory nerve and delicate appa¬ 
ratus connected with the reception of auditory impressions of various 
kinds. 


THE EXTERNAL EAR. 


175 


The External Ear. —The external portion of the ear consists of a 
framework of cartilage covered with skin, having a shape somewhat 
like that of a conch-shell. It is attached to the hones of the head in 
such a manner as to be easily movable within small limits. In lower 

animals the various movements 
admissible are produced by a 
special set of muscles for the 
purpose. In man these muscles 
are usually so slightly devel¬ 
oped that they are capable of 
producing no perceptible mo¬ 
tion, only in very exceptional 
instances. 

The outer portion of the ear 
is connected with the middle 
ear by means of a slightly 
curved canal about one and 
one-fourth inches in length, 
across the bottom of which is 
stretched the outer boundary 
of the middle ear. This canal 
is lined by a continuation of the skin of the ear, which here becomes 
very thin and sensitive, and contains glands that resemble the 
sweat glands found in other parts of the skin but which here secrete 
a waxy substance called cerumen, of an intensely bitter taste, the 
probable object of which is to guard the ear against the entrance of 
insects. Numerous fine hairs here found doubtless assist in protect¬ 
ing the ear from insects, dust, and other foreign bodies. The ear-wax 
is usually produced in small quantity, and dries and falls from the ear 
in thin scales. 



Fig-. 78. The Ear. The ent shows the External 
Auditory Canal, the Middle Ear with the Ossicles, 
and the Internal Ear. 


The Middle Ear.—The middle ear, or tympanum, is a cavity 
placed between the external and internal ears. Its structure is such 
as to remind one of a drum. The cavity consists of a little hollow in 
the temporal bone of the head, the outer side of which is bounded by 
a membrane which separates it from the outer ear and is known as 
the membrana tympani. Its inner side also presents an opening 
which is covered in a somewhat similar manner. The tympanum is 
not a closed cavity, as it communicates with the throat or back part 
of the nasal cavity by means of a small canal known as the Eusta¬ 
chian tube. 




176 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


The Ear-Bones. —The middle ear contains in its cavity a chain of 
hones, three in number, reaching across from one side to the other. 
These delicate bony structures have received names corresponding to 
their different shapes. The first, being shaped like a mallet, is called 
the malleus; the second, from its resemblance to a blacksmith’s an- 



Fig. 79. Bones of the Ear. a. Malleus; 5. Incus; c. Stapes. 

vil, is known as the incus, which has that signification ; and the third, 
from its resemblance to a stirrup, is called the stapes. The first of 
these bones is attached by its longer part, or handle, to the drum 
membrane. All the bones are connected by delicate joints, and the 
innermost bone, the stapes, fits into an opening in the opposite wall 
of the middle ear by which it is connected with the internal ear. 

Connected with the ear-bones and the drum membrane are three 
delicate muscles, the smallest in the body, which by their action reg¬ 
ulate the movements of these parts. Two of these are attached to 
the drum membrane, their use being to relax it and to render it tense, 
and the other to the stapes. 

The Internal Ear. —This is one of the most delicate and com- ' 
plicated mechanisms in the body. Owing to its complex structure 
and tortuous canals, it is called the labyrinth. This is the most es¬ 
sential part of the auditory apparatus. It is placed in a hollow in the 
densest part of the temporal bone. It may be divided into three 
parts : 1. The vestibule, or ante-chamber; 2. The cochlea, or snail- 

shell ; 3. The semi-circular canals. 

The vestibule, semi-circular canals, and cochlea are all filled with a 
limpid fluid. Suspended in this fluid by means of delicate bands of 
fibrous tissue placed like braces on all sides, is a membranous sac also 
filled with fluid, which corresponds in shape exactly to the form of 
the vestibule, canals, and cochlea. In the walls of this sac are found 
the terminations of the auditory nerve. 

The inner surface of the membranous sac presents a most wonder- 



TEE NATURE OF SOUND. 


177 


ful structure. Lining the sac in places are cells of various shapes, 
some of which bear upon their outer surface a number of minute, but 
sharp, stiff hairs. These cells are connected with the fibres of the audi¬ 
tory nerve, and it is supposed that the fine hairs described are really 
the extreme ends of the nerve filaments, which are thus bathed in 
the limpid fluid which fills the whole internal ear. Within the sac 
are also to be found curious little chalky particles called otoliths, or 
ear-sand. 



Physiology of the 
Ear.—Having briefly 
described the structure 
of the ear, we will now 
proceed to give a con¬ 
cise account of its 
functions. The chief 
duty of this organ is 
to receive impressions 
of sound, and to note 
the differences between 
various sounds in 
force, pitch, and qual¬ 
ity. In order to comprehend how this is done we must understand 
something of the nature of sound. 


Fig - . 80. The Internal Ear. 


The Nature of Sound. —If a stone be dropped into the water, a 
series of circular waves extend out from the point at which the stone 
entered the water. These waves are caused by vibration of the water, 
which is produced by the motion communicated to it by the stone. 
In a similar manner, moving bodies communicate motion to the air. 
A fan, gently moved by the hand, produces waves in the air which 
may be felt, though not heard. The wings of a humming-bird or an 
insect fan the air so rapidly that waves are produced which can be 
recognized by the ear. This is what is termed sound. The range of 
sounds which can be appreciated by the human ear is very great, 
the lowest being produced by sixteen vibrations per second, and 
the highest by about forty-eight thousand vibrations per second, 
equivalent to a range of about eleven and one-half octaves. Persons 
differ in their capacity for appreciating sounds, some being able to 
hear lower sounds than others, and vice versa. It is also probable 
that lower animals differ from each other and from man in this re¬ 
spect. There is at least good reason for believing that some insects 

12 


178 


ANATOMY , PHYSIOLOGY , ^VZ> HYGIENE. 


are capable of making sounds which are produced by vibrations too 
rapid to be appreciated by the human ear, though they may be heard 
by the insects themselves. Some years ago an eminent European sci¬ 
entist devised an experiment by which he was able to demonstrate 
not only that vibrations of air much more rapid than can be detected 
by the human ear can be produced, but that these extremely acute vi¬ 
brations possess the same qualities as those less rapid, except that 
they cannot be perceived by the ear. * 

Sounds are generally divided into musical sounds and noises, al¬ 
though this is a purely arbitrary division, as in reality no exact line 
can be drawn between these two classes of sounds. It is generally 
understood, however, that a musical sound is one that is produced by 
regular vibrations, or those which are repeated at regular intervals, 
while noises consist of irregular and discordant vibrations occurring at 

O O 

irregular intervals. 

The question sometimes discussed with so much display of argu¬ 
ment on both sides, whether there would be sound if there were no 
ears, we need hardly notice here; it will be at least sufficient to say 
that the settlement of the question wholly depends upon whether it 
is viewed from the standpoint of the physiologist or that of the phys¬ 
icist. The physiologist regards sound as the sensation produced 
upon the ear by certain vibrations of air; the physicist studies as 
sound the air-waves which produce the sensation upon the auditory 
nerve. 

How wc Hear. —The operation of hearing is a very interesting 
one, and becomes quite simple when the structure of the hearing ap¬ 
paratus is well understood, since there is provided for each necessary 
part of the operation an organ or series of organs well adapted to ac¬ 
complish the work. When the air is set in motion by a rapidly vi¬ 
brating body, the sound-waves are collected by the external ear and 
concentrated in the short canal at the inner end of which the drum 
membrane is placed. The motion of the air is communicated to the 
drum membrane, and by its movement the ear bones are caused to 
oscillate, and thus transmit the vibration to the fluid which fills the 
internal ear. The vibration readily extends from the fluid in the 
vestibule and its communicating cavities to the membranous sac 
which it contains, and to the limpid fluid contained in the sac. The 
motion of this fluid causes vibration of the delicate hairs which pro¬ 
ject into it, and which, as we have seen, are undoubtedly the ends of 


USE OF TIIE EUSTACHIAN TUBE. 


179 


the filaments of the nerve of hearing. Thus the external air-waves 
have been conducted to the auditory nerve, by which the impression 
is carried to the auditory center at the base of the brain, which in 
turn transmits it to the cerebrum, the seat of the intellect, and then 
the sound is recognized. 

The Musical Instrument of the Ear.— From the peculiar struct¬ 
ure of the cochlea it is believed that this part of the internal ear is 
devoted to the recognition of musical sounds, and especiallv to the 
pitch of sounds. There is in its structure so close a resemblance to 
the strings of a piano and the accessory apparatus that physiologists 
who have studied this part have universally remarked the analogy. 
There is even a damping arrangement, or what seems to be such, for 
the purpose of preventing the confusion of sounds when they are re¬ 
ceived in rapid succession. It was formerly supposed that the oto¬ 
liths had something to do with the production of sound, but it is now 
conceded that their action, if they have any, is not known. 

The Accommodation of Hearing. —Experiments concerning the 
action of stretched membranes with reference to sounds of various 
pitch have shown that the tension of the membrane must be varied 
for differences in pitch in order that they may be heard the best. 
For the safety of the ear it is also important that there should be 
some means of relaxing the membrane and the accessory organs so 
that injury shall not be received from very loud sounds. These needs 
are supplied by the delicate muscles of the drumhead and the stapes. 

Use of the Eustachian Tube. —The object of this canal is to 
equalize the atmospheric pressure in the drum or middle ear with 
that outside. The pressure of the atmosphere is constantly changing, 
as is indicated by the changes in the barometer; hence, if no provis¬ 
ion of this sort were made, the drum membrane would sometimes be 
pressed outward, and sometimes inward, which would greatly inter¬ 
fere with its function. This is well seen when the tube becomes 
closed up in consequence of a cold, which not infrequently happens; 
at such times the hearing is greatly obstructed. The Eustachian tube 
also comes into use when persons ascend to great heights by going up 
in a balloon or climbing mountains; also, in the cases of persons 
who work under water by means of diving-bells. The walls of the 
tube usually lie in contact, so when changes in the internal and ex¬ 
ternal pressure are made rapidly it sometimes becomes necessary to 


180 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


assist nature in changing the volume of air in the ears. This is real- 
ily done bv a very simple means which any one can employ. After 
taking a deep breath close the lips tightly, and close the nostrils with 
the fingers by pressing them firmly together; then attempt to ex¬ 
pel the air through the nose, as in blowing the nose, but still keep it 
tightly closed. By this maneuver the Eustachian tube will be opened 
and air forced into the drum. This procedure is found to be a very 
important one with divers who descend to their work under an im¬ 
mense bell. The weight of the water causes a very great increase in 
the pressure of the air in the bell upon the drum membrane. When 
persons so engaged neglect to observe this precaution, the membrane 
is not infrequently ruptured. 

Source of the Power of Maintaining Equilibrium. —Careful 

examination of the walls of the semi-circular canals of the internal 
ear have shown that they do not contain fibres from the auditory 
nerve, and hence do not take an active part in the process of hearing. 
For some time it was a source of great perplexity to decide the func¬ 
tion of these curious structures. At last an ingenious physiologist in¬ 
stituted a series of experiments on these organs in birds; and he 
found that their function is to aid in maintaining an equilibrium, by 
giving information respecting changes in position of the head. The 
manner in which this is done is very remarkable and interesting, but 
the process is too complicated for explanation here. It may be re¬ 
marked, however, that the function is based upon the well-known 
fact that fluids contained in vessels have a strong tendency to retain 
their actual position instead of changing with every movement of the 
containing vessel. For instance, a glass containing water may be 
turned around without tinning the water. The semi-circular canals 
contain a limpid fluid closely resembling water, and the three canals 
are so placed with reference to each other that the effect of any 
change of position may be noted by the change in the walls of the 
canals with reference to the fluid contained within them. This fact 
may explain the dizziness which often accompanies disease of the ear, 
the explanation being that in these cases the part of the ear is affected, 
the duty of which is to apprise the brain of the muscular actions nec¬ 
essary to maintain the equilibrium of the body. 

How Direction of Sounds is Determined.— The direction of 
sounds is probably determined by changing the position of the head 
and observing the direction in which the sound is most distinctly 


THE SENSE OF HEARING. 


181 


heard. Most lower animals can accomplish the same end in a large 
degree by changing the position of the ear by means of the muscles 
which they possess for that purpose, but which in man are not suffi¬ 
ciently developed to be of use. 

Our power to determine the direction of sounds is quite limited, as 
also is the power to determine the distance from which sounds come 
which fall upon the ear. That is, it is very difficult, often impossible, 
to distinguish between a feeble sound and one which comes from a 
distance. 

Interesting Facts about the Sense of Hearing. —Like most of 
the other senses, the ear refers its impression to the outside. It is a 
curious fact, however, that if the external ear be filled with water, 
this is no longer the case; sounds then seem to originate and to be 

O' O 

located within the head. 

The ear exceeds all the other senses in acuteness of perception. If 
impressions are made upon the eye in so rapid succession as ten in a 
second, they become fused; that is, they run together and become in¬ 
distinguishable. In the case of the ear, however, sounds which follow 
one another with the rapidity of one hundred a second, as in the tick¬ 
ing of a fast-beating pendulum, are heard as distinct sounds. 

It is a common observation that some people have not “ a musical 
ear.” This is owing to the fact that they cannot readily distinguish 
one tone from another. Ears which are well trained can distinguish 
between notes which differ less than the one-hundreth part of a tone. 
Notes higher than 4000 vibrations per second are, however, distin¬ 
guished with great difficulty. 

It is a commonly known fact that the ticking of a watch may be 
heard much more distinctly when held between the teeth than when 
at the same distance from the ear and not in contact with the teeth. 
Two new instruments for the relief of deafness have recently been 
invented which are based on this principle, known as the audipltone 
and the dentaplione. By the aid of these instruments the sound¬ 
waves are conducted to the internal ear through the bones of the 
head. It is probable that the drum membrane acts as when sounds 
are received in the ordinary way when present. It is said that by 
means of these instruments persons who were born deaf have been 
made to hear. These instruments have not yet been sufficiently 
tested to make it safe to recommend them, though they are undoubt¬ 
edly useful for some cases. 


182 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


THE EYE AND ITS FUNCTIONS. 


The organ of vision consists essentially of two parts, the optical 
instrument itself, or the eye-ball, and the accessory organs and envel¬ 
oping parts. The latter, which we will describe first, consist of the 
orbit , the eyelids , and the lachrymal or tear apparatus. 



Fig. 81. The Eye, showing at its inner border the appara¬ 
tus for removing the tears from the eye. 


The Orbit. —In or¬ 
der to protect it from 
mechanical injury, the 
eye is placed in a deep 
socket formed by the 
bones of the cranium 
and face. The edges of 
the socket project so 
much beyond the eye¬ 
ball that it will readily 
escape injury, even 
should a blow be re¬ 
ceived upon that part 
of the face, unless from a small instrument aimed directly at the eye. 
The overhanging brow is covered with short hairs so arranged as to 
conduct away the perspiration when a person is sweating freely, 
and prevent its entering the eye. An opening in the bottom of this 
bony socket gives entrance to the nerve of sight, which passes into the 
eye-ball. In the back part of the orbit is to be found a large amount 
of fatty tissue, which forms a sort of cushion for the eye-ball to pro¬ 
tect it from any injury from jar. 

The Eyelids .—The eye is protected in front by two movable cur¬ 
tains, the eyelids, the upper of which is the larger, and moves very 
freely, the lower being short and having little motion. The lids are 
chiefly composed of skin, lined with a delicate mucous membrane 
known as the conjunctiva. The edges of the lids present a row of 
fine hairs, the eyelashes, which protect the eye from dust, and when 
the lids are partially closed, diminish the amount of light that may 
enter the eye. Just within the row of eyelashes may be seen a line 
of delicate points which are the mouths of ducts leading from minute 
sebaceous glands which secrete an oily substance and pour it out upon 
the edge of the lids, by means of which they are prevented from ad- 










THE LACHRYMAL APPARATUS. 


1S3 


liering together during sleep. By the same means the lachrymal 
fluid which lubricates the eye is prevented from overflowing upon the 
cheek. 



The Lachrymal 
Apparatus. — Just 

within the outer and 
upper border of the 
orbit is placed a lit¬ 
tle gland, the func¬ 
tion of which is to 
secrete a limpid, lu¬ 
bricating fluid, the 

O 1 

lachrymal fluid, or 
tears, from which 
fact it is called the 
lachrymal gland. 

The fluid formed 
flows down a n d 
across the eye, moist¬ 
ening its whole anterior surface, and is drained off at the lower and 
internal angle of the eye by the nasal duct, a canal which leads to 
the nose. This fluid protects the eye both by washing away impu¬ 
rities and by keeping it transparent. When the cornea, or trans¬ 
parent part of the eye, becomes dry, it loses its lustre and becomes 
partially opaque. This is well seen in fishes when they have been 
removed from the water for some time. They have no lachrymal 
apparatus, since their natural element, the water in which they swim, 
answers the same purpose. 

In the edge of each lid, at the inner end, are little openings 
through which the tears are drained off into the nasal duct and so 


Figr. 82. The Glandular Apparatus of the Eye; 7. Lachrymal 
Gland. 8, 9, 10, Ducts. 11. Openings of ducts on inner border of 
upper lid; 6. Glands for lubricating edges of eyelids. 


conveyed to the nose. These can be seen in the lower lids by draw¬ 
ing them downward and forward. 

O 


The secretion of the lachrymal fluid is constant, but only in sufficient 
quantity for the purpose of lubricating the eye, except when the mind 
is laboring under the influence of some strong emotion, when it is poured 
out in such quantities that it escapes over the lids upon the cheek in 
tears. Irritating substances in the eye, a harsh, dry wind, and irritating 
vapors, produce the same effect. 






184 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


The Eye-Ball .—The ball of the eye, which is the essential instru¬ 
ment of sight, in many respects resembles the camera of the photo¬ 
grapher, as will be seen from the description. The eye-ball is not per¬ 
fectly spherical in shape, though approaching the form of a globe. Its 
average diameter is about an inch. It is composed, essentially, of three 
investing membranes or coats, called tunics, and three transparent me¬ 
dia inclosed, called humors. 



Fig. 83. Vertical Section of the Eye-Ball. a. Eyelashes; d. Eyelids; 
i. Cornea; V. Aqueous Humor; t. Crystalline Lens; s. Vitreous Humor; 

m. Iris; o. Retina. 


The outermost tunic is called the sclerotic. It is a tough, fibrous 
coat, and forms what is known as the white of the eye. It covers the 
whole eye-ball with the exception of a small circular portion which is 
covered by a peculiar, horn-like, transparent structure which is a con¬ 
tinuation of the sclerotic, and is called the cornea. It is this which 
forms the lustrous portion of the eye, through which its color is seen. 
The cornea acts as a window to the interior of the eye. 

Within the sclerotic is another tunic, the choroid, which is a delicate 
membrane filled with blood-vessels to nourish the eye, and lined upon 
the inside with a layer of dark, nearly black, coloring matter. The 
choroid is also absent in front, ending at the margin of the cornea ; but 
it is continued by a circular curtain called— 







THE STRUCTURE OF THE IRIS. 


185 


The Iris. —This delicate structure is what gives to the eye its color. 
Its outer side is in different persons a great variety of colors, being 
brown, blue, gray, hazel, and many other shades. Its center is pierced 
by an opening called the pupil. Its back side is covered, like the choroid, 
with a layer of black pigment, the object of which is the same as that 
had in view by the manufacturer of telescopes and microscopes when he 
covers with a coat of black paint the inside of his instruments, viz., the 
absorption of wandering rays of light, and the prevention of reflection 
in the eye, which would occasion confusion of vision. In albinos 
these dark cells are wanting, in consequence of which they suffer from 
imperfect vision. The same is true of albinos among lower animals, as 
white elephants, white rabbits, etc. In blue and gray eyes the pigment 
cells are less abundant than in black and brown, being found only on 
the back side of the iris, while in black and brown eyes pigment cells 
are found upon both sides and in its substance. Dark eyes are usually 
associated with dark features on account of the general greater abun¬ 
dance of pigment throughout the body. 

A careful examination of the iris with the microscope shows that it 
is made of two sets of fibres, one of which radiates from the center to¬ 
ward the circumference, while the other is arranged circularly. The 
circular fibres, by contracting, make the opening through the iris 
smaller, while the radiating fibres, by contracting, make it larger. Thus 
the size of the pupil is regulated according to the amount of light which 
is needed in the eye for the purposes of vision, or which may be tolerated 
without injury to its delicate structures. The action of the iris of the 
cat can be very easily seen. When exposed to a bright light, the pupil 
becomes very small; but when taken into a room where there is little 
light, it becomes greatly dilated. It is in part the great power of dila¬ 
tion of the pupil which enables the cat and the owl to see well where the 
light is insufficient for most other animals and human beings. When 
we enter a darkened room we cannot see distinctly for some minutes, 
as is also the case when we are suddenly brought into the presence of a 
brio-ht liffht. This is owing: to the fact that time is required for the 
iris to accommodate the size of the pupil to the amount of light fur¬ 
nished. When the variation in the intensity of the light is but slight, as 
is ordinarily the case, no perceptible time is required; but a longer period 
is necessary when the difference is great. Every person has experienced 
temporary inability to see objects distinctly after looking at the sun for 
a few seconds steadily. 


180 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


Certain drugs possess the power to cause dilatation of the pupil by 
paralyzing its muscular fibres. Belladonna, one of the chief of these, 
derives its name, which signifies beautiful lady, from the fact that it has 
been much used to cause dilatation of the pupil to add brilliance to the 
eyes. Death has not infrequently been occasioned in this way. 

The Ciliary Muscle. —Between the sclerotic and the choroid, 
around the edge of the cornea, is another curious little muscle, known 
as the ciliary muscle, the use of which will be seen presently. 

The Retina. —This constitutes the third and inner coat of the eye. 
It is made up almost wholly of the end filaments of the optic nerve, 
which enters the ball of the eye at the back side and spreads out into a 
thin membrane to form the retina. It contains many delicate and cu¬ 
rious structures connected with vision, but too complicated for explana¬ 
tion in a popular treatise like this. The retina is sensitive to no im¬ 
pressions but those produced by light. That is, if otherwise stimulated, 
it produces only the sensation of light. 

The Crystalline Lens. —This is the middle one of the three trans¬ 
parent media of the eye. It is placed in the eye just behind the iris, so 
that the center of the pupil is just opposite its center. Its shape, as will 
be seen by reference to Fig. 83, is like that of a convex lens or burn¬ 
ing-glass. It is of quite firm consistency, feeling to the touch almost as 
hard as cartilage. It is held in place by means of a delicate sac or cap- 
• sule which incloses it and is attached by its circumference to the cho¬ 
roid coat just behind the iris. Its thickness is about one-fourth of an 
inch. The lens possesses great transparency in health, but sometimes, 
especially in old age, it becomes opaque, occasioning the disease known 
as cataract. Attached to the choroid behind the border of the capsule 
of the lens is the ciliary muscle previously described. 

The Aqueous Humor. —This is a watery fluid contained in the 
small space between the lens and the cornea in front. The free inner 
edge of the iris floats in the aqueous humor. It is this limpid fluid 
which escapes when the eye is punctured by a sharp instrument. 

The Yitreous Humor. —Behind the crystalline lens, and filling the 
greater part of the eye-ball, is the vitreous humor, so called on account 
of its imagined resemblance to melted glass. This structure is also very 
transparent. It constitutes about two-thirds of the eye-ball. The ret¬ 
ina, the inner tunic of the eye, lies in close contact with it. 

The Physiology of the Eye. —In order to understand the manner 
in which the mechanism of the eye operates in producing vision, we must 


PROPERTIES OF LIGHT. 


187 


first learn something of the nature of light, that with which the eye has 
to deal. The generally accepted theory of light is what is known as 
the undulatory theory, which supposes that all space is filled with a sub¬ 
tile medium known as ether, and that light is simply the waves, or vi¬ 
brations, or undulations, of this ether, just as sound is the result of the 
vibrations of air. These vibrations are caused by luminous bodies, as 
the sun and stars, and by all substances undergoing combustion. 

Properties of Light. —Objects which allow waves of light to pass 
through them are called transparent or translucent according to the 
readiness with which they allow the passage of light. No substance 
known is perfectly transparent. Even the atmosphere and the purest 
water are opaque in some degree. 

Light-waves travel in straight lines, radiating from their source. 
Those which come from a great distance vary so little in direction that 
they are considered as parallel. 

Properties of Lenses.— 

Fig. 8-1 illustrates the prop¬ 
erty of a lens to change the 
direction of rays cf light. 

The ravs of light which 
pass from the arrow at the 

left of the lens have their Figr - 84 - Diagram showing the Optical Properties of 

Lenses. 

course changed so that they 

cross at a point upon the right of it and form an image of the ar¬ 
row inverted. This property of a lens may be readily seen by ex¬ 
periment with a burning-glass or a pair of convex spectacles of con¬ 
siderable magnifying power. 

How We Sec. —In studying the use of the eye in vision, it must 
be considered first as an optical instrument. As we have already 
seen, it contains a lens, the shape of which is similar to artificial 
lenses, and the effect of which in changing the direction of rays of 
light is precisely the same. The cornea, having a convex surface, also 
acts as a lens, so that there are virtually two lenses in the eye. 
When rays of light from an object fall upon the cornea they pass 
through it and on to the crystalline lens with a different direction 
from that in which they were received, being brought nearer together, 
or made to converge. Passing on to the lens they are by it made to 
converge still more, so that they cross just behind the lens and form 
an image, reduced in size and inverted, upon the retina. This may be 







1SS 


ANATOMY , PHYSIOLOGY, AND HYGIENE. 


seen in the eye of an ox taken from the animal immediately after it 
is killed. By removing the outer coverings at the back part with 
great care, leaving the retina in place, and then placing it in such a 
position as to receive a strong light from some object, the object may 
be seen pictured upon the retina upside down. 

The delicate nerve cells and filaments which form the retina con¬ 
vey the impressions thus made upon them to the base of the brain to 
the nerve center having charge of sight, whence they are communi¬ 
cated to the cerebrum, and the sensation of sight is produced, or the 
impressions recognized by the brain. Any sort of irritation of the 
retina or optic nerve will occasion the sensation of light, whether it 
be mechanical, or electrical by means of a battery. 

Accommodation of the Eye. —An opera-glass, when used for view¬ 
ing objects at different distances, must be adjusted in order to give 
distinct images of the objects viewed. If turned upon a distant object 
when rightly adjusted to make a near object distinct, the distant 
object will appear blurred and indistinct, if seen at all. Like the 
opera-glass, the telescope, and other similar optical instruments, the 
eye has an adjusting apparatus. The use of this adjusting mechanism 
is what is known as accommodation. By its use the healthy eye can 
be so adjusted as to see with the greatest possible degree of distinct¬ 
ness objects at the extreme limits of vision, as well as objects very 
near to the eye. This power differs with different persons in accu¬ 
racy and in the extent of its limits. A near-sighted person has a very 
small range of accommodating power, that is, he can see clearly only 
objects which are within narrow limits of distance. 

A very simple experiment will make clear to all what is meant by 
accommodation. Place in a strip of wood two or three feet long, two 
pins in range with each other, one at either end of the strip. Now 
hold the strip out horizontally at about the level of the eye, with one 
end toward the eye. By this arrangement one of the pins will be 
two or three feet farther from the eye than the other. Now look at 
the pin nearest the eye. "While doing so it will be observed that an 
indistinct Anew is also obtained of the pin at the other end, and that 
it looks blurred. Then look sharp at the pin at the farther end. The 
pin nearest the eye will now appear blurred and indistinct. This is 

because the eve cannot accommodate itself to more than one distance 

•/ 

at a time. Another interesting experiment shows the same thing in 
a different way. Make in a card-board two small holes about the clis- 


VISUAL JUDGMENTS. 


189 


tance apart shown in Fig. 85, in horizontal line with each other. 
Place the card very near to the eye, and hold vertically in the fingers 
a needle at a distance of eight or ten inches from the eye. When 

the eye is fixed in¬ 
tently upon the nee¬ 
dle, it is seen clearly; 
but if the attention 
be directed to an 
object either farther 
away or nearer by 
than the needle, it 
will appear indistinct 
and also double. If 
moved near enough 
to the eye, it will ap¬ 
pear double continually. The nearest point at which it appears single 
is the near limit of accommodation. 

Accommodation is accomplished by the action of the ciliary mus¬ 
cle, by means of which the form of the lens, and hence its refracting 
power, is changed, as shown in Fig. 86. 

Visual Judgments. —With the exception of the auditory sense 
and the sense of sight, all others of the senses require for their excita¬ 
tion the actual contact of something. No other sense gives us so 
much and such 
varied information 
respecting external 
things as the eye; 
yet a careful study 
of the knowledge 
thus gained shows 
us that the eye is 
very greatly aided 
by the other senses. 

Indeed, with only 
the sense of sight, 
we should be very 
badly off indeed, 
and the function of sight would render us but little service. In 
making visual judgments, or forming opinions which seem to be 



Fig\ 86. At the rieht of the vertical line, the lens, a a , is shown 
flattened, as when adjusted for seeing at a distance; on the left, the 
lens is thickened, as iu near-sighted persons and when examining 
near objects. 


Fig:. 5. 









190 


ANATOMY, THYSIOLOGY, AND HYGIENE. 


based upon the impressions received through the eye, we never take 
into account our dependence upon other senses, because we are 
scarcely able to separate them under ordinary circumstances. 

Judgment of Distance and Size. —The power to judge of dis¬ 
tance is evidently acquired. The little child reaches out its hand for 
the moon, undoubtedly supposing it to be within easy reach. A 
landsman at sea for the first time can form no correct estimate of dis- 
1 tance. The same is true of a person accustomed to live in a hilly or 
mountainous section when he first visits a prairie country. The judg¬ 
ment of distance is formed partly by the combined use of the two 
eyes,—one serving as a means of correcting the other,—by the 
amount of muscular effort required to accommodate the eye to see the 
objects clearly, and by the relative size of objects with which we are 
familiar. For instance, we are familiar with the size of a man or a 
horse ; if we see a man or a horse some distance away, we judge some¬ 
thing of the distance by the apparent size. If we were to look 
through a reversed telescope, which makes everything look small, we 
should have the same impression, that of a person a long distance oft', 
even though he might be very close by. The advantage of using 
both eyes in judging of distance is well appreciated by one who at¬ 
tempts to thread a needle with one eye closed. 

We are aided in judging of the size of an object by a knowledge 
of its distance. We can form no notion of the size of the moon, be¬ 
cause we can form no visual estimate of its distance, and rice versa. 

Judgment of Solidity.— W e are enabled to form an opinion re¬ 
specting the solidity of an object by two means; first, by means of the 
lights and shades of its surface, and second, by the conjoined use of 
the two eyes, which enable us to see more than half of a sphere, 
owing to the difference in position of the two eyes. 

It is thus evident that we do not form opinions respecting objects 
exactly as we see them, but as the impressions of sight are corrected 
by comparison with each other and with the impressions received 
through the other senses. 

Curious Facts about the Sense of Sight. —There are many 
curious facts about sight well worth mentioning, only a few of which 
we have room to consider. First we may mention that although 
every one is familiar with the fact that color as well as simple light 
may be appreciated by the eye, no explanation has yet been foimd for 
the power to distinguish color. The color of objects is due to the fact 


AFTER-IMAGES. 


191 


that light is compound, and that some objects have the power to ab¬ 
sorb some portions of the constituent elements of light and reflect 
others, the elements reflected determining the color. For example, an 
object reflecting red rays only, is red; one reflecting blue only, is blue, 
etc. It was. formerly supposed that red, yellow, and blue were the 
primary colors, or color sensations; but an eminent scientist has re¬ 
cently shown that the old view is incorrect, and that the primary 
color sensations are red, green, and violet, When all three of these 
colors fall upon the retina at once, white or colorless light is produced. 
By their combination in various proportions all other color sensations 
may be produced. White may also be produced by combining the 
following colors: red and blue-green; orange and blue : vellow and 
indigo-blue; green-yellow and violet; purple and green. 

After-Images. —After looking at a bright object, as the sun, for a 
few seconds, and then closing the eyes, the image formed on the retina 
will persist for some time. The same phenomenon may be noticed in the 
morning when the retina is rested. If upon first waking a person looks 
at the window, he may, upon closing his eyes, still retain the image 
with all the distinctness with which the objects viewed were seen when 
the eyes were open, the same form, color, and other visual properties 
being accurately preserved. Such images as these are known as posi¬ 
tive after-images. A more usual form of after-image is that which is 
produced by looking upon a white ground after the eye has been for 
some time steadfastly fixed upon some dark cr colored object. If a per¬ 
son has been looking at a white spot upon a dark ground, upon looking 
at a white ground, as the wall, he will see a dark spot of the same size 
and form as the light spot. When tire spot is of a red color, the image 
seen on the white ground will be greenish-blue, which is the comple¬ 
ment of red. Orange produces blue; green, pink ; yellow, blue; etc. 
The explanation is that the part of the retina upon which the im¬ 
age of the object is formed becomes weary with receiving the particular 
sensation, and consequently while the rest of the retina which is fresh 
receives a sensation corresponding to the color of the object viewed, the 
tired spot responds to but a part of the rays, and so shows a different 
color, really making a physiological decomposition of the rays of light. 
Images of this sort are called negative. 

The Blind Spot. —The portion of the retina which possesses most 
acute vision is the visual center, which is a little to one side of the point 
at which the optic nerve enters the eye. The point of entrance of the 


192 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


optic nerve is wholly insensitive to visual impressions, as there are at 
this point none of the terminal elements of the optic nerve, which alone 
possess the power of receiving impressions. The existence of this insen¬ 
sitive portion of the retina, commonly termed “ the blind spot,” can be 
easily shown by a simple experiment with Fig. 87. Holding the book 



Fig-. 87. 


squarely before the face and so that the figure will be on a level with 
the eyes, place the hand over the left eye, and with the right eye look 
steadily at the small cross at the left end of the figure. Now place the 
book at a distance of about four inches from the eye. Both the cross 
and the round white spot will be distinctly visible; but as the book is 
moved from the face the white spot will disappear at a distance of six 
to eight inches. With a little care any one can perform the experiment. 
Another way of showing the same fact without the figure is this: Pin 
two cards upon the wad about two feet apart, and on a level with the 
eyes. Now close the left eye and look at the left card with the right eye, 
or vice versa. Both cards will be visible, the right one indistinctly, of 
course. Keeping the right eye fixed upon the left card, walk backward. 
At a distance of six to eiirlit feet from the cards the rinht one will 

o 0 

vanish. 

Contrast. —A white stripe placed between two black stripes looks 
much whiter at its edges than in the middle, which may even look a 
little dull in contrast with the edges, though the color is uniform. A 
small sheet of gray paper placed in the middle of a larger sheet of green 
paper and covered with a sheet of thin tissue paper, appears of a pink 
color, which is complementary to green. 













TEE LAW OF USE AND ABUSE. 


193 


HYGIENE OF THE SPECIAL SENSES, 

The Law of L se and Abuse. —Sensation is clue to change of state. 

O 

If the external agents which make impressions upon our organs of sense 
remained always in the same relation to them, we should possess sensi¬ 
bility or sensation but a very brief space of time. Our sensations arise 
from the constant changes in the relations of surrounding objects to our 
organs of sense. For example, an object laid upon the hand resting upon 
a table is at first appreciated by the sense of weight or pressure. The 
first moment of contact the most intense sensation is experienced; after 
this the impression gradually diminishes, until finally the object is no 
longer felt at all unless the hand is moved. If the hand be placed in 
water which the sense of temperature at first appreciates as warm, it 
very soon loses the sensation of contact with water altogether unless the 
hand is stirred. Flavors at first very marked, when the sapid substance 
is held some time in the mouth become less intense. The most sensitive 
nose may become so accustomed to foul odors that it can no longer ap¬ 
preciate them. This is experienced by every person who leaves a close 
room for a few minutes and walks in the pure air. Upon returning, the 
close, fusty air is almost intolerable; but in a few minutes it is no longer 
noticed. Loud sounds are no longer heard by ears constantly accus¬ 
tomed to them unless they are varied, or the attention is especially 
called to them. An object continually gazed at finally disappears 
from view. 

Thus all sensation depends upon constant change of state. From 
this fact we may deduce the general law relating alike to all the senses, 
that frequent change is essential. Too long use of any of the senses 
in any particular way should be avoided, as by this means their sen¬ 
sibility is blunted. 

Evils of Excessive Stimulation of the Senses. —Excessive stim¬ 
ulation of any sense is felt as pain, when extreme in degree. A sensa¬ 
tion of warmth is pleasurable, but neither extreme cold nor extreme 
heat is felt as intense heat or cold, but as pain. Very loud sounds, as 
the noise of an explosion, are avoided as painful to the ear. Moderate 
light is grateful to the eye, but an intense light, as that of the sun, 
causes pain. Pain is a faithful sentinel of danger; and so, as might be 
supposed, these intense stimulations of the nerves of sense are harmful, 
and should always be avoided when possible. When experienced, they 
13 


194 


ANATOMY, PHYSIOLOGY , AND HYGIENE. 


rapidly deteriorate the sensitiveness of the organ involved. A tongue 
accustomed to the strong flavors of highly seasoned food, ceases to ap¬ 
preciate the delicate flavors which naturally pertain to most articles 
of diet in a less artificial condition. Hence the evil of condiments. 
Smoking, tobacco-chewing, tea-tasting, and the excessive use of tea 
and coffee, as well as the use of strong alcoholic liquors, deteriorate 
and often almost wholly obliterate the sense of taste. 

The sense of smell is often entirely lost in consequence of the vile 
habit of snuff-taking. The habit sometimes acquired by smokers, of 
expelling tobacco smoke through the nose, ruins the delicate sense of 
smell. The nerves of this sense, being more slightly protected than 
any other, are very easily injured. Nasal catarrh also obliterates the 
sense of smell in many cases. 

When we consider the great importance of most of the special 
senses, and the great value of all, it is indeed surprising that so little 
pains is taken to preserve them. Too often their value is not appre¬ 
ciated until they have been ruthlessly squandered by careless habits, 
and are in many cases irrecoverable. On account of their great im¬ 
portance, we shall devote a little space to the special consideration of 
the senses of sight and hearing. 

HYGIENE OF THE EYE. 

Being one of the most delicate of all the organs of sense, the eye 
is exceedingly liable to injury by improper use or exposure. Dr. Ed¬ 
ward G. Loring, an eminent oculist of New York City, makes the 
folio whig excellent remarks on this subject :— 

Common Neglect of the Eye. —“Whatever an ounce of preven¬ 
tion may be to other members of the body, it certainly is worth many 
pounds of cure to the eye. Like a chronometer watch, this delicate 
organ will stand almost any amount of use, but when once thrown 
off its balance, it can very rarely be brought back to its original per¬ 
fection of action, or, if it is, it becomes ever after liable to a return of 
disability of function or the seat of actual disease. One would have 
supposed from this fact, and from the fact that modern civilization 
has imposed upon the eye an ever-increasing amount of strain, both 
as to the actual quantity of work done and the constantly increasing 
brilliancy and duration of the illumination under which it is per¬ 
formed, that the greatest pains would have been exercised in main¬ 
taining the organ in a condition of health, and the greatest care and 


TOBACCO A CAUSE OF EYE DISEASE. 


195 


solicitude used in its treatment when diseased. And yet it is safe to 
say that there is no other organ in the body the welfare of which is so 
persistently neglected as the eye. 

“ I have known fond and doting mothers to take their children of 
four or five years of age to have their first teeth filled, instead of hav¬ 
ing them extracted, so that the jaw might not suffer in its due devel¬ 
opment, and become in later years contracted ; while the eye, the most 
intellectual, the most apprehensive, and the most discriminating of all 
our organs, receives not even a passing thought, much less an exam¬ 
ination. It never seems to occur to the parents that the principal 
agent in a child’s education is the eye; that through it it gains not 
only its sense of the methods and ways of existence of others, but 
even the means for the maintenance of its own; nor does it occur to 
the parents for an instant that many of the mental as well as bod¬ 
ily attributes of a growing child are fashioned, even if they are not 
created, by the condition of the eye alone. 

“ A child is put to school without the slightest inquiry on the part 
of the parent, and much less on the part of a teacher, whether it sees 
objects sharply and well defined, or indistinctly and distorted; whether 
it be near-sighted or far-sighted; whether it sees with one or two 
eyes; or finally, if it does see clearly and distinctly, whether it is not 
using a quantity of nervous force sufficient after a time not only to 
exhaust the energy of the visual organ, but of the nervous system at 
large.” 

O 

Tobacco a Cause of Eye Disease. —The numerous observations 
on the subject leave no room to doubt that the use of tobacco is a po¬ 
tent cause of disease of the eye. In fact, instances of nearly every 
functional disease of the eye have been traced to the use of this power¬ 
ful poison. Amaurosis, and total blindness from degeneration of the 
optic nerve, have also been traced to this cause. Recent observations 
point to tobacco and alcohol as the great causes of color-blindness, or 
Daltonism, which accounts for the fact that it is very much more com¬ 
mon in men than in women. 

Effects of Poor Light. —The use of poor light, and especially the 
improper construction of school-rooms in relation to light, is a most 
potent cause of diseases of the eye. Careful examinations of large 
numbers of students in all grades have shown that defects of sight in¬ 
crease in a rapid ratio from the lowest grades to the highest, students 
in the higher classes in colleges and universities suffering to a most 
astonishing and alarming extent. 


196 ANATOMY, PHYSIOLOGY, AND HYGIENE. 

Attention should be given to the eyesight of children at an early 
age, and especially before they are sent to school, or before a profes¬ 
sion or trade is chosen for them. If the sight is found to be weak 
or otherwise defective, they should not be compelled to close confine¬ 
ment with books, and should be put to learn some trade or engage in 
some business which will not require close attention of the eye. An 
eminent New York oculist has recently urged the enactment of a 
law requiring that all children be submitted to an examination of 
the eyes before being granted admission to the public schools. If 
this plan should be adopted, no doubt many cases of disease of the 
eye which become serious by neglect, might be cured by the early 
discovery which would be thus made. 

A Cause of Near-Sightedness. —One of the recognized causes of 
near-sightedness is looking at near objects for too long a time with¬ 
out relieving the eye. The optical apparatus is, by a curious mechan¬ 
ism provided by nature, constantly adapted to the varying distances 
at which objects are viewed when the eyes are being employed in look¬ 
ing about at various objects. If near objects are looked at too long 
a time, the result will be that the particular adjustment for short dis¬ 
tances will become a more or less permanent condition. It is in this 
way that watch-makers, microscopists, proof-readers, compositors, 
writers, book-keepers, and especially students, are so liable to this 
disease of the eye. It should be recognized that a near-sighted eye 
is really a diseased eye. The idea held by many persons that an eye 
which has this peculiarity is an uncommonly strong one is an error. 
Short-sight is an evidence of weakness and disease rather than of 
strength. 

O 

The following very sensible remarks referring to the prevention 
of this defect in school-children we quote from the Educational 
Weekly :— 

“ Encourage the pupil to look off* the book frequently, to change 
the focus of sight by regarding some distant object. It is not enough 
to look around vaguely; the eye must be directed to something which 
is to be clearly seen, like a picture or a motto upon the wall, or a bit 
of decoration. The greatest damage to the eyes of students is the 
protracted effort to focus the printed page. It was simply barbarous, 
the way we used to be “ waked ” in school, when we looked off the 
book. It is easy for a teacher to know the difference between the 
resting of the eye and the idle gazing around that cannot be allowed. 


IiULES FOR PRESERVING THE EYE-SIGIIT. 197 

I regard this as most important, and the disregard of it as most pro¬ 
lific of trouble.” 

The following excellent rules for preserving the health of the eyes 
have been chiefly compiled from the best authorities on the subject:— 

1. Never use the eyes when they are tired or painful, nor with an 
insufficient or a dazzling light. Lamps should be shaded. 

2. The light should fall upon the object viewed from over the left 
shoulder, if possible; it should never come from in front. 

3. The room should be moderately cool, and the feet should be 
warm. There should be nothing tight about the neck. 

4. Hold the object squarely before the eyes, and at just the proper 
distance. Holding it too near produces near-sightedness. Fifteen 
inches is the usual distance. 

5. Never read on the cars, when riding in a wagon or street-car, 
nor when lying down. Serious disease is produced by these practices. 

G. Do not use the eyes for any delicate work, reading, or writing, 
by lamp-light, before breakfast. 

7. Avoid much use of the eyes in reading when just recovering 
from illness. 

8. Never play tricks with the eyes, as squinting or rolling them. 

9. If the eyes are near-sighted or far-sighted, procure proper 
glasses at once. If common print must be held nearer than fifteen 
inches to the eye for distinct vision, the person is near-sighted. If it 
is required to be held two or three feet from the eye for clear sight, 
the person is far-sighted. 

10. A near-sighted person should not read with the glasses which en¬ 
able him to see distant objects clearly. A person who has long sight 
should not attempt to see at a distance with the glasses which enable 
him to read. 

11. Colored glasses (blue are the best) may be worn when the eye is 
pained by snow or sunlight, or by a dazzling fire or lamp light. Avoid 
their continued use. 

12. Never patronize traveling venders of spectacles. 

13. Rest the eyes at short intervals when severely taxing them, ex¬ 
ercising the lungs vigorously at the same time. Tired eyes may often 
be refreshed by bathing in cool water, or water as hot as can be borne. 

14 . Avoid sudden exposure of the eye to a bright light, as when 
first waking from sleep. Study by lamp-light before breakfast is par¬ 
ticularly injurious on this account. 


198 


ANATOMY , PHYSIOLOGY, AND HYGIENE. 


15. Defective ventilation, unequal heating,—causing cold feet and 
congestion of the head,—and had food, causing impure and impoverished 
blood, are serious causes of diseases of the eye. 

16. Popular eye-washes, and various ointments, salves, etc., prepared 
according to popular recipes, or sold by quacks, should never be used. 

17. Upon the discovery of any defect in the sight, consult a compe¬ 
tent physician (not a traveling quack) at once, as serious disease may be 
saved by timely advice or treatment. 

HYGIENE OF THE EARS. 

The number of people who suffer with defects of hearing in greater 
or less degree is almost if not quite as great as those who suffer with 
defective eyesight. The ears are neglected as much as the eyes ; but, 
fortunately, slight impairment of hearing is not accompanied by any¬ 
thing like so great inconvenience or loss as an equal degree of impair¬ 
ment of vision. From inattention, neglect, and abuse, the ears become 
seriously or hopelessly diseased, when a little timely attention or warn¬ 
ing might have saved them. It should be mentioned in this connection 
that diseases of the ear are to be avoided not only on their own ac¬ 
count, but on account of the fact that owing to the close proximity of 
the organ to the brain, and its intimate connection with the bones of 
the skull, serious and even fatal disease not infrequently results from 
affections of this organ. We will call attention to some of the most 
important points connected with the hygiene of the ear. 

Danger of Meddling with the Ears. —The common habit of 
picking at the ears to remove the wax or cerumen which accumulates in 
them, is very injurious. Especially bad is the use of ear-picks or spoons. 
Boring out the ear with the twisted corner of a towel is a most absurd 
as well as injurious practice, since it not only does not remove more 
than a very small portion of wax, but crowds the balance down into 
the bottom of the canal, against the delicate membrane of the drum. Ex¬ 
cept in cases of disease, ear-wax seldom requires removal, as nature has 
provided for this. When the ears are let alone, as they should be, the 
wax dries and scales off in thin flakes, which drop from the ear sponta¬ 
neously. It is only in cases of disease that the wax accumulates to such 
an extent as to be detrimental. If there is itching of the ears, it is a 
sign of disease; and the more they are irritated by picking or cleaning, 
the worse the evil will become. The more assiduous the attempts to 
keep the ears free from wax, the greater will be the accumulation, as 


DANGER OF BOXING THE EARS. 


199 


the secretion is increased by the mechanical irritation. Well-mean¬ 
ing mothers often do their children a great amount of harm by at¬ 
tempts to keep their ears free from what nature designed as a protec¬ 
tion. The protest which children always make to having their ears 
bored out with towels and scrubbed with soap and water inside as well 
as outside, is a perfectly natural and entirely proper resentment of the 
outrage. The outer parts of the ear may very properly be washed as 
often as desired, provided they are always wiped dry; but nothing 
should ever be introduced into the canal of the ear unless made nec¬ 
essary by disease or accident. 

Putting things in the ear is a practice sometimes acquired by chil¬ 
dren, and often irreparable injury is thereby done. Children should be 
carefully watched, and early taught to let the ear alone. Beans, kernels 
•f rice, wheat, and corn, and a great variety of small objects, have been 
removed from the ears of children by surgeons to whom they have been 
taken for treatment for deafness. Inflammation is not infrequently 
set up by this means, which may occasion permanent loss of hearing. 
Throwing at each other wheat, sand, and other small objects, should be 
strictly forbidden children, and should never be practiced by any one. 
We recently met a gentleman whose hearing in one ear was wholly de¬ 
stroyed when a child by having lodged in his ear a kernel of wheat 
from a handful thrown at him by a playmate. It was never extracted, 
and the inflammation excited caused a permanent loss of hearing. 

Danger of Boxing the Ears. —The common practice of cuffing 
the ears is not only cruel but dangerous. The violent forcing of air into 
the ear in this manner has oftencaused rupture of the delicate drum mem¬ 
brane. Sometimes serious inflammation is occasioned; and in one case 
which we have in mind a child died from the effects of a cufl upon the 
ear received at school. Both parents and teachers often box or cuff the 
ears of children for inattention, when it will be found in a large num¬ 
ber of cases in which a child is apparently inattentive that the difficulty 
is hardness of hearing, which will of course be made worse instead of 
being remedied by the punishment inflicted. It should be understood 
and remembered that the hearing of children is often temporarily im¬ 
paired by various causes, particularly by colds and attacks of “earache, 
and also that in some forms of deafness a person may be quite hard of 
hearing when not expecting to be spoken to and hence not giving at¬ 
tention, and yet hear very well when listening. Before a child who 
seems to be habitually inattentive is punished for the supposed fault, liis 


200 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


cars should both be carefully tested by trying each one alone with a 
watch, or by speaking in a moderate tone of voice at different distances. 

Taking Cold in the Ears. —The form of ear disease known as 
throat deafness is that in which the impairment of hearing is really due 
to disease of the throat, which is most commonly caused by taking cold. 
The thickness of hearing due to a common cold in the head is occasioned 
by the thickening of the mucous membrane about the openings of the 
Eustachian tubes in the throat. This usually passes away in a short 
time; but in cases of catarrh, especially post-nasal and pharyngeal catarrh, 
the condition may become permanent; am] the local disease may extend 
up into the canal and even to the ear itself, occasioning very great in¬ 
jury to the ear. 

It ought to be generally known, too, that the very common affection 
called earache is really a matter of quite serious character, being inflam¬ 
mation of the middle ear, or drum of the ear. Treatment should be 
prompt, and care should be taken to prevent recurrences, as the hearing 
may be thereby permanently injured. Full directions for treatment 
are given in the proper place. 

Exposures of the Ears. —Both extremes should be avoided in the 
case of the ears. Too much protection makes them delicate and easily 
disturbed by the occasional exposures to which they must be subjected. 
It i§ probably for this reason that women are more liable than men to 
suffer with acute inflammation of the ear, as has been observed by 
some aurists. People who always have their ears covered or pro¬ 
tected by plugs of cotton, are quite sure to be always troubled with 
their ears. The ears should be accustomed to exposure, and only pro¬ 
tected when subjected to some unusual exposure, as when riding a 
long distance in a cold wind. The use of cotton in the ears is at¬ 
tended by some risk, being often productive of harm, as cotton placed 
in the ear is not infrequently forgotten, being left in place, and even 
pushed farther into the ear by successive plugs. As many as three 
pellets of cotton which had been successively inserted in this way 
have been removed by an aural surgeon. When thus retained, wax 
accumulates about the cotton, and thus may occasion mechanical ob¬ 
struction to hearing, and serious inflammation. 

Cold water should never be introduced into the ear. When in¬ 
jected with a syringe, and even when poured in, it causes giddiness, 
and may give rise to inflammation. Boys often cause an inflamma¬ 
tion of the ear by “going in swimming” or ducking the head in wa- 


EXPOSURE OF THE EARS. 


201 


ter. By submergence of the head the external canals are filled with 
water, which is usually of a temperature lower than that of the blood, 
which causes congestion and may occasion inflammation. Early deaf¬ 
ness is often produced in this way. Those who own dogs which are 
accustomed to go into the water much, or are often thrown in, fre¬ 
quently find that they become deaf in consequence. 

Wetting of the hair is a cause of injury to the ear, as well as wet¬ 
ting the ear itself. The practice is especially harmful in cold weather. 
Care should be taken to dry the hair, especially near the ears, when¬ 
ever it is wet. 

It is well to protect the ear from loud sounds, which are especially 
liable to cause injury if unexpected. When anticipated, the drum 
membrane is prepared by the action of muscles for the purpose, so 
that injury is less likely to occur. Persons have been made stone 
deaf by confinement in a belfry during the ringing of a large bell. 
Artillery-men often lose their hearing in consequence of the loud 
noises to which their vocation exposes their ears. Even shouting 
loudly in the ear has been known to produce injury. A bit of cotton 
placed in the ear will do much to deaden sound. 

One other caution should be given in conclusion. The attempt is 
sometimes made to relieve toothache by placing in the ear cotton sat¬ 
urated with camphor, chloroform, or other medicaments. While this 
mode of treatment is sometimes successful, the plan is not a good one 
nevertheless, as the injury done to the ear may be greater than the 
benefit received by the tooth. Both the tooth and the ear should be 
treated on their own merits, each for its own maladies, unless the 
other be implicated as a cause. 

Full explanations respecting the use of ear-trumpets and other 
means of aiding impaired hearing are given in connection with the 
consideration of the subject of deafness. 


202 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


THE CIRCULATORY APPARATUS. 



The organs of circulation, or the circulatory apparatus, constitute 
the means by which the blood, the nutritive fluid of the body, is cir¬ 
culated through all 
its different parts, 
carrying new material 
to parts requiring it 
for repairs, and carry¬ 
ing away to be ex¬ 
pelled from the body 
worn-out and useless 
or clogging elements 

DO O 

wherever found. The 
circulatory apparatus 
consists of the heart, 
the blood-vessels, and 
the lymphatics, the 
structure and func¬ 
tions of which we 
will now briefly ex¬ 
amine. 

The Heart.— Fig. 
88. The heart is the 
central organ of the 
circulation, and hence 
is very properly 
placed near the center 

Fig’. S8. The Heart. 1. Hight Auricle; 18. Left Auricle; ^^dy, in tile 

2. Vena Cava; 3. Aorta; 4. Pulmonary Veins; 5. Coronary Arte- thorax its exact posi- 
ry and Veins; 6. Pulmonary Artery. _ ’ _ * 

tion being a little to 

the left of the median line in the central part of the chest, between 
the two lungs. The heart is a muscular organ. It is, in fact, a hollow 
muscle. It is conical in shape, and is suspended in the chest, with the 
base upward and the apex downward. The apex is free, and when the 
heart is beating may be felt to strike the chest just below the fifth rib 





Plate V. 


THE CIRCULATION. 

















VALVES OF THE HEART. 


203 



and about one and one-half inches to the left of the breast-bone. The 
weight of the heart is ten to twelve ounces in men, and eight to ten 

in women. The heart 
is really a double or¬ 
gan, and may properly 
be considered as two 
hearts joined together. 
See Fig. 89. In some 
lower animals the two 
hearts are separate. 
See Fig. 90. The two 
hearts are called, re¬ 
spectively, the right 
heart and the left heart. 
Each heart has two 
cavities, a lower, called 
the ventricle, and an 
upper, called the au- 

Fig. 89. Diagram showing the two sides of the Heart and ride, On aCCOUllt of its 
their cavities. ear-like appearance. 

The walls of the left ventricle, or the lower cavity of the left heart, 
are very much thicker than those of the right ventricle. A diagram 
of the cavities is shown in Fig. 89. 


Valves of the Heart.— The auricle and the ventricle of each 
heart communicate with each other, but there is no direct communica¬ 
tion between the two hearts except in the 
infant before and just after birth when 
there is an opening between the two auri¬ 
cles. This opening between the auricle and 
ventricle in each heart is guarded by a 
valve which allows the blood to pass from 
the auricle into the ventricle but not back 
into the auricle. The valve in the left 
heart is called the mitral or bi-cuspid, 
having two cusps, or curtains. The valve 
in the right heart, having three cusps, is 
Called the tri-CUSpid valve. See Fig. 91. Fig. 90. The Double Heart of 
Each of the cavities of the two hearts tL ' Dus ° ns ' 
communicates with blood-vessels, the auricles communicating with 





204 


ANATOMY, PHYSIOLOGY , v!2V r D HYGIENE. 




Figr. 91. The Heart with portions of its walls removed, show¬ 
ing interior of cavities. 6, Try Cuspid Valve; 10. Mitral Valve; 
12. Semi-Lunar Valve. 


Figr. 92. Section of the Heart, showing rela¬ 
tive size of its cavities, and thickness of the walls 
of the ventricles. 


veins, and the ven¬ 
tricles with arteries. 
The openings between 
the ventricles and ar¬ 
teries are also guarded 
with valves upon both 
sides, which from 
their half-moon shape 
are termed semi¬ 
lunar valves. The 
left semi-lunar valve 
guards the opening 
between the left ven¬ 
tricle and the aorta. 
The right semi-lunar 
valve guards the 
opening between the 
rie'ht ventricle and 

o 

the pulmonary ar¬ 
tery. The veins have 
no true valves at their 
openings into the au¬ 
ricles, but are slightly constricted. 

The Pericardium* —The heart 
is contained in a delicate sac 
called the heart-case, or pericar¬ 
dium, the lining membrane of 
which secretes a fine lubricating 
fluid to secure the utmost ease of 
action. The heart is lined with 
a delicate membrane, the endo¬ 
cardium, which is continuous 
with the lining of the blood-ves¬ 
sels. 

The Blood -Vessels.—There 

are three classes of blood-ves¬ 
sels, — arteries, capillaries, and 
veins. The arteries differ from 
the veins in having rigid walls, 





THE PRINCIPAL ARTERIES. 


205 


■\\ hich are in the large arteries chiefly composed of connective tissue, 
but in the smaller ones contain a large proportion of involuntary 
muscular tissue. The smallest arteries, called arterioles, have their 
walls almost wholly made up of muscular tissue. The arteries derive 

their name from the fact that they 
are found empty after death, which 
led the ancients to suppose they were 
simply ducts for air. Fig. 93 gives 
a general view of the arterial sys¬ 
tem. 

Names of Some of the Principal 
Arteries. — The following are the 
names of some of the principal arte¬ 
ries of the body :— 

The aorta is the great artery of 
the body. It starts at the left ven¬ 
tricle, and subdivides into numerous 
branches in the various parts of the 
body through which it passes. Arch¬ 
ing upward as it leaves the heart, 
the aorta sends off large branches 
which supply blood to the head and 
upper extremities. The chief of these 
are the innominate, the carotid, and 
the subclavian. The first two sup¬ 
ply the right arm and the head, and 
the third the left arm. In the arms 
the arteries become first the brachial, 
which divides in the fore-arm into 
the ulna and radial, the ends of which unite in the hand to form an 
arch in the palm, known as the palmar arch. 

As it passes downward through the chest, the aorta gives off 
branches to the lungs and other organs contained in the thorax. In 
the abdominal cavity, branches are given off to the abdominal organs, 
the stomach, pancreas, spleen, intestines, liver, kidneys, and other 
viscera. In the pelvis the aorta divides into two branches, one of 
which goes to each of the inferior extremities, the plan of distribution 
in the lower limbs being similar to that in the arms. 

The large pulmonary artery which leaves the right ventricle is 
distributed wholly to the lungs. 



The Arterial System. 




206 


ANATOMY , TIIYSIOLOGY, AND HYGIENE. 


The Capillaries. —These are the smallest of the blood-vessels. 
They are so very small that they can only be seen with a good micro¬ 
scope. Their walls consist only of the lining membrane of the arte¬ 
ries. They form an intricate mesh work 
through all the soft tissues of the body. 
The size of the capillaries is generally 
not more than of an inch, and some¬ 
times less. 

The Yeins. —The veins begun with 
the capillaries, and gradually increase 
in size as they approach the heart, by 
the joining together of branches from 
different parts of the body. The veins 
differ from the arteries, 1. In being more 
numerous, there usually being two veins 
for one artery; 2. In having flaccid walls 
which collapse when they are not filled; 
3. In having little or no muscular fibre 
in their walls, so that they cannot con¬ 
tract as do the arteries; 4. In having 
valves in some parts of the body which 
allow the passage of blood in only one 
direction,—toward the heart; 5. In com¬ 
municating freely with each other by 
connecting branches. The location of 
the valves can be readily seen by tying a 
cord around the arm, thus interrupting 
the flow of blood. In a few seconds the 
veins of the hand and arm will be very 
much swollen with blood, and at regular intervals along the vein, 
about an inch apart, will be noticed little prominences which mark 
the location of valves. Fig. 94 gives a general view of the Venous 
System. The valves are well shown in Figs. 95 and 96. 

The veins usually correspond in name to the arteries which they 
accompany. A few of the most important are, the ascending and de¬ 
scending venal cavce, which gather all the blood from the veins of the 
upper and lower parts of the body respectively; the innominate, 
which collects the blood from the head and upper extremities; the 
jugular, which returns blood toward the heart from the brain and 



Fig:. 94. The Venous System. 


































ACTION OF THE HEAET. 


207 


head; the portal vein, -which collects the blood 
from the stomach, pancreas, spleen, and intestines, 
and conveys it to the liver; the hepatic vein, 
which conveys blood from the liver to the as¬ 
cending vena cava; and the four pulmonary veins, 
which convey the blood from the lungs to the 
left auricle of the heart. For a representation 
of the system of blood-vessels, see Fig. 93. 

Action of the Heart. —Like all other muscles, 
the function of the heart is to contract. In do¬ 
ing so it expels from its cavities the blood con¬ 
tained in them, just as water is pressed out of 
the rubber bulb of a syringe. Each portion of 
the heart goes through a rhythmical action of 
contraction and dilatation, the two hearts, or right and left side of 
the heart, if it be considered as one, acting together. The auricles, 
contracting, send the blood which they contain through the mitral 
and tri-cuspid valves into the ventricles. When the ventricles contract, 
they send their blood through openings guarded by the semi-lunar 
valves into the aorta and pulmonary artery. This action is shown 
in Figs. 97 and 98. 



%ig. 95. Fig-. 96. 


Fig. 95. Valves of 

veins closed. 

Fig. 96. Valves of 
veins as thev appear «hen 
a vein is slit open. 


This action of the heart occurs 
about seventy-two times a minute, 
or four times for each respiration, 
and is called the heart-beat. 

Heart Sounds. —The beating 
of the heart is accompanied by 
two sounds, the first of which is 
produced by the striking of the 
apex of the heart against the wall 
of the chest, by the muscular con¬ 
traction of the heart, and by the 
closing of the valves between the 
auricles and the ventricles. The 
second sound is a short click 
made by the semi-lunar valves as 
they close together after the blood 
has been forced from the ventricles 



Fitr. 97. Diagram showing Valve between 
Auricle and Ventricle open, ana Semi-lunar Valve 
closed, allowing the Ventricle to fill. 


into the arteries, to prevent its return into the heart. 















208 


AX ATOMY, PHYSIOLOGY, AND HYGIENE. 


Amount of Work Done by the Heart. —Various estimates 
have been made of the force exerted by the heart in driving the 
blood through the arteries. Recently it has been shown very conclu¬ 
sively that the left ventricle exerts a force of no less than fifty 
pounds in its contraction, that of the right ventricle being only about 

one-third as much, and the auri¬ 
cles about one-tenth as great. 
Adding together the force ex- 
erted by the different portions of 
the heart at each beat, we have 
an aggregate of over seventy-five 
pounds. By this is meant that 
the heart exerts, each time it beats, 
a force as great as would be re¬ 
quired to lift seventy-five pounds 
a foot high. To ascertain the 
amount of work done by the 
heart, then, we have only to mul¬ 
tiply the amount of work done 
at each beat by the number of 

Fig. 98. Diagram showing Valve between , . . . 

Auricle and Ventricle closed, and Semi-lunar beats in a given time. Hie aver- 
alve open, allowing blood to pass into the Arte- ao - e jg seventy-two beats a 

ries. J 

, minute, which would be 4,320 an 
hour, and 103,680- in a day of twenty-four hours. Multiplying the 
last amount by seventy-five, gives us 7,776,000 pounds as the entire 
work done by the heart during one day, which is equivalent to lifting 
3,888 tons a foot high in a minute. This amount seems so enor¬ 
mous as to be almost incredible; but there is no doubt of the correct¬ 
ness of the estimate. 

The wonderful vitality of the heart is shown not only by the amount 
of work done by it, but by the remarkable tenacity of life which it 
manifests, continuing to work under the most embarrassing circum¬ 
stances, as in disease, and when other important parts of the body 
have ceased to act. In cold-blooded animals it will even continue its 
rhythmical contractions for hours after the animal is killed and the 
heart taken from the body. The heart of a turtle can be made to con¬ 
tract more than twenty-four hours after being removed from the body 
of the animal. 

Although the heart seems to be in such constant activity, some 




FREQUENCY OF THE PULSE. 


209 


part of it is always at rest, each acting part taking a short rest after 
each contraction before acting again. The heart in this way obtains 
nine or ten hours of rest out of each twenty-four. 

The Pulse. —When the heart contracts, a wave-like impulse is sent 
throughout the whole arterial system, traveling from the heart to the 
remotest part of the body in about the sixth part of a second, so that 
it is practically instantaneous. Where the arteries come near the sur¬ 
face, this impulse may be felt, and is called the pulse. The most con¬ 
venient place for feeling the pulse is in the radial artery just above 
the wrist, on the outer or thumb side of the arm. It may also be felt 
in the carotid artery of the neck, the temporal artery of the temple, 
and in many other localities. 



Fig:. 99. Tracing of the pnlse obtained by the sphygmograph. 


An ingenious instrument known as the sphygmograph, the use of 
which is described elsewhere, has been invented within a few years, 
by which the character of the pulse may be more carefully studied 
than with the finger. The tracing shown by the white line in Fig. 99 
we obtained with one of the latest and most improved forms of the 
instrument, known as Pond’s Sphygmograph, a cut of which is shown 
elsewhere. As the pulse is really an index to the condition of the 
heart, it becomes also a good indicator of the general condition of the 
system, and much valuable information can be gained from its careful 
study. The various indications of the pulse are given elsewhere. 

Frequency of the Pulse, —The pulse, of course, corresponds ex¬ 
actly with the heart-beat in frequency, and whatever modifies one af¬ 
fects the other as well. The usual average rapidity is about seventy- 
two beats a minute. This rate is very considerably modified by vari¬ 
ous influences, some of which may be mentioned with advantage. 

1. The frequency of the pulse greatly depends upon the age. At 
birth the pulse rate is 136; from two to seven years, 97; fourteen to 
twenty-one, 76; twenty-eight to thirty-five, 70; fifty-six to sixty- 
three, 68; seventy-seven to eighty-four, 71. In females the pulse is 
seven to ten beats faster than in males. The average rate of pulsa¬ 
tion in males, from two to eighty years, is 73 ; that of females is 82. 

14 




210 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 



2. Posture modifies the pulse rate. For 
example, it has been found that the pulse 
of a person whose heart beats 66 times a 
minute while lying’ down will be about 71 

J o 

when sitting, and 81 when standing. 

8. The frequency of the pulse is affected 
by temperament. In some persons the 
pulse is naturally much more rapid than 
in others. Some persons have remarkably 
slow pulses. Both Napoleon and Welling¬ 
ton had pulses remarkable for their slow¬ 
ness, not averaging more than fifty beats 
a minute. We once met a case, that of a 
young lady, in which the pulse was but 
thirty-two ; another patient, a young man 
who was in a very debilitated condition, 
we found with a pulse of but thirty. 

4. Digestion increases the heart-beat 
from five to ten per minute. The increase 
in frequency of the pulse is particularly 
marked after a meal consisting largely of 
flesh food. 

o. The influence of exercise upon the 
heart’s action is very great. A person 
whose pulse is 68, after a slow walk will 
have a pulse of 78; after walking at the 
rate of four miles an hour, 100; and after 
a rapid run, 140 to 150. In children and 
women the pulse is considerably slower 
during sleep than when simply reclining 
while awake. In adult males there seems 
to be no difference. 

6. The heart’s action is greatly ac¬ 
celerated by a high temperature, and is 
retarded by cold. A Turkish or Russian 
bath or a warm full bath will occasion a 
very considerable increase in the activity of the heart. The pulse of 
persons living in warm climates averages greater than that of those liv¬ 


Fig - . lOO. A Diagram of the Cir¬ 
culation. 1. Left Ventricle; 2. Right 
Ventricle; 3. Liver; 4. Spleen; 5. In¬ 
testines; 6. Stomach; 7. Pancreas; 
9. Urinary and Sexual Organs; a. 
Aorta; r r. Lungs; a. Pulmonary Ar¬ 
teries; V. Pulmonary Veins. 


ing in cold climates. 

O 






THE SYSTEMIC CIRCULATION. 


211 


A curious account is given by physiologists of a man who possessed 
such control of his heart as to be able to suspend its action altogether. 
On one occasion he remained for half an hour appearing as though dead, 
neither respiration nor heart action being perceptible. Several medical 

men were present. 

The Course of the Blood 
in the Circulation. — The 

circulatory apparatus of the 
system may be divided into 
three distinct circulatory sys¬ 
tems; viz., the general or 
systemic, the pulmonary, 
and the portal. These three 
systems and their relations to 
each other and to the heart 
are shown in Figs. 100 and 
101, and still better in the 
diagram on Plate V. The 
general course of each of 
these three systems we will 
now trace. 

The Systemic Circula¬ 
tion. —The circuit of blood 
for the body in general starts 
at the left ventricle of the 
heart. By the contraction 
of the heart the blood is 
forced into the aorta, and 
as the semi-lunar valves 
close tightly behind it, each succeeding contraction forces the blood far¬ 
ther on in the arteries until it is thus propelled to the minute capillaries 
of the whole body. In these the blood flows very slowly, the motion 
often being imperceptible. The capillaries finally merge into veins, 
which gradually grow larger in size and smaller in number until they 
finally all unite to form two great venous trunks, the ascending vena 
cava, which conveys to the heart all blood from the lower part of the 
body, and the descending vena cava, which empties into the heart all 
the blood from the upper part of the body. The two vessels empty 
their contents into the right auricle. This completes the circle of the 



Fig:. 101. Diagram of the Circulation, showing by 
means of arrows t.ie direction of the blood current in 
the blood-vessels. 






212 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


systemic circulation, which, as will he observed, conveys the blood from 
the ventricle of the left heart to the auricle of the right heart. 

Tlie Pulmonary Circulation. —In order to provide for its purifica¬ 
tion, we have a second s} r stem through which the blood is circulated. In 
this system the blood which is received into the right auricle from all 
parts of the body is forced by its contraction into the right ventricle, 
whence it is forced into the pulmonary arteiy. This artery conveys it to 
the lungs and distributes it in a special set of capillary vessels in which it 
undergoes purification, and is then, by means of the pulmonary veins, 
conveyed back to the heart, which it enters at the left ventricle. It is 
thus seen that the pulmonary circulation forms a circuit for the blood 
from the right ventricle of the heart to the left auricle, whence it enters 
the left ventricle and again begins its round in the systemic circuit. 

The Portal Circulatiou. —This system is really a subdivision of the 
systemic circulatory system. The blood which is distributed to the 
stomach, intestines, pancreas, and spleen, instead of returning with the 
rest of the blood of the general system direct to the heart by means of 
veins and the vena cava, is collected from all these organs by a large 
vein knoAvn as the portal vein, which conveys it to the liver, where it is 
distributed through a special set of capillaries provided to enable the 
liver to perform its special functions upon the blood, removing impuri¬ 
ties, completing the work of digestion to some extent, etc. All the ele¬ 
ments absorbed by the veins of the stomach during digestion are thus 
submitted to inspection before being allowed to enter the general circu¬ 
lation. From the liver the blood is carried to the ascending vena cava 
by means of the hepatic vein, and thus the portal circulation is com¬ 
pleted. 

Forces of the Circulatiou. —The heart, although the chief, is not the 
only active agent in the circulation of the blood. Several agents have 
part in the work, the principal of which will be enumerated as follows:— 

1. The Heart .—As already seen, the force exerted by the heart 
amounts to about seventy-five pounds each beat; and although this 
force is sufficient to propel the blood to the capillaries, so large an 
amount of friction results from the immense surface over which the 
blood passes in the capillaries that additional force is required. Again, 
there is good evidence for believing that the blood will continue to circu¬ 
late without the action of the heart, the arteries being always found 
empty when examined after death, though they must have been full 


FORCES OF THE CIRCULATION. 


213 


when the heart ceased its activity. In some low animal forms, too, the 
circulation is carried on without the aid of the heart, just as the sap is 
circulated in a plant. 

2. The Arteries .—The contraction of the heart, which gives the blood 
a propulsive impulse, is followed up by the contraction of the arteries. 
The small arteries are supposed to be specially active in assisting the cir¬ 
culation. Some observers claim that the small arteries or arterioles keep 
up a constant peristaltic action, by means of which the blood is urged 
forward. 

3. The Capillaries .-—While the capillaries themselves are simply 
passive agents, the passage of the fluid part of the blood through their 
walls must occasion a capillary action similar to that which causes the 
rising and circulation of sap in trees and plants. It is claimed by some 
physiologists that the circulation is aided by the attraction of the. walls 
of the capillaries for the nutritive elements of the blood. It is proven, 
at any rate, that blood which is well oxygenated passes readily through 
the capillaries, while that which contains carbonic acid is very much re¬ 
tarded in its progress in this part of the circulation. 

4. The Muscles and the Valves of the Veins. 

—The veins are so placed among the muscles that 
whenever contraction of the muscles occurs they 
are compressed, and the blood which they contain 
is necessarily displaced. As it cannot pass back¬ 
ward, on account of the valves which close when¬ 
ever a backward current is established, it must of 
necessity move forward. Contraction of a mus¬ 
cle has essentially the same effect upon it that 
squeezing has upon a sponge filled with water. 

This is undoubtedly an important aid to the venous circulation. See 
Tig. 102. 

5. Heat .—It is probably true that in certain parts of the body, at 
least, the elevation of temperature which the blood undergoes in the cap- . 
diaries aids the circulation by increasing its volume, the pressure of blood 
from behind compelling expansion in one direction, toward the veins. 

G. The Lungs .—The lungs operate with considerable force in aiding 
at least a portion of the venous circulation. When the chest is ex¬ 
panded, and while it is filling, the pressure being partly removed from 
the large veins which pass through the chest, the blood rushes in to fill 
them. In this way much assistance is especially afforded to the circula- 



Fig\ 102. Diagram 
showing how the valves of 
the veins aid the circulation 
by preventing back current. 




214 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


tion of blood in the liver, which is a wise provision of nature, as it will 
be observed, by reference to the diagram of the circulation, Plate X, 
that the blood of the portal system passes through two sets of capilla¬ 
ries, the double amount of friction thus produced having a strong tend¬ 
ency to render the circulation in the liver sluggish. 

Regulation of tlie Circulation. —The heart’s action is under the 
immediate control of the nervous system. Each beat of the heart is in 
obedience to an impulse sent to it from the nerve centers of the brain 
and spinal cord. In order to provide for the various exigencies which 
make necessary an increase or diminution of the action of the heart, 
two sots of nerves are provided, one of which accelerates the action of the 
heart, while the other slows its contractions. The first function is per¬ 
formed by the s} r mpathetic nerves, the second by the pneumogastric. 
By the action of these nerves the supply of blood to the general system 
is regulated according to its wants. For example, when a person is en¬ 
gaged in active exercise the muscles and nerves demand an increased 
supply of nourishment, which can only be furnished by an increased 
supply of blood. The increased waste also demands a quickened circu¬ 
lation to remove the products of the disintegration due to muscular 
activity. Hence the pneumogastric nerve releases in part its hold upon 
the heart, and the sympathetic nerve increases its action. Every part of 
the body receives an increased supply of blood, those not engaged in 
active exercise, to some degree at least, as well as those which partici¬ 
pate in the activity. 

Regulation of Local Blood Supply. —In addition to the nerves 
already referred to, there is a set of nerves which accompany the blood¬ 
vessels in their minutest subdivisions and remotest ramifications, by 
means of which the circulation of each organ, even each small portion 
of the body, is controlled. The nerves are connected with a collection of 
cells in the medulla oblongata known as the vaso-motor center. When 
an impulse is sent out from this center along any of the nerves which 
go out from it, the muscular walls of the small arteries to which the 
nerves are distributed are caused to contract, and thus a less amount of 
blood is allowed to flow through the part. When a .slight degree of ex¬ 
citation of the nerves is kept up by the center, the walls of the arteries 
become relaxed, so that by their dilatation a much larger amount is al¬ 
lowed to flow through them than before. An experiment often per¬ 
formed by physiologists well demonstrates this action of the vaso-motor 
nerves. The vaso-motor nerve of the ear of a white rabbit be km di- 

O 

















A. "Foot of a frog, slight]}' magnified, B. Tfie heart, showing the origin of the large 
bipod vessels ; C- Circulation in foot of frog, greatly magnified; V. Red blood corpuscles; 
E. Blood corpuscles, red and white— a. white, b. red. 


Prate VI. 









COMPOSITION OF THE BLOOD. 


215 


vided, the white skin of the ear quickly becomes red, being congested 
with blood, the result of paralysis of the small arteries of the part. If 
the end of the divided nerve be stimulated by electricity, the arteries 
will at once contract and the skin assume its natural color. 

Blushing is due to the dilatation of the small arteries of the face 
from the effect of certain emotions upon the vaso-motor center in the 
brain. The paleness due to fright and extreme rage results from con¬ 
traction of the small arteries induced in the same way. 

The circulation of blood in the stomach, liver, and other internal 
organs, as well as in all other distinct parts of the body, is controlled by 
dilatation and contraction of the small arteries, in the manner described. 

THE BLOOD. 

The blood is a fluid tissue. In the body there are tissues of all 
degrees of consistency, from the dense bones and tendons to the per¬ 
fectly fluid blood. It is a highly vitalized fluid, not a mere chemical 
solution. The blood contains all the elements necessary for the building 
up and keeping in repair of all the various tissues of the body. In addi¬ 
tion to nutritive elements the blood also contains the various effete or 
waste products which result from the breaking down of the various tis¬ 
sues as the result of vital action. It not only supplies nourishment to 
the hungry tissues but washes them free from the noxious products of 
daily waste. 

The quantity of the blood has been variously estimated, the esti¬ 
mates varying from ten to eighteen pounds, or about half as many 
quarts. 

Composition of the Blood. —To the unassisted e}'e the blood ap¬ 
pears to be a homogeneous fluid, of a reddish color which varies from 
the bright red of the arterial blood to the dark purple blood found in 
the veins. When examined with a microscope of sufficient power, the 
blood is found to be made up of about equal quantities of fluid and cer¬ 
tain minute solid bodies floating in the fluid, called blood corpuscles, of 
which there are two varieties, white , and red, each of which we will de¬ 
scribe. 

White Blood Corpuscles. —The microscope reveals in the blood 
minute protoplasmic bodies, resembling drops of transparent jelly, which 
constitute the white blood globules or corpuscles. Plate A I. These 
minute specks of life may be considered as independent individuals, since 


216 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


they may be removed from the body and kept alive for weeks. A sci¬ 
entific writer not inaptly calls them little fishes swimming in the life- 
current which flows through the veins and arteries. So small are these 
little creatures that twenty-five hundred of them arranged in a row 
would make a line but an inch in length. When examined closely the 

white corpuscles may be seen to 



have in their central portion 

specks. See 


minute granular 


Fig. 103. Red and White Blood Corpuscles. 
a. White Blood Corpuscle; b. Red Corpuscle; 
c. Red Corpuscle, showing edge; d. Red Corpus¬ 
cles in rolls, an evidence of health. 


Fig. 103. 

The white corpuscles are sup¬ 
posed to have their origin in the 
lymphatic glands, in which cor¬ 
puscles exactly resembling them, 
and known as lymph corpuscles, 
are found in great numbers. 
When carefully studied under 
various circumstances they are 
found to undergo a regular proc¬ 
ess of growth and development 
like large animals, finally grow¬ 
ing old and at last dying and being removed from the body, cast out as 
dead bees are thrust out from a hive by the living workers. While 
in their active state these remarkable little bodies exhibit many won¬ 
derful properties. Though they have no organs of locomotion, they are 
able to move from point to point with ease and considerable rapidity. 
Having no mouths, they are yet voracious eaters. Though possessing 
no nerves or organs of any other sort, they appear to be exceedingly 
sensitive to heat and cold, electricity, and other agencies which in higher 
forms of life are recognized by organs of sense. How these functions 
are performed by the white blood corpuscle,—sometimes called the ani¬ 
malcule of the human blood,—we need not dwell upon in detail here, as 
the same subject has already been more fully explained in another con¬ 
nection. * 

What are known as mucous, lymph, and pus corpuscles are appar¬ 
ently identical with white corpuscles. 

The Bed Blood Corpuscles. —Besides the white corpuscles just 
described, and constituting by far the largest share of the solid con¬ 
stituents of the blood, are found the red blood corpuscles. See 





THE BED BLOOD'CORPUSCLES. 


217 


Fig. 104. Like the white corpuscles, the red are exceedingly mi¬ 
nute, from three thousand to thirty-five hundred being required to 
form a row an inch in length. The red corpuscles differ from the 
white in several particulars. Instead of being globular, they are 
bi-concave and disc-like in form, being about one-fourth as thick 
as broad. Instead of be in" trans- 

O 

parent, or gray in color, they are 
of a faint amber color, the red 
color of the blood resulting from 
the massing together of such im¬ 
mense numbers as are found in the 
vital fluid. It has been recently 
determined that there are more 
than 3,000,000 of these delicate 
bodies in a drop of blood no 
larger than can be made to ban" 
upon the point of a pin. There 
are no less than 30,000,000,000,- 
000 red corpuscles in the whole 
body. The red are much more 
numerous than the white cor¬ 
puscles, in health, the average proportion being about 300 red to one 
white. The proportion of white corpuscles is greater just after a meal, 
and in certain forms of disease they occasionally become so numerous 
as to equal in ■ numbers the red corpuscles, a condition which is very 
unfavorable to life. 

The color of the corpuscles is due to a peculiar kind of coloring 
matter which they contain. By means of this singular substance, as 
is supposed, the corpuscle acquires the power to absorb many times its 
own bulk of certain gases, a property similar to that possessed by 
fresh charcoal, which is rendered a good filtering medium on account 
of the large amount of condensed oxygen stored up in its pores. The 
color of the corpuscles differs according to the character of the gas 
which they are carrying, they being of a bright color when carrying 
oxygen, and darker when carrying carbonic acid, thus occasioning the 
difference in color between arterial and venous blood, as will be fur¬ 
ther explained in treating on the subject of “ Respiration.” 

The origin of the red corpuscles was for years a puzzle to physiolo¬ 
gists ; but an ingenious German solved the problem by removing a 



Fig. 104. Red Blood Corpuscles. 





218 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


small quantity of blood from the body and carefully watching it for 
a sufficient length of time to witness the actual development of red 
corpuscles. The blood, by being kept at the temperature of the body 
and in a moist atmosphere, seemed not to suffer by its removal; and 
the patient observer was rewarded for his pains by seeing white blood 
corpuscles gradually turn into red ones, thus demonstrating that red 
corpuscles are simply white ones grown old. 

Each corpuscle acts a part in the body but a brief period, as 
it passes quite rapidly through its various stages and becomes useless, 
when it is destroyed and removed from the body. The spleen and 
liver seem to be the most active blood-destroying organs. The color¬ 
ing matter of the blood corpuscles after their destruction is converted 
into the coloring matter of the bile. 

The blood corpuscles of animals resemble more or less closely those 
of human beings. Those of the dog are so near like human blood 
corpuscles as to be scarcely distinguishable. Those of the goat, sheep, 
and ox, are much smaller, and those of the elephant much larger than 
those of human beings. The corpuscles of the camel and llama are 
elliptical in shape, as are also those of birds, reptiles, and fishes. In 
the three last-named classes of animals the corpuscles are bi-convex 
instead of bi-concave. 

The liquid Portion of the Blood. —The liquid half of the blood 
may be regarded as a solution of albumen, containing also small quan¬ 
tities of fat, certain salts, waste products, and gases. 

When exposed to the air the albuminous constituent of the blood 
is decomposed very quickly, one portion becoming semi-solid. This is 
what is known as coagulation of the blood. The part which coagu¬ 
lates is ordinarily known as fibrine. The albuminous elements of the 
blood are its chief nutritive elements. From these the tissues derive 
the material from which they are formed. While in solution in the 
fluid portion of the blood, or 'plasma, they permeate every organ and 
tissue of the body, thus bathing with a nutritive fluid all the tissues 
requiring repair. It is a curious fact that the fluidity of these 
elements seems, in some degree at least, to depend upon their constant 
motion, for blood soon coagulates when stagnation occurs. Any for¬ 
eign body introduced into a blood-vessel will also occasion coagula¬ 
tion. In inflammation and some other conditions the tendency to co¬ 
agulation is increased. 

The proportion of fat is ordinarily very small, being not more than 


FUNCTIONS OF THE BLOOD. 


219 


one part in twenty-five hundred of blood, or .04 per cent. After a 
meal consisting largely of fat, a much larger quantity may he found 
in the blood. In the blood of habitual drunkards, fat is also usually 
found in greatly increased quantities. 

The various analyses which have been made for the purpose of de¬ 
termining the saline constituents of the blood seem to us to be less re¬ 
liable than would at first appear, since they do not take into account 
the nature of the individual’s food. We have no doubt that a laro-e 

O 

share of the so-called saline constituents of the blood are both unnat¬ 
ural and unnecessary elements in the quantities in which they are 
usually found, and that they only occur in the blood incidentally, hav¬ 
ing been taken in excess in the food, and being absorbed and carried 
by the blood to the various organs capable of eliminating them. This 
seems to be particularly true of the various compounds of soda, es¬ 
pecially sodium chloride, or common salt, which is found in the human 
system almost exclusively in the blood, merely a trace being found 
even in the bones, the hardest of all the tissues of the body. 

Functions of the Blood. —As before remarked, the blood not 
only supplies to the various tissues material from which they may re¬ 
plenish themselves, but washes them free from the poisonous products 
of vital activity, which are conveyed to the various organs designed 
to remove them. It will be interesting to, consider briefly the work 
performed by the two varieties of corpuscles found in the blood and 
already described. 

Function of the White Blood Corpuscles.-- The principal use 
of the white corpuscles probably is to ultimately become red ones, 
which have the most important work to perform. It is probable, also, 
that the white corpuscles have something to do with nutrition, since 
it has been noticed that they are most abundant at points where some 
injury has occurred or where repair is necessary for some other cause. 

Function of the Bed Blood Corpuscles. —The red blood cor¬ 
puscles are probably the most immediately necessary to life of any of 
the elements of the body, if we except some of the nerve centers. 
This is well shown by the fact that many persons when nearly 
dead from loss of blood have been quickly recovered by the injection 
into the veins of fresh blood from which the fibrine had been removed, 
leaving only the corpuscles and serum. When serum alone has been 
used, no appreciable result has been obtained, but when the corpuscles 
are used with the serum, even though the nutritive fibrine be removed, 


220 


ANATOMY , PHYSIOLOGY, AND HYGIENE. 


the effect is sometimes almost as marvelous as the restoration of the 
dead to life. Indeed, it is stated on good authority that a dog which 
had been bled to death, after having blood from a living dog injected 
into Ins veins, got upon his feet and walked a short distance. Almost 
equally marvelous experiments have been made with human beings, 
decapitated criminals being used for the purpose. 

The chief business of the red corpuscles is to carry oxygen from 
the lungs to the tissues. Oxygen is the most essential to life of all 
the elements received into the system. The lungs are the organs by 
which it is taken into the body, and the red blood corpuscles act as 
carriers to distribute it. Each corpuscle takes on a load of oxy¬ 
gen about twenty times its own size, condensing it so as to make it 
portable, and this it carries to the capillaries, where the load of oxy¬ 
gen is laid off and a smaller load of carbonic acid taken on, the latter 
being carried to the lungs and discharged, and a new load of oxygen 
taken on. 

Ail Interesting Sight. —One of the most interesting of all the 
many marvelous sights revealed by the microscope, and one of great 
beauty and interest, is that of the circulation of the blood. The most 
convenient object for a demonstration of this kind is the tail of a 
young tadpole. The tissues near the end of the tail are so thin as to be 
translucent, so that sufficient light will pass through to form an image 
in the microscope. Almost any thin tissue can be used in the same 
way, as the web of the hind foot of a frog, the mesentery of a rat, or 
the ear of a bat. By placing one of these objects under the microscope 
a most marvelous sight is beheld. One who has once seen it will 
never forget it. Qn Plate Y will be found an excellent representa¬ 
tion of what may be seen with the microscope. We have never 
watched this wonderful spectacle without feeling impressed anew 
with the power and wisdom of the Great Designer and Creator of all 
nature. As will be seen by reference to the engraving, the capillaries 
form a close network of minute canals through which the blood cor¬ 
puscles course in narrow lines. In the smallest capillaries they follow 
each other in single file; through the larger ones they pass in twos. 
In some of the smallest vessels the corpuscles seem to squeeze through 
with difficulty, being actually larger than the vessels through which 
they pass, which seeming impossibility they accomplish by changing 
their form, becoming elliptical, and going through their long way. 

Close inspection will bring to notice the fact that the red corpus¬ 
cles in their passage through the capillaries file along in the center of 


THE LYMPHATICS. 


221 


the vessel, while the white ones seem to loiter along the walls, stopping 
here and there a few seconds and then lazily pulling themselves along 
a short distance farther. If watched closely they may be seen, now 
and then, to make their way out of the blood-vessels in a curious 
fashion, by tucking themselves through the minute openings in the 
capillary walls very much as a ball of putty might, by changing its 
form, be tucked through a finger-ring. The red corpuscles sometimes 
accomplish the same feat, though very seldom. The corpuscles which 
thus leave the blood channels do not find their way back again, but 
are carried to the heart by means of the lymph channels,—to be next 
described,—thus being saved and again used so long as they are serv¬ 
iceable. 

The capillary circulation has recently been observed in human be¬ 
ings by an eminent physiologist who discovered a means of making 
visible the capillaries and corpuscles in the lip. 

THE LYMPHATICS. 

The lymphatic system differs from the circulatory system of blood¬ 
vessels in that it has but one set of vessels, all of which run in the 
same direction, toward the center of the body. The lymphatic system 
also differs from the arterial and venous systems in that it has few 
large trunks, being almost wholly made up of minute vessel which 
constantly communicate with 
each other in all parts of the 
body. In certain localities 
there are found small gland¬ 
ular bodies about which the 
lymphatic vessels seem to col¬ 
lect, or from which they seem 
to radiate. These are known 
as lymphatic glands. They 
are chiefly found in the vicin¬ 
ity of the groins, the armpits, the neck, beneath the knee, in the bend 
of the elbow, and among the folds of the small intestine. See Figs. 
105, 10G, and 107. 

The smallest vessels seem to originate in the connective tissue 
spaces, in all parts of the body. In the mucous membrane of the small 
intestine they originate in minute protuberances known as villi, which 
will be described hereafter. All the lymph vessels of the lower extrem- 



Figr, 105. Lymphatic Glands. 


222 


ANATOMY, PHYSIOLOGY , AND HYGIENE. 



rig. 106. The Lymphatic Vessels and Glands of Ihe head and neck. 

ities, the abdomen, and left half of the upper part of the body, empty 
their contents, directly and indirectly, into a large duct known as the 
thoracic duct, which passes up at the back part of the cavity of the 
abdomen and the thorax and empties into the left subclavian vein. 
Those of the right half of the upper part of the body are drained by 
the lymphatic vein, or duct, which empties into the right subclavian 
vein. 

The contents of the lymphatic vessels is a clear, limpid fluid, which, 
when examined chemically and microscopically, is found to contain a 
fluid substance similar to the serum of the blood, except that it con¬ 
tains more of the waste or excrementitious elements than the blood. 
It also contains large numbers of corpuscles called lymph corpuscles, 









FUNCTIONS OF THE LYMPHATICS. 


223 


which are similar to, and undoubtedly identical 

with, the white corpuscles of the blood. The 

motion of the lymph fluid is toward the center 

of the circulation, being only in one direction. 

Like the venous system, the lymph vessels have 

valves so arranged as to allow of a current in but 
\i k™\ . ° 

Mill one direction. These valves are much more nu- 
merous m the lymphatics than in veins, as will 
be seen by reference to Fig. 108. In some low¬ 
er animal forms, as in frogs, there is a distinct 
lymph heart which propels the lymph fluid in the 
vessels. There is no such force 
in operation in man and higher 
animals, however, and it is prob¬ 
able that the current of fluid in 
the lymphatics is chiefly due to 
the forces which aid the venous 
circulation; viz., the pressure of 
fluid from the heart, which is 
being constantly propelled into 
the tissues, the contraction of the 
muscles, acting in conjunction 
with the valves, and tbe suction 
force of the lungs in the act of 
inspiration. 

Functions of the Lymphat¬ 
ics. —As would be readily sur¬ 
mised from the structure of the 
lymphatic system, its principal 
function is absorption. From the skin, which is abundantly supplied 
with lymph vessels, water and many substances in solution may be 
absorbed, and thus taken into the system. A case is on record in 
'which a boy in a London hospital, suffering with diabetes, absorbed 
nine pints of fluid through the skin in twenty-four hours. The por¬ 
tion of the lymphatic vessels which are most active in absorption are 
distributed in the mucous membrane of the intestines, where, as al¬ 
ready remarked, special facilities are afforded for the absorption of 
fluids by means of villi, projections of mucous membrane which 
float in the fluid to be absorbed. Through these channels—in this 




Fig 1 . 107. Shows Lym¬ 
phatic Vessels of the arm. 


Fig. 108. The 

Lymphatic Vessels 
showing Valves. 











224 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


part of the body known as lacteals—much of the food finds its way 
into the system. Absorption is also going on all through the body. 
Worn particles and waste products of all the tissues find their way to 
the heart through the medium of the lymph vessels. It is through 
these channels, also, that the white blood corpuscles, which, as we 
have already seen, sometimes escape through the capillary walls, find 
their way back to the blood-vessels. 

It is supposed, also, by many of the most eminent physiologists 
that the lymphatic glands manufacture white corpuscles. 

HYGIENE OF THE CIRCULATION, 

Although the heart and blood-vessels are the least subject to serious 
direct injury of any part of the body, the circulatory apparatus is of all 
parts of the system the most liable to derangement, from sympathy 
with other parts. No part of the system can become in any way im¬ 
paired without affecting the circulation, so universal and intimate are 
the sympathies established by the nervous connections of the heart and 
blood-vessels. 

Exercise Necessary for a Healthy Circulation. —An abundance 
of muscular exercise is essential for the health of the circulatory appa¬ 
ratus. As already observed, the movements of the muscles in contract¬ 
ing squeeze the blood out of the small veins and press it onward toward 
the heart. This compels the heart to beat faster in order to dispose of 
the increased amount of blood which is brought to it, by which means 
two excellent results are obtained : 1. The impure, venous blood is sent 
to the lungs,—which in turn act w r ith greater rapidity,—and is there 
purified and returned to the heart, so that the purity of the blood is in¬ 
creased by the exercise, notwithstanding some w r aste products from 
muscular action are added to it; 2. The heart, by beating faster, sends 
an increased supply of blood not only to the muscles, but to all the or¬ 
gans and tissues of the body ; and thus each part is enlivened and in¬ 
vigorated by the increased quantity of fresh, vitalized blood circulating, 
through it. This increased activity of the circulation is not only bene¬ 
ficial to the muscles, nerves, and other tissues of the body, but also to 
the heart and blood-vessels themselves. The heart is a muscle, and by 
vigorous contractions it becomes strong, as would any other muscle. 
The proportionate strength of the heart is well shown by a simple ex¬ 
periment. Let two persons, one who is not accustomed to active mus- 


DANGERS OF EXCESSIVE EXERCISE. 


225 


cular exercise, and another who uses his muscles vigorously every day, 
each count his pulse while standing. Now let both walk briskly or run 
a few rods, or up and down stairs two or three times. Upon counting 
the pulse a second time it will usually be found that the pulse of the 
sedentary person is very much more excited than that of the person ac¬ 
customed to exercise. This shows that his heart is weaker, and is com¬ 
pelled to make much more violent exertions to accomplish a little extra 
work than a heart accustomed to demands of that sort. It is for this 
reason, mainly, that persons unaccustomed to running or walking usu¬ 
ally get out of breath so quickly, while one trained in this kind of ex¬ 
ercise will endure it with apparent ease for hours. Vigorous exercise, of 
course avoiding excess, makes strong muscles and a vigorous heart. 

Dangers of Excessive Exercise. —While a proper amount of ex¬ 
ercise is important and essential to the health of the circulatory system, it 
should be borne in mind that excess is not only detrimental but danger¬ 
ous. Violent exertion on the part of one unaccustomed to exercise is 
often productive of the most serious injury ; and even those who have 
been trained to violent exercises often suffer great detriment. Instances 
have occurred in which rupture of a blood-vessel has resulted from 
violent straining in lifting, j umping, or trapeze performances. It is well 
known that the valves of the heart hi professional oarsmen are not in¬ 
frequently torn loose by the strain induced by rowing. Under violent 
muscular exertion the pressure of the blood in the arteries is very greatly 
increased, hence the danger. Violent exercises should always be avoided 
as in no way beneficial, and always detrimental and dangerous. All the 
advantages to be gained by exercise can be derived from such moderate 
exercises as have already been recommended in connection with the sub¬ 
ject of the “ Hygiene of the Muscles,” and will be more fully described 
in a chapter especially devoted to the subject. 

Proper Clothing Essential to Healthful Circulation. —We 
cannot in this connection consider more of this broad subject of clothing 
than has an immediate bearing upon the subject in hand, and need not, 
as we have elsewhere devoted a chapter to its consideration. Undoubt¬ 
edly the prime object in clothing is to satisfy the demands of modesty ; 
but besides this, the greatest want supplied by artificial covering of the 
body is the necessity for an equable temperature. This can only be at¬ 
tained by clothing all parts of the body in such a manner as to secure 
the natural degree of temperature for its several parts, adapting the 
clothing to the climate and season of the year. Failure to regard this 
15 


226 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


law is probably more common than the opposite. One-half of the hu¬ 
man family, at least, are habitually clad in a manner which totally ig¬ 
nores the requirements of nature in this regard. It is an exceedingly 
rare occurrence to find a woman who clothes her arms and limbs as 
nature requires them to be clad for health, at any rate among civilized 
nations. The women of barbarous tribes and nations are more sensible 
in this regard, and imitate their husbands and brothers in clothing then- 
limbs as warmly as nature and the exigencies of climate demand. Civ¬ 
ilized women not only neglect themselves—we should properly say abuse 
themselves—in this regard, but their children are allowed to suffer from 
the same cause. Thousands of these little innocents have been sacrificed 
to the insatiable Moloch of Fashion 

The extremities, being farthest from the great centers of heat and 
life, evidently need more clothing than other parts more favorably lo¬ 
cated ; but they commonly receive less. This is an evil, the magnitude 
of which can scarcely be overestimated. We have no hesitation in ven¬ 
turing the assertion that thin shoes and stockings, and bare arms and 
legs, kill more children every year than the infamous Herod murdered 
in Bethlehem. Every philanthropist ought to join earnestly in the 
work of effecting a reform in this direction. Little reward can be ex¬ 
pected, however, for this kind of work in the present generation. The 
results would be best seen in the next, in the effective labors of thou¬ 
sands whose lives are now made useless by disease, the foundation of 
which was laid in early childhood by the evil practice in question, and 
of thousands of others who to-day are filling tiny graves which ought 
to have remained vacant for at least threescore years. Every mother 
who becomes enlightened on this subject ought to communicate the 
knowledge she has gained to the mothers in the circle of her acquaint¬ 
ance. By this means, together with the influence of example, we might 
hope for good results. There has been recently organized in New York 
City a society, the stated object of which is the prevention of cruelty to 
children. We would most earnestly commend to their attention this 
question of proper clothing, and we doubt not that the amount of 
good they might do by propagating correct principles on this subject 
would far exceed the good results in all other departments of their work. 

Evil Effects of Constriction. —Constriction of any part of the 
body is certain to be followed by evil consequences. Suppose, for ex¬ 
ample, a string be tied tightly around the finger. Every one is fa¬ 
miliar with the fact that the finger thus ligated will speedily lose its 


EFFECTS OF FOOD ON THE CIRCULATION. 


227 


natural color, become dark and as quickly lose its natural warmth, 
becoming cold, and that notwithstanding its swollen condition due to 
the superabundance of blood. An elastic around a limb will have 
precisely the same effect upon the foot, though in less degree. The 
circulation being obstructed, less blood than is necessary to health 
flows through the foot, and it is habitually cold; and from the con¬ 
stant interference with its nutrition, it becomes shrunken and weak. 
The use of elastics is well known to be a cause of thin calves. 

A constriction about the waist, from compressing the stomach, liver, 
and other internal organs, must do an immense amount of harm to the 
body by interfering with the functions of these important organs. 
It makes no difference whether the constriction is due to a tightly 
drawn corset or to the bands of skirts hung upon the hips, or to a 
belt tightly clasped; the effect is the same. An English medical 
journal is authority for the statement that in that country quite a 
large proportion of women upon whom post-mortem examinations are 
held are found to have their livers malformed from compression due 
to this very cause. We have seen cases in which the liver was cut 
nearly in two, and cases are reported in which the liver had actually 
been divided by this cruel process. By the interference with the cir¬ 
culation in abdominal organs, piles or hemorrhoids is induced, with 
painful local disorders peculiar to females. 

Constriction of the throat is an evil not now so common as in 
former days when the old-fashioned cravat was worn; but occasion¬ 
ally care is not taken to secure the degree of freedom about the neck 
which is essential to health. It requires but a very slight constric¬ 
tion of the neck to interfere with the circulation of the head suffi¬ 
ciently to occasion very unpleasant and even serious symptoms, such 
as headache, dullness, and vertigo; even apoplexy may be induced in 
this way. 

Effects of Food oil the Circulation. —As the blood is made of 
what we eat, it is evidently of the greatest consequence that what 
is taken into the stomach for the purpose of making blood should 
be of the very best material. Poor food will make poor blood, which 
will, in turn, make all the tissues of poor quality. Certain kinds of 
food, as what is termed rich food, or that which contains too much of 
sugar, fats of various sorts, and condiments, deteriorate the blood, both 
directly and indirectly. Directly, by filling it with useless or super¬ 
abundant material; indirectly, by rendering the liver sluggish and in- 


228 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


efficient, thus occasioning an increase in the elements which ought to 
be removed as bile. Other foods damage the blood by filling it with 
material which is not only directly injurious to the blood itself, but to 
all the tissues with which it comes in contact, whether in finding their 
way into the blood through the stomach or out of it through the 
liver, kidneys, skin, bowels, and other eliminating organs. Of this 
character are most condiments, as will be shown in treating of the 
subject of “Food and Diet,” as well as in connection with “The 
Hygiene of Digestion,” to which we would invite the further attention 
of the reader. 

Narcotics and stimulants must not be overlooked in this connec¬ 
tion, for their influence for evil upon the heart and the circulation is 
too great and too well determined to allow of the possibility of doubt, 
or the need of waiting for further evidence. Alcohol, tobacco, hashish, 
opium, absinthe, even tea and coffee, must be included in the category 
of harmful agents of this class. The manner in which each of these 
agents operates in effecting its evil work must be left for special con¬ 
sideration in a chapter devoted to the subject. 

Injurious Effects of Cold .—Cold paralyzes the heart, and 
to its depressing influence is due the fact that so large a propor¬ 
tion of aged persons die in the cold season of the year. Having 
lost ~ in some degree their power to produce animal heat, they 
quickly succumb to the exposures incident to the inclement season 
of the year. Hence it is important that the old, of all others, should 
be warmly clad in winter. There are current many incorrect 
notions respecting the means of protection from the injurious in¬ 
fluence of cold. The idea that stimulants will enable a person to 
withstand cold has been long exploded. The uniform testimony of 
physiologists and Arctic explorers is to the very reverse. Physi¬ 
ologists find by actual experiment, testing the temperature of a 
person both before and after the imbibition of spirits, that the tem¬ 
perature is uniformly lowered by alcohol in all forms. Arctic navi¬ 
gators say that for a man to take alcohol when traveling amid the 
snow and ice of the frozen regions of the North, where the tempera¬ 
ture is often 70° F below zero, is almost certain death. Alcohol makes 
a man feel warmer, but really abstracts heat from him. So with to¬ 
bacco, which many persons habitually smoke, in the winter to make 
them warm and in the summer to keep them cool. It depresses the 
action of the heart, and consequently diminishes the amount of heat 


EVIL EFFECTS OF HEAT. 


229 


produced. The best means of protection are those which will raise 
the vital tone, strengthen the force of the circulation, and thus increase 
the manufacture of heat, while proper means are taken to preserve 
and economize that which is produced. Cool bathing for the robust is a 
splendid method of augmenting animal heat. . The use of the oil-bath 
is an excellent means of protection from cold. A gentleman who was 
able to speak from experience said very truthfully that an inunction 
was as good as an extra overcoat. 

Many persons make the great mistake at the beginning of cold 
weather of shutting themselves up indoors with hot stoves or furnaces, 
confining themselves to avoid taking cold. This is the most certain way 
to prepare one’s self to acquire a cold upon the slightest provocation. A 
person may become so tender and susceptible by following such a plan 
that simply opening the window for a breath of fresh air, stepping to 
the door to admit a friend, or the most trivial degree of exposure will be 
sufficient to bring upon him the most severe effects of “ taking cold.” 
All persons, particularly those who are specially sensitive to cold, even in¬ 
valids, should, at the beginning of winter, begin to accustom them¬ 
selves to cold. Thus by degrees their susceptibility may be overcome in 
a very large measure, if not wholly. Daily exercise in the open air, and 
a daily bath with friction of the skin and inunctions, with plenty of 
good food and abundance of sleep are also important means of fortify¬ 
ing the system against the ravages of cold. 

Evil Effects of Heat. —Excessive heat has a still more disastrous 
effect upon the circulation than cold, as is evidenced by the large 
number of cases of sudden death which annually occur from “sun¬ 
stroke ” and “ heat-stroke.” That this malady is really due to heat and 
not to the influence of the sun, as many suppose, is evidenced by the 
fact that many cases occur among factory operatives, furnace men, 
stokers in ships, and other persons whose occupation is wholly indoors. 
The remedies for this affection are given in the proper place. As it is 
often fatal, its prevention is of equal importance with its cure. Those 
who have had the most extensive experience with this disease assert that 
those who suffer from it are, as a general thing, persons who are in a 
debilitated condition from overwork, loss of sleep, dissipation, the use of 
alcohol, or poor and insufficient food. Stimulants are especially condu¬ 
cive to the disease. All these predisposing causes should, of course, be 
avoided, as well as the exciting cause already indicated. Persons who 
are exposed to excessive heat in the summer season should take care to 


230 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


keep the head cool, which may be accomplished by means of a cloth wet 
in water and worn inside the hat, by very frequent wetting of the head, 
by the use of umbrellas in the sun, and by other means which special 
circumstances may require or suggest. Fig. 109 illustrates a mode of 
keeping the back part of the head cool in hot weather which may be 
adopted with advantage by those whose occupation obliges them to be 
much exposed to the sun. 

The habit of frequently applying ice or ice-cold 
water to the head in hot weather is likely to be 
productive of injury. The head is cooled for the 
moment, but a reaction soon takes place, and then 
there Is a greater determination of blood to the 
head than ever. It is best to employ for bathing 
the head, water which Is only moderately cool, and 
then depend on the evaporation to produce the 
necessary cooling effect. Ice and iced-water should 
be used only in cases requiring sudden and ex¬ 
treme cooling of the head, and then should be con¬ 
tinuously applied until the desired effect is obtained. 

The natives of Africa protect themselves from 
the intense heat of the tropical sun to which they 
are exposed by smearing their bodies with ghee> 
It is difficult to see what benefit can be derived 
from such a proceeding, but it is possible that the smooth, oiled surface 
of the skin may reflect the solar rays of heat and thus protect the body 
from their influence, at least to some extent. 





Fig-. 109. A means 
of protecting the back of 
the head and neck from 
exposure to the sun. 


a kind of ointment. 










THE RESPIRATORY APPARATUS. 


231 


THE RESPIRATORY APPARATUS. 




Fig. 110. The Pharynx, shown by slittingthe cheeks 
at the corners of the mouth; 6. Mouth of ductfrom the pa¬ 
rotid gland; 7. Eoof of mouth; 8. Posterior nares; 9. Fau¬ 
ces; Uvula; 11. Tonsils; 13. Tongue. 


The respiratory apparatus 
consists of the air-passages, 
the lungs, and the thorax, 
each of which will be briefly 
described. 

The Air-Passages. — 

These consist first of the 
mouth, the nose, the 'phar¬ 
ynx, or back part of the 
mouth, the trachea, or wind¬ 
pipe, the upper part of which 
is also called the larynx, and 
the bronchial tubes. The 
mouth needs no precise de¬ 
scription. The nose or na¬ 
sal cavity consists of a hollow left between the bones of the face 
and those of the skull, which is divided into two parts by a bony and 
cartilaginous septum, each compartment communicating separately ex¬ 
ternally through the anterior nares, or 
nostrils, and with the back part of the 
mouth through the posterior nares. 

The trachea, or windpipe, is a flexible 
open tube situated just in front of the 
meat pipe, or gullet, and is composed 
chiefly of rings of cartilage connected 
together by membrane. These rings are 
not quite complete at the back side, the 
space being filled by muscular tissue. 

The larynx is the upper part of the 
trachea, and consists of a cai'tilaginous 
box across which are stretched four deli¬ 
cate ligaments, the vocal cords, the up¬ 
per two being the false, and the lower 
the true vocal cords, which are con¬ 
cerned in the production of the voice. 


Fig. 111. Tbe Larynx. 6. Thy¬ 
roid Gland. 





232 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


The top of the larnyx is guarded by a cartilage, the epiglottis, which 
is shaped somewhat like a leaf, and has a hinge-like attachment to 
the upper end of the windpipe, so that when the tongue is drawn 
back, as in swallowing, it will fit down upon the larynx like a cover, 
and completely close it. By this wonderful provision of nature, both 

solids and liquids are 
prevented from en¬ 
tering the trachea 
while eating or 
drinking. A patient 
in Bellevue Hospi¬ 
tal, New York, whose 
epiglottis had been 
destroyed by disease, 
had great difficulty 
in swallowing on ac- 
count of the frequent 
entrance of particles 
of food into the tra¬ 
chea, causing violent 
coughing. The car¬ 
tilages of the larynx 
form the prominence 
in the throat just 
below the chin, 
which moves up and 
down in swallowing, and is popularly known as Adam’s apple. 

The bronchial tubes are simply continuations of the trachea, 
which divides into two branches in the chest, one of which enters 
each lung and there subdivides until the tubes become not more than 
jhg- of an inch in diameter, when they terminate in the air-cells. 
After the bronchial tubes become so small as fa of an inch, the carti¬ 
lage disappears from their walls, so that the small bronchial tubes, or 
bronchioles, have membranous and muscular walls. 

The air-passages are lined throughout with mucous membrane. 
The epithelium of the windpipe and bronchial tubes is very peculiar, 
consisting of cone-shaped cells, the large ends of which are covered 
with delicate hairs. These are kept in constant motion, always wav¬ 
ing in the same direction, by which means there is maintained a con- 



Fig;. 112. The Air-Passages. 







THE LUNGS. 


233 


stant current of mucus in the direction of the mouth. The evident 
purpose of this arrangement is the protection of the lungs from dust, 
which will he caught in the stream of mucus and carried to the 
mouth for expulsion. 

The relative position of the several portions of the air-passages is 
well shown in Fig. 112. 

o 



The Lungs. —The real structure of the lungs is seen only by ex¬ 
amination with a powerful microscope, which shows the pulmonary 
tissue to be made up almost wholly of small cells and minute capillary 
blood-vessels, together with the small bronchial tubes. These several 
elements are somewhat loosely 
held together by bands of yellow 
elastic tissue, of which a great 
share of the lung substance is com¬ 
posed. The cells are arranged in 
groups of fifteen or twenty, which 
are called lobules. Each lobule is 
attached to the end of a bronchiole 
with which it communicates. Fig. Fig 1 . 113. Lobules of Lung, showing at a end 

„ .. ... ...of bronchial tubes, and at c e air cells. 

113 shows two or the lobules with 

the end of the small bronchial tube with which they are connected. 
The number of cells in the lungs has been calculated to be not less 


than seventeen hundred million (1,700,000,000). 

The lung cells as well as the air-passages are lined with a mem¬ 
brane which is so very thin that twenty-five hundred layers would 
be required to make an inch in thickness. The extent of this mem¬ 
brane is very great, owing to the great number of the cells. It has 
been estimated that if spread out its area would be not less than two 
thousand square feet. Underneath this thin membrane is spread out, 
in the walls of the cells, the closest network of capillaries in the body. 
So small are they that only a single blood corpuscle can pass through 
at once, and so near are they placed together that they occupy fully 
three-fourths of the entire surface, great as it is. Through these minute 
channels pass over fifteen barrels of blood every twenty-four hours. 

The lungs occupy the two sides of the chest, the cavity of which 
they nearly fill. The right lung is divided by two deep fissures 
into three portions, called lobes. The left lung consists of two lobes. 
Both lungs are covered over with a delicate serous membrane, the 

O 

pleura, which also lines the chest walls. 



234 


AX ATOMY, Pll YSIOLOGY, AND HYGIENE. 


The thorax is the upper of the two cavities into which the trunk 
of the body is divided, being separated from the abdomen by the dia¬ 
phragm, a muscular organ which has been already described. It is 
made up of its bony framework—the ribs, vertebrae, and sternum—and 

the muscles which lie 
between the ribs and 
about the upper part 
of the chest. It is 
lined by the same 
membrane which cov¬ 
ers the lungs, the 
pleura. The lungs lie 
in immediate contact 
with its inner walls, 
but are perfectly free 
from attachment to it. 
The thorax contains, 
in addition to the 
lungs, the heart and 
the great blood-ves¬ 
sels, together with im¬ 
portant nerves. Con¬ 
nected with the tho¬ 
rax and accessory or- 

Figr. 114. Cut showing the relation of the Lungs and Heart. gang q£ respiration are 

several sets of muscles which aid in expanding and contracting 
the cavity of the thorax. 

PHYSIOLOGY OF RESPIRATION. 

The lungs are the means by which the system receives gaseous 
food. It is received all ready for use by the system, no elaborate prep¬ 
aration being required as in the case of solid food taken by means of 
the stomach. Of the three kinds of food received by the body, solid, 
liquid, and gaseous, air is by far the most immediately essential to 
life. A person may live many days without solid food, and several 
days with neither solid nor liquid aliment; but death occurs in a few 
minutes when the supply of air is cut off, as in suffocation or drown¬ 
ing, a fact which indicates with sufficient clearness the importance of 
the subject. 









MOVEMENTS OF RESPIRATION. 


235 



Fig - . 115. Cut showing how the ca¬ 
pacity of the chest is enlarged by ex¬ 
pansion of its walls and depression of 
the diaphragm. 


Movements of Respiration.— The 

acts of respiration are two,—inspira¬ 
tion and expiration. These two acts 
are performed by changes in the size of 
the thorax. In producing inspiration, 
the thorax is made larger, by depres¬ 
sion of the diaphragm—which elongates 
the chest cavity—and elevation of the 
ribs, which enlarges the chest laterally. 
In consequence of the increased space 
in the thorax, the air simply rashes in 
to occupy the room made for it. It 
should be noticed in this connection that 
the air does not force its way in, but 
simply enters when invited by room 
being made for it. In expiration, the 
opposite takes place. The ribs are low¬ 
ered, and the diaphragm, being relaxed, 
is pressed upward into the chest by 
the contraction of the abdominal mus¬ 
cles. The natural elasticity of the lungs 
also aids in expiration, as they are for¬ 
cibly distended during inspiration, and 
naturally tend to return to their normal 
state, which is undistended, as at birth. 
There are said to be three kinds of res¬ 
piration, according to the portion of the 
luims which is most active. When 

O 

the breathing is performed mostly by 
the diaphragm, it is termed abdominal 
respiration; when the lower portion of 
the ribs is used, inferior costal; and 
when the upper part of the chest is em¬ 
ployed, superior costal. The last-named 
is the most common respiration in 
women, which is said to be natural for 
them, but which, in our opinion, is due 
to the fact that by their mode of dress the lungs are usually confined 
so that only the diaphragm and upper ribs can operate freely, the 



Fig. 116. A lateral view illustrating 
the same as Fig. 1.5. 








236 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


chest being effectually hindered from lateral expansion by the em¬ 
ployment of tight-lacing with or without the use of corsets. For 
change in size and appearance of chest during respiration, see Figs. 
115, 116, 117, 118. 

Frequency of Respiration.— The general law of respiration re¬ 
quires one respiratory act for every four heart-beats. As the pulse is 
seventy-two to eighty per minute in the adult, respiration is from 
eighteen to twenty during the same time. The frequency of respira¬ 
tion is increased and diminished by the same causes which affect the 
pulse rate. It is notably increased by exercise, heat, and stimulants, 
and diminished by sleep and by cold. During the hibernation of an¬ 
imals respiration is so slight and infrequent as to be almost impercep¬ 
tible, the pulse being diminished proportionately. 

Coughing, Sneezing, Laughing, and Other Modifications of 
Respiration. —Most of these modifications of the respiratory act are 
more or less involuntary, though to some degree controllable by the 
will. Coughing and sneezing consist of a prolonged inspiration fol¬ 
lowed by a forcible exhalation, produced by a convulsive expiratory 
effort, the air, in coughing, being expelled wholly through the mouth, 
in sneezing by both mouth and nose, though chiefly by the mouth, 
contrary to the usual opinion. Sighing is a deep and prolonged in¬ 
spiration, followed by a rapid and audible expiration. A slight sigh 
naturally occurs every seventh or eighth respiration, by which a more 
complete change of air in the lungs is effected than in ordinary 
breathing. Yawning is similar to sighing, except that the mouth is 
widely opened during inspiration and that it is involuntary. It is a 
curious fact that yawning is contagious in a remarkable degree. A 
person who is able to imitate yawning well may by adroit manage¬ 
ment set a whole company of people yawning. Laughing and sobbing 
differ more in the character of the emotions which they accompany 
than in the mode of production. Both acts result from short and 
convulsive movements of the diaphragm, accompanied by contraction 
of the muscles of expression. Hiccough is a modification of inspira- 
- tion, being due to sudden contraction of the diaphragm. It is usually 
indicative of derangement of digestion, being often caused by rapid 
eating and by the use of effervescing drinks. 

Capacity of the Lungs. —The cubic contents of a pair of well 
developed lungs is about three hundred and twenty cubic inches. Of 


VITAL CAPACITY. 


237 


this quantity but a small part is used in ordinary respiration, not 
more than twenty cubic inches. It is possible, however, after making 
an ordinary expiration of twenty cubic inches, by a strong effort to 
force out one hundred cubic inches more. It is also possible after an 
ordinary inspiration to inhale, by a strong effort, one hundred cubic 
inches extra. Thus after 
a forcible inhalation a 
person may expel from 
the 1 liners two hundred 

O 

and twenty cubic inches 
of air; but there always 
remains one hundred 
cubic inches of air in 
the lungs which cannot 
be expelled. The object 
of this great surplus of 
breathing capacity is to 
provide for contingencies 
of various sorts which 
are continually arising, 
and which make demands 
for an increased quan¬ 
tity of air. It is to this 
that is due the fact that persons may even live for years after one 
lung has become entirely useless, examples of which we have several 
times met in our own practice. The comparative capacity of the 
lungs after inspiration and after expiration is well shown in Figs. 
117 and 118. 




Fig:. 117. 


Fig-. 118. 


Fig. 117. Relative capacity of the Chest and position of 
the Diaphragm after a complete Expiration. 

Fig. 118. Relative capacity of the Chest and position of 
the Diaphragm after a full Inspiration. 


Vital Capacity. —The amount of air that can be changed at one 
respiration is called the vital capacity of an individual. Dr. Hutchin¬ 
son has shown that vital capacity depends much upon the height, and 
increases regularly at the rate of eight cubic inches for every inch of 
increase in height between five and six feet, being about one hundred 
and seventy-five cubic inches for a person five feet in height, and 
about two hundred and fifty-five cubic inches in persons six feet in 
height. The vital capacity can be greatly increased by proper train¬ 
ing, as we have often demonstrated in the treatment of consumptive 
patients. 





238 


ANATOMY , PHYSIOLOGY, AND HYGIENE. 


Composition of the Air.— The air we breathe is a simple mixt¬ 
ure of numerous gases, the chief of which are oxygen and nitrogen, 
the former constituting about one-fifth, and the latter four-fifths of 
the whole, the other gases being so minute in quantity that they need 
not be taken into account, with the exception of carbonic acid, or 
more properly carbon di-oxide, and watery vapor. Of the former the 
air contains about four parts in ten thousand; and of the latter a va¬ 
riable quantity. That is, in one hundred cubic inches of air there are 
about twenty cubic inches of oxygen (20.89), and about eighty cubic 
inches of nitrogen (79.11); and in ten thousand cubic inches of air 
there are four of carbon di-oxide. Besides these the air contains slight 
quantities of the various gases given off in animal and vegetable 
decomposition, and arising from the numerous chemical and physical 
changes going n upon the surface of the earth, together with dust 
and various other foreign matters, all of which may be considered im¬ 
purities, the nature and dangers of which will be elsewhere explained. 

For animals, and, in fact, according to recent discoveries, for all 
living forms, vegetable as well as animal, the oxygen of the air is 
the essential element. Life is dependent upon its regular and ade¬ 
quate supply more than upon any other element. 

The nitrogen of the air is only useful to dilute the oxygen, as in 
an atmosphere of pure oxygen we should live so fast as to be very 
short-lived. Experiments with animals show that prolonged inhala¬ 
tion of air in which the proportion of oxygen is much different from 
that in which it naturally occurs in the atmosphere produces great 
disturbance of the system and finally death, from which it appears 
that the mixture which we call air is not an accidental compound, but 
one admirably adapted to the wants of human beings as well as lower 
animals and even plants. 

The carbonic acid in the air is the result of animal and vegetable 
decomposition, combustion, and the respiration of plants and animals. 
It is not necessary to human life, but is essential to the life of plants, 
of which it constitutes one of the principal forms of food, another ad¬ 
mirable adaptation of nature by which what is poisonous to one part 
of the animate creation is essential to the existence of the other. 
Plants require carbonic acid, or carbon di-oxide, as food, yet they re¬ 
spire oxygen, as do animals. This fact has not been known until re¬ 
cently. 

The watery vapor of the air is necessary to enable the lungs to 


CHANGES IN THE BLOOD IN RESPIRATION. 


230 


utilize the oxygen readily, it being found by experiments that dry 
oxygen is absorbed much less rapidly than that which contains a due 
proportion of moisture. 

Changes in the Air During Respiration. —Upon examining the 
air which is exhaled from the lungs it is found that while passing 
through these organs it undergoes certain changes, both losing and 
gaining certain elements. The air taken into the lungs in an ordinary 
respiration— 

Loses about one cubic inch of Oxygen. 

Gains about one cubic inch of Carbonic Acid Gets. 

Gains about one cubic.inch of Watery Vapor. 

Gains about one cubic inch of Organic Matter. 

During forced respiration, when a larger quantity of air is inhaled, 
the quantity of oxygen lost in the lungs and the amount of carbonic 
acid gained are of course greater, which is also true of the other 
changes mentioned. It should be remarked that the amount of car¬ 
bonic acid gained is a little less than that of the oxygen lost. 

Changes in the Blood in Respiration. —The changes which 
occur in the blood while passing through the capillaries of the lungs 
are equally marked. When the blood enters the lungs from the pul¬ 
monary artery, which brings it from the right heart, it is of a dark pur¬ 
ple color, its color being due to the impurities which it contains, the 
chief of which is carbonic acid. When the blood leaves the lungs, 
it is of a bright red color, having exchanged its carbonic acid for oxy¬ 
gen, which is absorbed by the red corpuscles to be conveyed to every 
part of the system, being assimilated in the capillaries of the tissues 
and changed to carbonic acid, which is brought back to the lungs in 
the venous blood. Other impurities are also given out in the lungs, 
constituting the organic matter of the expired air. The blood also loses 
a little of its water in passing through the lungs, and is slightly 
cooled. The last-mentioned fact completely refutes the old theory of 
an eminent chemist, which is still believed by some, that the lungs are 
a sort of furnace in which the carbon of the blood is consumed as coal 
or wood is consumed in a stove, since if the theory in question were 
true, the blood would gain heat in the lungs instead of losing. 

The blood and air are brought into such close contact in the lungs, 
being only separated by the delicate membrane already described, 
which is not more than an inch in thickness, that the change 



240 


AX ATOMY, PHYSIOLOGY , ^BVD HYGIENE. 


of gases takes place with the greatest facility. Indeed, it is believed 
that the membrane lining the air-cells facilitates, rather than hinders, 
the escape of the carbonic acid in the lungs and the absorption of oxy¬ 
gen. When it is considered that nearly five hundred gallons of blood 
are thus purified every day (the same blood being purified over many 
times), for which more than eighty barrels of air are required, it is 
readily seen that there is abundant necessity for the two thousand 
square feet of membrane devoted to this purpose in the lungs. 

By this process of indirect combustion, in many respects analogous 
to the burning of coal on a grate or of wood in a stove, or the burning 
of a candle or a gas jet, more than half a pound of solid carbon is 
daily consumed in the body. In persons whose occupation is very 
laborious, more than three-quarters of a pound is thus daily consumed. 

The amount of carbonic acid exhaled is modified by several other 
influences besides exercise, as age, sex, diet, etc. The largest amount 
is exhaled during the prime of life, gradually increasing from infancy 
to that period, and declining during advancing age. Females exhale 
much less than males. Much more is produced during digestion than 
at other times, the amount being particularly increased by certain 
articles of food, as sugar and animal food, and especially by stimulants, 
wine, rum, beer, ale, cider, and even tea and coffee, a fact which com¬ 
pletely refutes the argument made in favor of the last-named articles, 
that they diminish the waste of tissue, since it is evident that they in¬ 
crease it. These facts were chiefly established by the experiments of 
the late Dr. Edward Smith, of England. During sleep the amount of 
carbonic acid exhaled is greatly diminished. In the winter sleep of 
some hibernating animals it is reduced to less than ^ of the ordinary 
amount. Violent exercise may increase the quantity of carbonic acid 
exhaled to six times the ordinary amount. In a dry atmosphere the 
mucous membrane of the lungs becomes dry, and thus loses in a con¬ 
siderable degree its power to transmit gases, so that the amount of 
carbonic acid is greatly diminished while breathing it. 

Respiration of the Skill.— The lungs are not the only respira¬ 
tory organs. The skin also participates in the process, though it does 
but a small amount compared with the lungs, the proportion being 
not more than one to forty. In some lower animals, as in the frog, a 
much larger amount of respiratory work is done by the skin. 


LUNG EXERCISE. 


241 


HYGIENE OF RESPIRATION. 

Under this head we shall dwell specially on such portions of the 
subject as pertain particularly to the lungs, leaving the hygiene of the 
air and the subject of ventilation for more complete and explicit con¬ 
sideration in a separate chapter. 

Lung Exercise. —No part of the body is susceptible to greater 
improvement from systematic exercise, or suffers greater detriment 
from neglect of exercise. When the lungs are not well expanded 
habitually, they gradually lose, to some degree, their elasticity, so that 
the power to expand them is lost. 

In the physical examination of 
hundreds of chests we have had 
occasion to notice, in scores of in¬ 
stances, the almost total loss of pow¬ 
er to expand the chest. If asked 
to do so, the patient would shrug his 
shoulders, perhaps elevate them as 
high as possible, and make a despe¬ 
rate attempt to get a little more air 
than usual into his lungs, accom¬ 
plishing but very little in that di¬ 
rection, however, as the tape-line 
placed about the chest showed no 
appreciable increase in size. We 
have often found persons in this 
condition, whose chests ought to 
have measured two to four inches 
more when filled than after inspiration. 

The Spirometer. —The use of the spirometer is an excellent 
means of noting the change which can be made in the vital capacity 
©f the lungs by systematic exercise persevered in daily for months. 
This instrument is shown in Fig. 119. As it is very simple, it can be 
made by any tinsmith at an expense of a few shillings. The instru¬ 
ment consists of two tin vessels, one inverted inside the other. The 
larger one should be nearly filled with water, and should have a small 
tube passing up through the center nearly to the top. This should 
communicate with a flexible tube outside, to the end of which is at- 
16 



Fig. 119. Spirometer, a. Inner vessel, 
with which the inhaling tube communicates; 
6. Outer vessel containing water; c. Scale in¬ 
dicating the number of cubic inches inhaled. 







































































242 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


tached a mouth-piece which may consist of a short glass tube with a 
good-sized bore. By blowing into the tube the inner vessel will be 
made to rise, and the amount of air expelled will be indicated by a 
scale accurately determined by previous calculation or experiment, 
and marked on the outside. If the inner vessel is eight inches in di¬ 
ameter, a scale may be made with lines one-tentli of an inch apart, 
each of which will represent five cubic inches of air. A person five 
feet high ought to be able to raise the scale three inches and a half 
after taking a full inspiration. A person six feet high should be 
able to raise it five inches. 

By the daily practice of lung gymnastics as described in the chap¬ 
ter on exercises, a person may increase his vital capacity from a few 
inches to many times as much. 

When a person is weary, and feels exhausted from sedentary em¬ 
ployment, the practice of deep and prolonged respiration with the 
chest well expanded, the shoulders back, and the spine erect, will be 
exceedingly refreshing. 

The great advantage of abundance of lung exercise is well seen in 
the fact that professional singers suffer less from pulmonary difficul¬ 
ties than others. A medical professor of St. Petersburg recently ex¬ 
amined the chests of more than two hundred professional singers in 
that city, and found their chests better developed than those of the 
majority of persons, and an almost entire absence of lung diseases. 

Corset Choking. —Choking is keeping air out of the lungs; at least, 
that is a practical definition of the word. It makes no difference to the 
lungs and no difference to the blood, whether the life-giving oxygen is 
kept out by confining the respiratory apparatus at its lower or its upper 
part. The result is precisely the same in either case. A man who ties a 
rope around his neck and kills himself by choking is called a suicide. 
A young lady who does essentially the same thing by lacing her waist, 
only taking a little longer time for it, is considered extremely fashion¬ 
able. Pure air is the first and the last desideratum of human life. In¬ 
dependent life begins with the first breath, and ends with the last act of 
respiration. A human being lives in proportion as he breathes. Frogs 
and lizards are sluggish because they breathe little. Birds are more vig¬ 
orous in their movements because of the wondrous capacity and activity 
of their lungs. So with human beings. Need we suggest that those 
feeble-minded creatures who emulate each other in compression of the 
waist—thus curtailing the breathing power—are like frogs and lizards 


POISONOUS CHARACTER OF EXHALED AIR. 


243 


in their capacity for appreciating the “joy of living”? or that their 
organs of cerebration may be as diminutive as their waists ? 

The evils of corset-wearing have already been dwelt upon quite 
fully, and we will not recapitulate here ; but we wish to call special 
attention to three ways in which the use of corsets, whether worn 
extremely tight or not, acts injuriously upon the lungs and respiration. 

1. By compression, the muscles of respiration lose their power 
to act, and waste away, so that strong, deep respirations become impos¬ 
sible. This is the reason why ladies feel, when deprived of their cor¬ 
sets, as though they would “ fall all in pieces.” 

2. By confinement in a stiff, unyielding case, the elastic cartilages 
which unite the ends of the ribs to the breast-bone so as to give free¬ 
dom of action become rigid, and thus prevent full expansion of the 
chest and filling of the lungs. 

3. By compression of the lower part of the lung the upper part is 
crowded up against the inner border of the first rib, against which it 
is continually pressed, so that the constant motion and friction finally 
excite irritation which undoubtedly becomes the starting-point of many 
cases of consumption. 

Poisonous Character of Air Which Has Been Breathed. —As 

already shown, air which has been breathed contains a large proportion 
of carbonic acid, and besides this a poison much more deadly in its char¬ 
acter, organic matter, the exact nature of which chemists have never 
yet been able to determine. The carbonic acid is not itself greatly inju¬ 
rious in the quantities in which it is produced by breathing, but as it is 
always in about the same proportion to the organic matter, it is a relia¬ 
ble index to the amount of the latter poison, and so to the character of 
the air. It is the organic matter referred to which gives to close rooms 
the peculiar fusty odor with which every one is familiar. Persons who 
are confined in-doors most of the time become so accustomed to this 
warning of danger that they do not appreciate it, and hence do not heed 
it; but when a person who has been some time in the open air comes 
into a poorly ventilated room occupied by several persons, the odor is 
very perceptible, and the first impulse is to open the doors and windows 
and let the foul air out and pure air in, though the persons in the 
room may be wholly unconscious of the condition of things. This foul 
and pernicious poison is closely associated with the watery vapor of the 
expired air. In cold weather this vapor condenses upon the window- 
panes, and may be collected. The fluid thus collected forms a most fetid 


244- 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


and disgusting mass after standing in an uncorked bottle for a few days. 

The experiments and researches of eminent scientists on the nature 
and effects of this poison as it exists in respired air seem to show quite 
conclusively that it is the principal cause of the numerous evil effects of 
breathing air which has been previously respired. 

Rapidity with which the Air is Contaminated by Breathing.— 

Experiments have shown that air which has been breathed over a few 
times contains ten per cent of carbonic acid, and of course a correspond¬ 
ingly large proportion of the organic poison, which is an increase from 
four parts in ten thousand of air, to one thousand parts in the same 
amount of air. According to the results which have been obtained by 
Parkes, Cameron, and numerous other investigators in this line of sani¬ 
tary science, a single breath, containing a cubic inch of carbon di-oxide 
renders unfit for respiration three cubic feet of air. It may be easily cal¬ 
culated from this, with the fact that we usually respire twenty times a 
minute, how long the air in a seven-by-nine bedroom may be made to 
last. Supposing such a room to be eight feet high and tightly closed, 
with one occupant in it, the air would remain fit to breathe less than ten 
minutes ! If bedrooms were air-tight, thousands more would have died 
from neglect or ignorance of this fact than have already filled premature 
graves in consequence. Fortunately for the human race, at least for the 
civilized part of it, our houses are seldom air-tight. A little air will find 
its way in, even through brick walls. Nature has provided us with an 
ample abundance of the greatest necessary of life, making it free to all, 
—for no despot ever put a tax upon the air his subjects breathed,—and 
even urging us to accept whether we desire it or not. 

The Effects of Breathing Impure Air. —Without going into de¬ 
tails these may be briefly summed up to be headache, dullness, nervousness, 
debility, consumption, and an aggravation of all other maladies. The 
headache of which school-children suffer so much is chiefly due to foul 
ah'. Consumption is well known to be most frequent in those whose 
habits or vocations are chiefly sedentary, or which keep them in a foul 
atmosphere. 

Experience in the late war showed that impure air was an important 
cause of rendering diseases fatal which otherwise would have been far 
less serious. At the first Sanitary Convention in this country, held at 
Detroit, Jan. 7 and 8,1880, under the auspices of the State Board of Health 
of Michigan, in the discussion of a paper on ventilation, an old army sur¬ 
geon who had charge of large hospitals during the war, related a very 


EFFECTS OF BREATHING IMPURE AIR 


245 


interesting experience illustrating the importance of securing to the sick, 
and especially to persons suffering with fever, an abundance of pure air. 
He stated that during the war he had charge of a large hospital in which 
at one time in the winter season he had under treatment three hundred 
and twenty cases of measles. Just at this time the hospital took fire and 
burned to the ground. The patients were placed in tents, and all but 
one or two recovered. He had no doubt that the number of deaths 
would have been thirty or forty, at least, had the patients remained in the 
hospital. He afterward sent one hundred men who were only slightly 
ill to the general hospital at Nashville, and seventy-five of them died. 
Upon visiting the hospital, he found it so poorly ventilated that the air 
was exceedingly foul, producing a sickening sensation when he had only 
been in it for a few minutes. The Doctor concluded by remarking that 
he regarded pure air and water as most important agents, and believed 
them to be capable of controlling the ravages of raging disease. 

The best methods of receiving an abundance of pure air by ventilation, 
the amount necessary for each individual, and other questions of impor¬ 
tance pertaining to this subject are considered in another chapter. 



246 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


THE DIGESTIVE APPARATUS. 



Fig - . 120. The Alimentary Canal, a. (Esopha¬ 
gus; b. Stomach; c. Cardiac Orifice; d. Pylorus; e. 
Small Intestine; /. Bile Duct; g. Pancreatic Duct; 
h. Ascending Colon; i. Transverse Colon; j. De¬ 
scending Colon; k. Itectum. 


The Alimentary Canal.— 

Fig. 120. The digestive appa¬ 
ratus consists of a long, tort¬ 
uous tube, the digestive or ali¬ 
mentary canal, to which are 
appended various accessory or¬ 
gans. 

The alimentary canal is about 
thirty feet in length, and is lined 
throughout with mucous mem- 
brane, which is variously modi¬ 
fied, according to its location. 
Each end of the canal is guard¬ 
ed by a circular muscle, the up¬ 
per opening, the mouth, being by 
this means opened or closed at 
pleasure, while the lower is in¬ 
voluntary in its action, only 
opening when overcome by force 
applied from above, a wise pro¬ 
vision of nature to antagonize 
the influence of gravitation upon 
the contents of the bowels, and 
to retain the same during sleep 
or other periods of unconscious¬ 
ness. This canal, which at an 
early period of development in 
human beings—as permanently 
in some simple animal forms—is 
merely a straight tube, in the 
fully developed individual be¬ 
comes so modified as to present 
at least five distinct portions, 
each of which possesses peculiar 
and important functions, and 






THE MOUTH—THE TEETH. 


247 


hence requires separate description, together with the several accessory 
organs which are connected with them. Although a more detailed clas¬ 
sification is possible, for our purpose it will be sufficient to consider the 
alimentary tube as divided into the 'mouth, oesophagus, stomach, small 
intestine, and large intestine, or colon. 



The Mouth. —The 

mouth, the upper portion 
of the canal, guarded by 
the circular muscle of the 
lips, contains the teeth and 
tongue, and presents in its 
mucous membrane the ori¬ 
fices of the ducts of three 
pairs of secreting organs, 
known as the salivary 
glands. The back part of 
the mouth, usually known 
as the 'pharynx, communi- nr t , 

* J * Fig*. 121. The Mouth. 6. Mouth of duct from the 

cates through the posterior Parotid Gland; r. Roof of mouth; 8. Posterior Nares; 9. 

... .. , Fauces; 10. Uvula; 11. Tonsils; 13. Tongue. 

nares with the nasal cav¬ 
ity; through the Eustachian canals, with the ears; through the 
upper end of the larynx, with the lungs: and through another open¬ 
ing at its extreme back part, with the stomach, by means of a canal 
known as the oesophagus. See Fig. 121. 


The Teeth. —Each tooth has three parts, a crown, a root, or fang, 
and a neck. The crown is the part which appears above the gum. 
It is covered with a hard, dense substance, the hardest in the body, the 
enamel, which is in turn protected by a very thin covering not more 
than - a 0 ^ o ~ir of an inch in thickness, the object of which is to protect 
the enamel from the action of acids. The enamel prevents wear of 
the teeth in chewing hard substances. Its density varies much in dif¬ 
ferent persons, often becoming soft in consequence of disease. The 
interior of the tooth presents a cavity which is filled by what is termed 
the pulp, which is made up of delicate blood-vessels and nerves enter¬ 
ing the tooth through an opening for the purpose in one or more of 
the roots. The hard part of the tooth is chiefly made up of a bony 
substance called dentine, which is identical with ivory. The smaller 
teeth have but one fang, the larger two, or even three. The neck is 
simply the slight constriction between the crown and root. 




248 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


The Milk Teeth. —Two sets of teeth are furnished most persons, 
some being so fortunate as to acquire a third in advanced age. The 
first set, called temporary or milk teeth, are twenty in number, ten in 
each jaw, consisting of four incisors, two cuspids,—sometimes called 
canine teeth, also eye-teeth in the upper jaw, and stomach-teeth in the 
lower,—and four molars, or double teeth. These are developed in the 

following order between 
the ages of seven months 
and two years : At seven 
months, the two centra] 
incisors, or front teeth; 
at eight months, the other 
two incisors; at one year, 
the first molars ; at one 
year and a half, the cus- 
pids; at two years, the 
second molars. See Fig. 
122. 

The Permanent Teeth, 

—Between six and seven 
years the permanent teeth, 
which number thirty-two 
in all, sixteen in each jaw, 
begin to appear. The 
permanent teeth comprise 
the same teeth as the temporary, with four small molars and two large 
ones in each jaw in addition. See Fig. 123. The first permanent 
teeth which appear are the first of the large molars, which come just 
back of the temporary molars, at about six and one-half years. At 
seven the central incisors are thrown off'. The other incisors disap¬ 
pear the eighth year. In the ninth and tenth years the temporary 
molars give place to the permanent small molars. At twelve the cus¬ 
pids are changed. During the thirteenth year the second large mo¬ 
lars appear ; between the seventeenth and twenty-first years the set 
is made complete by the appearance of the third large molars, or 
wisdom-teeth. The latter teeth are apt to decay early. The teeth 
in the lower jaw are generally developed somewhat earlier than those 
of the upper jaw. The roots of the first set of teeth are absorbed, 
and probably help to form the second set. 

It is important that mothers should be familiar with the proper 



Pi^. 122. The Temporary or Milk Teeth. The cut 
shows at 1, 2, 3, 4, 5, 6, 7, and 8 the rudiments of the Per¬ 
manent Teeth. 






T1IE (ESOPHAGUS. 


249 



Fig:. 123. The Permanent Teeth. The cnt shows how each 
tooth is supplied with nerves and blood-vessels from the same 
nerve trunks and arteries which supply other parts of the face. 

The (Esophagus. —This organ, commonly called the gullet, or 
meat-pipe, is a muscular canal about nine inches in length, extending 
from the back part of the mouth to the left upper portion of the 
stomach. Its walls contain two layers of muscular fibres, the outer 
layer running longitudinally, or lengthwise of the tube, the fibres of 
the other being circular in arrangement. When not in use, the walls 
of the oesophagus lie in contact, so that there is no opening. At the 
lower end, the circular fibres are sufficiently thickened to form a 
sphincter muscle, by means of which the contents of the stomach are 
prevented from escaping upward. 


time for development of the several teeth, especially those of the first 
set, as many of the maladies of children are connected with “ teething,” 
and may often be prevented by proper attention to the teeth. 







250 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 



The Stomach. — This, 

though one of the most im- 
portant, is by no means the 
(ssential organ of digestion, 
as was formerly supposed. 
Contrary to the old view, 
it is now understood that 
the stomach is only one of 
of organs which 


a series 

take part in the work of 
digestion, each of which has 
an important function to 
perform, as necessary in its 
place as that of any other. 
The stomach may be briefly described as a hollow muscle. It is 
simply an expansion of the alimentary canal, which in the oesophagus 
is reduced to a narrow tube, but at the lower extremity of that organ 


I’ig. 124. The Stomach, with a portion of the Duo¬ 
denum attached. 


abruptly expands into a pear-shaped viscus nine to twelve inches in 
length, and four to five inches in width, in its broadest part. It is 
capable of holding one to two quarts, but it will allow of consider¬ 
able distension, so as to be made to hold much more than this quan¬ 
tity. 

In early infancy, the stomach is a mere spindle-shaped expansion 
of the digestive tube ; but as the individual advances in age, 
it becomes more irregular in shape, its lower border being convex, 
while its upper is concave in outline, as may be seen by reference to 


Fig. 124. 

The walls of the stomach are made up of the outer serous coat, 
next to which is the muscular coat, made up of three distinct layers, 
the outer of which, like that of the oesophagus and of the whole ali¬ 
mentary canal, is longitudinal, the next inner layer being made up of 
circular fibres, and, in addition, still another set of fibres peculiar to 
the stomach, running in an oblique direction. Within the muscular 
coat, and lining the organ, is the mucous membrane, which, in addition 
to the usual characteristics of a mucous membrane, presents peculiar 
glandular structures, which have received the name of peptic glands, 
from the character of their secretion. These glands are tubular in 
structure, and are found in all parts of the stomach, but most abun¬ 
dantly in the left, or cardiac end of the stomach, the whole number 
being estimated at five millions. 





In the above diagram the position of the stomach will be clearly seen, together with 
its relation to other internal organs. I. Stomach, partially covered by the liver and 
lungs; III. Small intestines; IV. Colon; V. Lower or Sigmoid portion of the colon. 

/ 



































THE STOMACH. 


251 


Besides its peculiar glands, the gastric mucous membrane con¬ 
tains a remarkable arrangement of blood and lymphatic vessels 
designed to produce rapid absorption of liquids received into the stom¬ 
ach or prepared for absorption by the process of digestion. Cover¬ 
ing the mucous membrane of the stomach everywhere, and lining 
its tubular glands, is a layer of living cells, known as epithelial cells, 
or epithelium. It is to these living, active molecules of life that the 
vital functions of this organ are chiefly due. By them are formed 
both the mucus which protects the surface of its delicate membranous 
lining, and the gastric juice for the solution of the food in gastric di¬ 
gestion. The epithelium itself also protects the membrane upon which 
it rests. 

At the lower end of the stomach is a narrow orifice at which the 
circular muscular fibres are much thickened, forming a sphincter 
muscle; this is known as the pylorus, which literally signifies, “gate¬ 
keeper.” The relative position of the stomach and of the other 
digestive organs may be readily seen by reference to Plate VII. 

The Small Intestine. —The pylorus forms the division between 
the stomach and the small intestine, which constitutes by far the 
greater portion of the alimentary canal, being about twenty feet in 
length. Its convoluted form, as seen in the diagram already referred 
to, is necessitated by its great length, which, together with the several 
functions which it performs, makes it by far the most important of 
the different portions of the digestive apparatus. See Fig. 120. 

That portion of the small intestine joining the stomach is called the 
duodenum, which is about ten inches in length, and broader than the 
rest of the small intestine. In structure, the small intestine has the 
same general plan as that observed in the stomach; viz., an external 
serous coat, the peritoneum, then the longitudinal and circular mus¬ 
cular layers, and an inner lining of mucous membrane with its glands 
and epithelium. The mucous membrane of the small intestine pre¬ 
sents a variety of glands, together with peculiar and remarkably 
well adapted structures for increasing the rapidity of absorption, 
known as villi. Figs. 125, 126, and 127. 

The Liver aud Pancreas. —Fig. 128. In close proximity to the 
duodenal portion of the small intestine are two large glands, the liver 
and the pancreas, each of which communicates with the intestine by a 
duct, the two ducts having a common orifice in the mucous membrane 
of the duodenum, a little more than five inches below the stomach. 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


9^9 



The Colon. 

—At its lower 
extremity, the 
small intestine 
c o m m u nicates 
with a greatly 
expanded p o r - 
tion of the ali¬ 
mentary canal, 

called the colon. The point of junction between these two portions is 
upon the right side, near the groin, and is guarded by a peculiar 
structure of the mucous membrane known as the ileo-coscal valve. 
The colon is about five feet in length. It consists of the ascending, 
transverse, and descending portions, the last-named part having at its 


Fig - . 12b. Villi of Intestines slightly magnified. T 1. A Solitary Gland ; 
2. Agminated or Clustered Gland. 



Fig\ 126. The Villi of the intestinal mucous membrane. 14. Artery; 

15. Vein; 16. Lactehl Vessels; 17. Lacteal Absorbents; 18. Venous Absorbents. 

lower extremity the rectum. The peculiar structure of the colon is 
such as to well fit it for completing the process of digestion. Like 
the stomach and the small intestine, the colon has also its muscular 
and mucous coats, the latter containing various glands, most of which 
are excretory in character. The position of the colon and of its sev¬ 
eral portions will be readily seen by reference to Plate VII~ 

The Digestive Juices.— The apparatus of digestion thus far de¬ 
scribed is chiefly mechanical in its operation, serving to comminute 




















TEE DIGESTIVE JUICES. 


253 



Fig. 127. 1. Folds of the intestinal 
mucous membrane; ii. Tubular Glands; 
3. Mouths of the tubular glands. 


and transport the food. In some animals, as in some species of birds, 
this is the most essential part of the work of the stomach. In man 
and most animals, another class of agents is required ; viz., a variety 
of fluids capable of reducing to a soluble and liquid condition the 

several elements of food, thus prepar¬ 
ing them for absorption. We find 
these several fluids produced in the 
human digestive apparatus at the sev¬ 
eral points where they can accomplish 
the work required of them in the most 
efficient manner. They are five in 
number, and may be briefly described 
as follows:— 

Tlie Saliva. —The first of the di¬ 
gestive fluids is formed by the three 
pail's of salivary glands located in the vicinity of the mouth and con¬ 
nected with it by a system of ducts, through which the salivary 
fluid is conducted into its cavitv. As found in the mouth, the saliva 
is a mixed secretion, containing, in addition to the products of the 
three pairs of glands, mucus from the membrane lining the oral 
cavity. It is a clear, limpid fluid, slightly alkaline in character, and 
is produced in abundance by frugivorous and herbivorous animals. 
Carnivorous animals 
produce it in scanty 
quantity, having little 
need for it, as their food 
rarely contains the par¬ 
ticular elements which 
the saliva is designed 
to aid in digesting. The 

o o 

quantity of saliva se¬ 
creted by the human 
salivary glands is about three pints in twenty-four hours, of which 
about one-half is formed during digestion. 

o o 



Fig. 128. A. Pancreas; B. Duodenum; C. Spleen. 


The Gastric Juice. —This is an acid fluid formed only during 
digestion, by the peptic glands of the stomach. It is produced in 
great abundance, amounting, in twenty-four hours, to twelve or four¬ 
teen pints. Its activity as a digestive agent is due to a peculiar 







254 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


principle which it contains, known as 'pepsin, which can be readily- 
separated from the gastric juice, and can be extracted from the mu¬ 
cous membrane of the stomach after death. Large quantities of pep¬ 
sin are manufactured in this way from the stomach of the hog. One 
firm with which we are acquainted employs for this purpose over 
three hundred hog stomachs daily. A similar principle is extracted 
from the lining membrane of the gizzard of fowls ; and an enterpris¬ 
ing foreigner has recently utilized the stomach of the ostrich for the 
same purpose. 

The acidity of the gastric juice seems to be a condition necessary 
for the efficiency of pepsin, its active principle; but physiologists 
have not yet been able to determine the exact nature of the acid to 
which this property is due. It is most probable that pepsin itself, when 
existing in its normal organic combination, possesses acid properties. 

The Pancreatic Juice. —This fluid, which so nearly resembles 
the saliva that it was once called “ abdominal saliva,” is the product 
of the pancreatic gland, which resembles the principal salivary glands 
in structure as closely as does its secretion the salivary secretion. 
This fluid is secreted only during digestion, and is then produced in 
considerable quantity, although the amount formed in twenty-four 
hours, or the quantity necessary for the digestion of a given amount 
of food, has not been ascertained. Like the saliva, the pancreatic 
juice is alkaline in character, and has an important office to perform 
in the digestion of certain of the elements of food. 

The Bile. —This fluid, usually considered an excretion, also seems 
to possess certain useful properties as a digestive agent. It is 
strongly alkaline, of a greenish color and bitter taste, and is produced 
most abundantly during digestion, although its secretion continues in 
limited degree during the intervals of digestion. This fact well ac¬ 
cords with the compound nature of the fluid, it being both a secretion 
and an excretion, the latter function evidently requiring continuous 
activity, while as a secretion its activity is demanded only at in¬ 
tervals. 

The bile, in company with the pancreatic juice, enters the duode¬ 
num at a point about five inches below the stomach, so that, contrary 
to the old views of digestion, the bile is found in the stomach only 
under very exceptional circumstances. 

The Intestinal Juice. —This, the most complicated of all the di¬ 
gestive juices, is the product of the activity of the numerous and 


THE ELEMENTS OF FOOD. 


255 


varied glands found in the mucous membrane of the intestines. 
Being a mixture of the secretion of a number of different glands, the 
intestinal fluid is of a compound character, which well fits it for its 
varied functions, as will be seen when we come to consider the physi¬ 
ology of digestion. 

THE PHYSIOLOGY OF DIGESTION, 

The Chemistry of Digestion. —While the numerous and really 
remarkable changes which take place in digestion are by no means 
chemical in character, in the sense in which the word is generally 
understood, yet we may allow the term if we understand that by it is 
meant, in this connection, not the reactions which take place in dead 
matter in obedience to the laws of chemical affinity, and which the chem¬ 
ist can command at will in his laboratory, but a living chemistry, work¬ 
ing, through the laws of organized or living matter, changes infinitely 
more wonderful than any chemist can produce, and which he is power¬ 
less to imitate except through the same agencies. 

Let it be understood, then, that digestion is not a chemical, but a 
vital process. Before the process was understood as well as it now is, 
the changes wrought were supposed to be those of fermentation, to which, 
indeed, the process is in some degree analogous ; but we now know that 
fermentation occurs in conjunction with digestion only as an incidental 
and abnormal—though, unfortunately, a very common—process. 

The Elements of Food. —A correct understanding of the philos¬ 
ophy of digestion and its derangements cannot be obtained without 
a knowledge of the nature of food and of its relation to the digestive 
organs in general, and to each of the digestive juices. The demand for 
food is created by the wearing out of the tissues by the vital activities 
in which they are employed. Every vital action, no matter how slight, 
is performed at the expense of certain portions of the living tissues. 
New material is constantly required to supply the want created by this 
waste. As there is a great diversity in the character of the several 
tissues of the body, it is necessary that the food should contain a variety 
of elements in order that each part may be properly nourished and re¬ 
plenished. Classified according to their relation to the digestive organs, 
the elements of food may be divided into the following classes :— 

1. Farinaceous and saccharine. 2. Albuminous. 

3. Fatty. 4. Indigestible. 


256 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


These elements are sometimes found in an isolated state; but ordi¬ 
narily they are combined in varying proportions. Nearly all food con¬ 
tains a larger or smaller proportion of each. 

For description of the several classes of food, see chapter on ‘‘Food 
and Dietetics.” 

Action of the Saliva. —The saliva contains a peculiar organic 
principle which possesses the property of converting starch into sugar.. 
This property of the saliva can be studied at will in the following man¬ 
ner : Place in the mouth a fragment of a dry cracker containing no 
sugar, or a small portion of well-boiled rice. Now chew it for five min¬ 
utes. It will be observed that after the first few seconds it begins to 
have a perceptible sweet taste, which increases as the mastication is con¬ 
tinued. A quantity of pure starch treated in the same manner will 
secure the same result. Evidently, sugar is formed during the chewing, 
as it did not exist in the starch before it was masticated. While under¬ 
going the process of chewing, the saliva was brought in contact with 
the starch, and the change noted was effected. Further proof of this 
change is afforded by the chemist, by means of the chemical test for 
sugar. If a quantity of starch be submitted to the test referred to, be¬ 
fore coming in contact with the saliva, it will be found that it contains 
no sugar. If the same test be applied after the starch has been mixed 
with saliva for a few moments, an abundance of sugar is found. This 
experiment we have often made in the presence of an audience, in illus¬ 
trating lectures on digestion, and with effects clearly visible to all. It 
should be mentioned that the saliva has the same effect outside of the 
body as in the mouth, provided that the proper temperature is maintained. 

It has been recently discovered that most of the fluids of the body 
possess the power of converting starch into sugar in some degree. It 
was formerly supposed that the action of the saliva ceased as soon as 
the food entered the stomach, on account of the presence of the acid of 
the gastric j uice; but recent investigations seem to show that this is an 
error. 

The secretion of saliva is excited by the presence of food in the 
mouth, or by any sweet, acid, or other sapid substance. Even the odor 
of agreeable foods will excite the secretion very strongly. It is also in¬ 
creased to a considerable extent by the act of chewing, even if the article 
chewed does not possess either sapid or odorous properties. 

Action of the Gastric Juice. —After many years of patient study 
and experimentation, physiologists have at last arrived at a quite accu- 



ACTION OF TIIE GASTRIC JUICE. 


257 


rate knowledge of the nature of the gastric juice and of its action upon 
the food. About the first knowledge gained was by an ingenious ex¬ 
perimenter who inclosed different kinds of food in small perforated 
wooden tubes which he swallowed, and afterward vomited. He found 
that albuminous substances were dissolved in the stomach, so that the 
wooden tubes containing such foods were vomited empty, while those 
containing starch and fatty substances remained unchanged. Some 
years later, a most remarkable opportunity for the study of the gastric 
juice and its action was afforded by a serious accident suffered by a young 
Canadian. While hunting, he received in his side the full charge of a 
gun loaded with buck-shot and fired at the distance of a few yards. 
An immense rent was made in his body, which exposed not only the 
lungs but the inside of the stomach. Fortunately, the wounded man 
fell into the hands of Dr. Beaumont, an unusually intelligent physician, 
by whose skillful care, together with his own powerful constitution, he 
was restored to health after many months of suffering and imminent 
peril to life from the extensive sloughing of the soft parts, with injured 
ribs and cartilages, being finally left with a large opening through the 
abdominal wall into the stomach. Through this opening the food was, 
at first, expelled after each meal, unless retained by a bandage ; but 
after the lapse of a few months, thoughtful nature drew a membranous 
curtain before it, when the injured man suffered no further inconven¬ 
ience, although he could expel food through the opening at will, and 
often performed the experiment of drinking a cpiart of milk and pouring 
it out thi'ough the abdominal opening. The accident served to in no 
way interfere with his general health, and according to late accounts he 
is still living in Canada, though very old. 

Dr. Beaumont was not slow to embrace this excellent opportunity 
for observation and study, and retained St. Martin for several months, 
and at intervals for a number of years, for the purpose of experiment 
and investigation. Allowing him to eat various articles, he had but to 
push aside the little curtain, and the long-studied mystery of stomach- 
digestion appeared before his eyes, solved by an accident. Dr. Beau¬ 
mont soon discovered that the principal work of the gastric juice is to 
dissolve the albuminous elements of food. This conclusion was also 
proven then, as it has been hundreds of times since, by the fact that a 
portion of pure gastric juice, collected from the stomach, possesses the 
property of dissolving albuminous substances, as meat, boiled eggs, the 
curd of milk, gluten, etc. In repeating the experiment, physiologists 

17 


258 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


have purposely produced similar openings in the stomachs of dogs, thus 
enabling them to collect a quantity of gastric j uice for examination at 
any time desired. It is even possible to separate from the gastric j uice, 
or from the mucous membrane of the stomach of various animals , pepsin, 
the active principle of the gastric juice, and by means of it to experi¬ 
ment at pleasure upon its digestive properties. The pepsin which can 
be extracted from the stomach of a healthy dog has been estimated to 
possess sufficient digestive power to dissolve two hundred pounds of 
albumen, which would be equivalent to more than two thousand eggs. 

It has also been observed that the gastric juice of calves, horses, and 
other herbivorous animals is much less active in digesting animal food 
than that of carnivorous animals. 

The secretion of gastric juice is excited by the presence of food in 
the stomach, especially of semi-solid food, by the presence of the saliva, 
by sudden alternations of heat and cold, especially by the application of 
heat. A temperature less than that of the body causes its action to 
cease ; a slight elevation of temperature increases its activity. Alcohol, 
alkalies, and tannin antagonize its action, since they precipitate the pep¬ 
sin and the digested albuminous elements. Bile, which is occasionally 
forced upward into the stomach, has the same effect. Antiseptics of all 
sorts, that is, such substances as will prevent fermentation, also interfere 
with digestion. The metallic salts, as compounds of lead, zinc, iron, cop¬ 
per, etc., together with compounds of lime, magnesia, and other salts 
found in hard water, hinder digestion. 

It has been supposed that acids of all sorts aided digestion, which the¬ 
ory has led to the frequent recommendation of vinegar and other acids, 
especially with articles difficult of digestion. This theory has been op¬ 
posed by those who studied dietetics practically rather than theoretically, 
and now M. Charles Richet, a distinguished physician of Paris, comes 
forward with the assertion that he has demonstrated that acetic, tar¬ 
taric, and all similar acids diminish the secretion of gastric juice while 
they are in no sense substitutes for it, and so hinder digestion. 

Action of the Bile. —It has long been well known that the bile is 
an excrementitious fluid ; but more recent investigations show that it 
also has an important office to perform in the process of digestion. The 
alkaline character of the bile enables it to emulsify the fatty elements 
of food, and by thus permanently dividing it into very small particles, 
renders possible its absorption. It is probable, also, that the alkaline 
elements of the bile to some extent saponify the fats, and thus render 


ACTION OF THE DIGESTIVE JUICES. 


259 


them soluble in water. An additional office of this digestive fluid is to 
stimulate the absorption of the digested food, as well as to encourage ac¬ 
tivity of the intestinal mucous membrane. Deficiency in the quantity 
of the biliary secretion is a cause of constipation. 

Action of tlie Pancreatic Juice.— This peculiar digestive fluid is 
unlike those which have been previously mentioned, in that its action is 
not confined to a single element of the food. Its office is to digest both 
starch and fat. It also converts cane-sugar into grape-sugar, or glucose. 
It thus acts upon two of the three classes of food elements. 

The most recent experiments on the subject also seem to show that 
the pancreatic juice has power to act upon the albuminous elements of 
food, after they have first been acted upon by the gastric juice, so that 
it really completes the digestion of all the elements, though its chief 
function is, doubtless, the digestion of starch and fat. It has been shown 
very recently that removal of the spleen destroys the power of the pan¬ 
creatic j uice to digest albuminoid food elements. 

Action of the Intestinal Juice. —This juice, of still more complica¬ 
ted nature than the pancreatic, digests all three of the classes of digestible 
foods, acting alike upon the farinaceous, the albuminous, and the fatty 
elements of food. This complicated function well corresponds with the 
compound nature of the secretion, it being the mixed product of several 
glands. It should be remarked, however, that the intestinal juice seems 
to have little power to dissolve the elements of food unless they have first 
been acted upon, to some extent at least, by the other digestive juices. 

Review of the Action of the Digestive Juices. —Having now con¬ 
sidered in detail the action of each of the digestive j uices, we find that of 
the five separate fluids, three digest one each of the three classes of digest¬ 
ible food, while one of the remaining two digests two of the elements, and 
the other three, or the whole food. Considering the nutritive elements, we 
find that starch is digested by three separate juices, fats by three, and al¬ 
buminous elements by two, which would seem to intimate that the di¬ 
gestion of fats and farinaceous substances is more difficult than that of 
albuminous elements, a fact which is abundantly confirmed by experi¬ 
ence in the treatment of disorders of digestion. 

The Digestive Process. —Before the middle of the last century 
very little was understood respecting the real nature of the phenomena 
which together make up the complete process of digestion. Since that 
time, the subject has been studied so carefully and patiently that physi- 


260 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


ologists have now arrived at a pretty clear understanding of the matter. 
By far the greatest advances made in this study have been through the 
aid of several curious accidents by which the human stomach has been 
exposed to view during life, giving an opportunity for its inspection 
both when inactive and when in a state of activity from the presence of 
food. Numerous cases of this nature have been purposely produced in 
the dog by physiologists for further study, and hundreds of canines have 
suffered unwilling martyrdom at the shrine of science for the gratifica¬ 
tion of man’s thirst for knowledge on this subject. 

Having considered at some length the anatomy of the several di¬ 
gestive organs, the nature of the various digestive fluids, and the action 
of each upon the different elements of food, we are now prepared to 
consider in a connected manner the several processes of digestion. As 
before remarked, the digestive apparatus consists of a series of organs, of 
which the stomach is only one, and perhaps not the most important, 
since life can long be sustained without the activity of the stomach, by 
alimentation through the lower bowels. In the complete digestive proc¬ 
ess each one of the series of organs acts successively upon the food ; 
and the arrangement is such that the prompt and thorough action of 
each organ is essential to the successful action cf the succeeding ones. 

In order to simplify the idea of digestion in the mind of the reader, 
we may remark at this point a fact which is well sustained by the most 
careful study of the process, that digestion really depends upon two dis¬ 
tinct vital actions ; viz., secretion and muscular action. The alimentary 
canal is simply a muscular tube lined with mucous membrane, along 
which are situated, at different intervals, secreting organs which pour 
into its cavity their potent juices by means of which the contents of the 
tube are, if possible, rendered soluble and dissolved. The chief objects of 
the muscular canal seem to be to move the food along: and bring: it in 
contact with the active agents of digestion. With this general view of 
the subject, let us now consider the several steps in the process. 

In order to form an idea of normal or healthy digestion, let us ob¬ 
serve the process in a healthy man, in whom all parts of it are purely 
physiological. He sits down to his breakfast about one hour after ris¬ 
ing, having taken a little gentle exercise to arouse the activities of the 
system, and perhaps taken a small quantity of cold water a few min¬ 
utes before to supply the demand for fluid without taking too much at 
the meal and to excite the gastric and intestinal secretions, as well as 
that of the liver, thereby insuring both an active digestion and proper 
activity of the bowels. 


STOMACH DIGESTION. 


261 


Mastication. —Our subject places in his mouth a small variety of 
foods containing in proper proportion the several elements of nutrition, 
and simply prepared, without the admixture of stimulating or irritating 
spices and condiments. As the food is slowly received, it is thoroughly 
masticated, being ground and triturated by a set of sound teeth, capable 
of vigorous use, and aided by the salivary secretion, until it is reduced to 
a pulpy mass. 

Insalivation. —At the same time that this grinding process is going 
on, the saliva, while also aiding the mechanical division of the food, is 
performing its specific work upon the starch of which the food is likely 
to be largely composed, converting it into sugar, so that the mass of food, 
or alimentary bolus as it is termed, becomes sweeter in flavor the longer 
it is chewed. 

Stomach Digestion. —After thorough mastication, each mouthful 
of food is in turn swallowed, being drawn down into the stomach by the 
muscles of the oesophagus, not simply dropping into that organ through 
an open tube, as many people suppose, the oesophagus being always 
closed, excepting only that portion which is occupied by the food in its 
passage to the stomach. Shortly after the food has reached that organ, 
its mucous membrane assumes, according to the observations of Beau¬ 
mont on the stomach of Alexis St. Martin, a rosy appearance, and there 
may be seen oozing from its surface the gastric juice in tiny drops like 
perspiration on the skin. The secretion increases rapidly, and begins at 
once its specific action on the albuminous elements of the food, which 
have been made accessible by thorough mastication, which has broken 
up the food structures in such a manner as to expose freely all its differ¬ 
ent elements. It may occur that the gastric .secretion has been excited 
before the food has been swallowed ; in which case there is no delay 
whatever in the commencement of gastric digestion. 

Dr. Beaumont observed, in watching patiently at the curious win¬ 
dow-like opening in the stomach of St. Martin, that very soon after food 
is received into the stomach, the muscular structures of that organ be¬ 
gin to act, setting up a sort of churning process, turning the food over 
and over, squeezing, pressing, and variously manipulating it, moving it 
along its lower border toward the pylorus, and returning it along its 
upper border to the pouch-like left extremity into which it is first re¬ 
ceived from the oesophagus. 

If the food contains a large quantity of fluid, this is absorbed be¬ 
fore the process just described begins, since it is evident that too great 


262 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


an amount of fluid would effectually prevent such action on the food 
by the muscular walls of the stomach. It is obvious, also, that a con¬ 
siderable amount of bulk is needed in the food, to enable the stomach 
to operate upon it effectually. When milk is taken, it is quickly co¬ 
agulated by the gastric juice, and the whey being absorbed, the gas¬ 
tric juice acts upon the semi-solid masses formed. Soups, gruels, and 
all fluid foods, are rendered semi-solid by partial absorption of their 
watery constituent. 

At the same time that the gastric juice is acting upon its special 
elements, the digestion of starch continues through the activity of the 
mucus of the stomach, the saliva being neutralized by the gastric juice 
when the food reaches the stomach. Absorption of the portions of the 
food which are rendered liquid by digestion is all the time taking place, 
so that the semi-solid character of the mass is in a measure preserved. 

After this process has continued for a time, which is longer or 
shorter according to the nature of the food or the manner of its prep¬ 
aration, portions of food begin to pass out of the stomach. As the 
mass is moved along the lower border of the stomach toward the py¬ 
lorus, the orifice is opened a little, instead of being tightly closed as 
before, and small portions of food which have been properly acted 
upon by the stomach and the gastric juice, are allowed to pass through. 
If approached by portions of undigested food, the pylorus contracts 
strongly and allows none to pass. By this means the food is kept in 
the stomach until gastric digestion has been well completed. A curi¬ 
ous fact, however, rather difficult of explanation, is that the pylorus 
seems to possess a peculiar faculty for discovering whether substances 
brought in contact with it ought to be digested in the stomach or not. 
Unbroken seeds, as cherry stones, apple and grape seeds, etc., together 
with pieces of glass, stone, or other insoluble substances, are allowed 
to pass without opposition. After a time, the acidity of the food be¬ 
comes so great from the increase of gastric juice, that the stomach is 
excited to strong contraction, and the whole mass is crowded through 
the pylorus into the small intestine, where the work is completed. 
The length of time intervening between the ingestion of food and the 
emptying of the stomach varies from an hour or an hour and a half, 
when the article eaten is boiled rice or a mellow apple, to between 
five and six hours after eating fat pork or similar food. The figura¬ 
tive expression used by laborers who claim that pork is an excellent 
article of food because it “sticks by the rib,” rendered literally, means 


ABSORPTION. 


263 

that it is so difficult of digestion that the stomach has hard work to 
get rid of it after it has been received. 

Intestinal Digestion. —While stomach digestion has been going 
on, the gastric juice acting upon the albuminous elements of the food, 
and the digestion of the starch slowly progressing, the fatty elements 
of the food have undergone no changes except such as have resulted 
from the elevated temperature. Being to some extent freed from its 
association with the other elements, the fat floats upon the surface of 
the contents of the stomach, when fluid, but undergoes no further 
change until it comes in contact with the bile and pancreatic juice in 
the duodenum, when those fluids act upon it in the manner already 
described. The pancreatic juice also acts vigorously upon the portions 
of starch remaining undigested, and such portions of cane sugar as 
may have escaped digestion or absorption in the stomach. 

W e now have all the elements of food acted upon by the saliva, 
gastric juice, bile, and pancreatic juice, but, lest any portion should es¬ 
cape undigested, nature provides the intestinal juice, which continues 
its action upon all the elements of food alike during the whole of its 
passage through the small intestine, and perhaps to some extent in the 
large intestine also. 

During the process of intestinal digestion the food is slowly moved 
along through the twenty-five feet of small and large intestines, grad¬ 
ually becoming more and more solid by the absorption of the portions 
rendered fluid by the digestive juices, and also gradually being more 
and more completely deprived of its nutrient elements, until at last 
there is left in the lower part of the large intestine nothing but the in- 
nutritious residue of the food, mixed with the excrementitious prod¬ 
ucts of the intestinal mucous membrane, constituting alvine matter, 
or feces, which are destined in due time to be discharged from the 
body, such a discharge occurring normally as often as once in twenty- 
four hours, in most persons, and usually in the morning before or just 
after taking breakfast. 

Absorption. —The process of absorption begins almost as soon as 
food is taken into the mouth, and continues so long as any soluble nu¬ 
triment can be extracted from the alimentary mass. The work of ab¬ 
sorption is performed by two sets of absorbent vessels, minute veins, 
and lymphatics, here called lacteals. The venous absorbents take up 
whatever is held in solution, in the fluid taken into the stomach, and 
the principal portion of the digested farinaceous, saccharine, and albu- 


264 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


minous elements of food. The lacteals (See Fig. 129) absorb the 
emulsified fats, and some portion of the other elements. The products 
absorbed by the venous absorbents find their way into the general cir¬ 
culation through the hepatic vein, after passing through the liver, 
which is apparently a wise arrangement of nature, to provide for a sort 
of filtration before the more delicate tissues of the body are exposed to 

the action of whatever delete¬ 
rious elements the food may 
happen to contain. It is 
claimed by physiologists that 
the liver has also an impor¬ 
tant function to perform in 
completing the work of di¬ 
gestion, especially that of 
starchy substances. The 
food mingled with venous 
blood is conveyed to the 
liver by the portal vein. 
Those products which are ab¬ 
sorbed by the lacteals, reach 
the general circulation 
through the thoracic duct, 
a long, slender lymph vessel 
which empties into the large vein from the arm on the left side. 

Oxygenation. —From the right heart the mixed products of diges¬ 
tion are sent to the lungs, where, by coming in contact with the oxy¬ 
gen of the air, the final change is effected, whereby heterogeneous or¬ 
ganized matter is converted into human blood, with properties and 
qualities to nourish and repair each of the great variety of delicate 
tissues found in the body. After the blood has passed through the 
lungs, neither sugar nor fat, which may abound in the blood before 
its oxygenation, are found. 

We have now traced through its various subdivisions the entire 
process of digestion, and found, until we came to the process of ab¬ 
sorption, that, as at first remarked, the process chiefly depends on two 
vital actions; viz., muscular action, and secretion. Muscular action 
masticates the food—by the aid of the passive accessory organs, the 
teeth—and mingles with it the saliva. Muscular contraction draws 
the alimentary bolus from the mouth down into the stomach. Here, 









NERVOUS RELATIONS. 


2G5 


by the action of the muscles, it is churned up with the gastric juice, 
and finally squeezed through the pylorus into the small intestine, 
where, by the aid of muscles, it is mixed with the bile and the pancre¬ 
atic and intestinal juices, and is moved along, constantly coming in 
contact with fresh secreting and absorbing surfaces, until its digestion 
is complete. Even absorption is greatly aided by this muscular ac¬ 
tion, as the circulation in the absorbing parts is thereby quickened, so 
that larger quantities of fluid are taken up. 

Nervous Iielatious. —Before leaving the physiology of digestion 
it should be noted that both the secretion of the digestive fluids and 
the muscular action of the stomach and intestines are under the 
control of nerves. The digestive organs are all intimately connected 
with the general nervous system, so that any change in one is readily 
noted in the other. A demand for nutriment in the general system is 
referred to the stomach as hunger, just as the demand for liquor is re¬ 
ferred to the throat as thirst. Undigested food, or any other obnox¬ 
ious substances in the stomach, may excite a nausea which will relax 
and prostrate the whole system. In certain states of the system, and 
especially in young children, disorder of digestion may even produce 
convulsions. . On the other hand, we see that agents which affect the 
general nervous system often influence the digestive organs indirectly 
with almost the promptness of agents addressed directly to them. 
The sight or smell of savory viands will “ make the mouth water ” by 
exciting the salivary secretion. Seeing or smelling disgusting objects 
will not infrequently cause prompt emesis, when there is nothing 
whatever in the stomach to occasion vomiting. In a case which came 
under our observation a few years ago, a gentleman was deprived of 
several meals by having had the misfortune to meet a very loathsome 
object. Whenever he attempted to eat, an image of the repulsive ob¬ 
ject came before his mind, and the immediate nauseating effects were 
so great as to make it impossible for him to keep anything in his 
stomach. On more than one occasion a patient has been made to 
vomit bv being told that he had taken an emetic, when the dose he 
had swallowed was inert. 

Vomiting. —This is evidently a result of reflex nervous action in 
most cases. The exact mechanism of the act we do not need to ex¬ 
plain, except to say that the expulsive effort is made chiefly by the 
abdominal muscles and the diaphragm, the stomach taking little active 
part in the process; being powerfully compressed against the rigid 


266 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


diaphragm, by the vigorous contraction of the abdominal muscles, its 
contents are forcibly expelled upward through the oesophagus, contrac¬ 
tion of the pylorus preventing exit from the stomach in a downward 
direction. 

Retching is an effort of the same character as vomiting, only less 
in degree. Gulping is a peculiar action by which air is drawn down 
into the stomach. It frequently precedes vomiting, having the effect 
to relax the sphincter muscle at the lower end of the oesophagus. 
Other abnormal actions connected with the stomach and bowels will 
be explained in connection with the diseases of these organs. 

HYGIENE OF DIGESTION. 

Probably no part of the vital economy is subjected to so much 
abuse as the digestive organs. The majority of people eat and drink 
what their fancy or tastes call for, not once taking into account any 
possible injury which may result to the stomach from what is put in¬ 
to it. The stomach is treated like a garbage box, and then is expected 
to do its duty, or rather to dispose of the indigestible messes imposed 
upon it promptly and uncomplainingly. If it lags a little in weari¬ 
ness from overwork, instead of being allowed to rest like any other 
organ of the body when tired, it is whipped up and goaded on by 
stimulants in the shape of spices, mustard, pepper, and other condi¬ 
ments, and often even with wine, beer, ale, brandy, and other artificial 
means of getting out of an organ more work than it is able to do. 

The importance of this subject demands serious attention. Its 
neglect has made the American people a nation of dyspeptics. We may 
therefore be justified in devoting considerable space to this topic, and 
going quite fully into the details of it, so that some practical benefit 
may be derived from its consideration. 

From our study of the anatomy and physiology of digestion we 
have acquired a pretty good knowledge of the principles of the sub¬ 
ject. Now let us apply these principles, and by so doing we shall be 
able to discover that many of the most common customs relating to 
eating and drinking are in direct opposition to the laws of healthy 
digestion. And first, as one of the most common of all dietetic errors 
we will mention—• 

Hasty Eating. —That Americans are everywhere noted for the 
precipitate manner in which they bolt their meals, tumbling into their 


DRINKING AT MEAL8. 


2G7 


stomachs indiscriminately material that is digestible and indigestible, 
and spending only enough time to reduce the food to a sufficient degree 
of fineness to allow it to be swallowed without choking,—often hardly 
enough for safety in that regard,—is too well known to require special 
confirmation. The average American eats as he works, recreates, and 
does everything else, in fact, on the high-pressure system. He treats 
his mouth like a corn-hopper, and his stomach like a garbage box. 

The evils resulting from hasty eating may be enumerated as fol¬ 
lows :— 

1. From deficient mastication, the food is not properly divided, so 
that the digestive juices cannot gain access to its various elements. 

2. By being retained in the mouth too short a time, an insufficient 
amount of saliva is mingled with it, so that salivary digestion cannot 
be properly performed. As the saliva is also a stimulus to the secre¬ 
tion of gastric juice, stomach digestion must necessarily be imperfect. 

3. Again, the food entering the stomach in a coarse, unmasticated 
state, may act as a mechanical irritant to the delicate lining of the 
stomach, and thus occasion congestion and gastric catarrh, one of the 
most common disorders of the stomach, and one which is often very 
obstinate in its nature. 

Drinking at Meals.— In addition to the evils which it occasions di¬ 
rectly, hasty eating induces an individual to drink largely of hot or 
cold liquids to wash the food into the stomach. Thus, two evils are as¬ 
sociated. Liquid of any kind, in large quantity, Is prejudicial to diges¬ 
tion because it delays the action of the gastric j uice, weakens its digestive 
qualities, and overtaxes the absorbents. In case the fluid is hot, if in 
considerable quantity, it relaxes and weakens the stomach. If it is cold, 
it checks digestion by cooling the contents of the stomach down to a 
■degree at which digestion cannot proceed. Few people are aware how 
serious a disturbance even a small quantity of cold water, iced cream, or 
other cold substance, will create when taken into a stomach where food 
is undergoing digestion. This process cannot be carried on at a temper¬ 
ature less than that of the body, or about 100’. Dr. Beaumont observed 
that when Alexis St. Martin drank a glassful of water at the usual tem¬ 
perature of freshly drawn well-water, the temperature of the food un¬ 
dergoing digestion fell immediately to 70°, and did not regain the proper 
temperature until after the lapse of more than half an hour. 

Of course the eating of very cold food must have a similar effect, 
making digestion very tardy and slow. If any drink at all is taken, it 


268 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


should be a few minutes before eating, time being allowed for absorption 
before digestion begins, or an hour or two afterward. If the meal is 
mostly composed of dry foods, a few sips of warm or moderately hot 
water will be beneficial rather than otherwise, taken at the beginning of 
the meal or at its close. The habit of drinking during the meal should 
be discontinued wholly, and especially by those whose digestive powers 
are weak. If the diet is of proper quality, and the food is well masti¬ 
cated, there will be little inclination to eat too much. When the food is 
rendered fiery and irritating with spices and stimulating condiments, it 
is no wonder that there is an imperious demand for water or liquid of 
some kind to allay the irritation. 

Eating too Frequently. —One of the most pernicious customs of 
modern society is that of frequent meals. This custom is seen in its ex¬ 
treme development in England more clearly than in this country, five 
meals a day, including lunches, being there thought none too many. 
The idea seems to prevail that the stomach must never be allowed to be¬ 
come empty under any circumstances. In this country, three meals a 
day is the general custom, though more are often taken. Healthy di¬ 
gestion requires at least five hours for its completion, and one hour for 
rest before another meal is taken. This makes six hours necessary for 
the disposal of each meal. If food is taken at shorter intervals than 
this, when ordinary food is eaten, the stomach must suffer disturbance 
sooner or later, since it will be allowed no time for rest. 

Again, if a meal is taken before the preceding meal has been di¬ 
gested and has left the stomach, the portion remaining, from its long ex¬ 
posure to the influence of warmth and moisture which especially favor 
fermentation, is likely to undergo that change in spite of the preserving 
influence of the gastric juice, and thus the whole mass of food will be 
rendered less fit for the nutrition of the body, and the stomach will be 
liable to suffer injury from the acids developed. 

Eating between Meals.—This is a gross breach of the require¬ 
ments of good digestion. The habit many have of eating fruit, con¬ 
fectionery, nuts, sweetmeats, etc., between meals, is a certain cause of 
dyspepsia. No stomach can endure such usage. Those who indulge 
in this manner usually complain of little appetite, and wonder why 
they have no relish for their food, strangely overlooking the real 
cause, and utterly disregarding one of the plainest laws of nature. 

This evil practice is often begun in early childhood. Indeed, it is 
too often cultivated by mothers and the would-be friends of little 


IRREGULARITY OF MEALS. 


269 


ones, who seek to gratify them by presents of confectionery and 
other tid-bits of various sorts. Under such a regimen, it is not 
singular that so many thousands of children annually fall victims 
to stomach and intestinal diseases of various forms. In great num¬ 
bers of cases, early indiscretions of this sort are the real causes of 
fully developed dyspepsia in later years. 

Irregularity of Meals. —Another cause of this disease, which is 
closely related to the ones just mentioned, is irregularity respecting 
the time of meals. The human system seems to form habits, and to be 
in a great degree dependent upon the performance of its functions in 
accordance with the habits formed. In respect to digestion this is 
especially observable. If a meal is taken at a regular hour, the stom¬ 
ach becomes accustomed to receiving food at that hour, and is prepared 
for it. If meals are taken irregularly, the stomach is taken by sur¬ 
prise, so to speak, and is never in that state of readiness in which it 
should be for the prompt and perfect performance of its work. The 
habit which many professional and business men have of allowing 
their business to intrude upon their meal hours, quite frequently 
either wholly depriving them of a meal or obliging them to take it an 
hour or two later than the usual time, invariably undermines the best 
digestion, in time. Every individual ought to consider the hour for 
meals a sacred one, not to be intruded upon under any ordinary cir¬ 
cumstances. Eating is a matter of too momentous importance to be 
interrupted or delayed by ordinary matters of business or conven¬ 
ience. The habit of regularity in eating should be cultivated early in 
life. Children should be taught to be regular at their meals and take 
nothing between meals. This rule applies to infants as well as to 
older children. The practice of feeding the little one every time it 
cries is a most serious injury to its weak digestive organs. An in¬ 
fant’s stomach, though it needs food at more frequent intervals,—two 
to four hours according to its age,—requires the same regularity which 
is essential to the maintenance of healthy digestion in older persons. 
The irregularity usually practiced is undoubtedly one of the greatest 
causes of the fearful mortality of infants from disorders of the digest¬ 
ive organs, as appears in our mortuary reports. 

The subject of infant feeding is a very important one, and on this 
account we have devoted considerable space to it in the chapter on 
“Food and Dietetics,” which see. 


270 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


The Proper Number of Meals. —How many meals should be 
taken by a person in health ? The answer to this question depends 
somewhat upon the habits of the individual, his occupation, number 
of hours of labor, etc. There is good reason to believe that for a 
large share of those who now take three to five meals a day, two> 
would be much better. According to Hippocrates, the ancient Greeks 
ate but two meals a day. This was the prevailing custom in oklen 
times. Indeed, the modern frequency of meals is the outgrowth of a 
gradual losing sight of the true function of food and of eating, and 
making the gratification of the palate the chief object, instead of the 
nourishment of the body. It is distinctly a modern custom. That 
the system can be well nourished upon two meals a day is beyond 
controversy, seeing that not only did our vigorous forefathers require 
but two meals a day, but hundreds of persons in modern times have 
adopted the same custom without injury, and with most decided ben¬ 
efit. Students, teachers, clergymen, lawyers, and other literary and 
professional men, will be especially benefited by this plan. We have 
employed it for about fifteen years; and with great benefit. The spe¬ 
cial advantages gained by it are, 1. The stomach is allowed a proper 
interval for rest; 2. Sleep is much more recuperative when the stom¬ 
ach is allowed to rest with the balance of the body; 8. Digestion can¬ 
not be well performed during sleep. 

If six hours are allotted to each meal, and the proper length of 
time is allowed to elapse before going to sleep after the last meal, it 
will be found impossible to make any arrangement by which oppor¬ 
tunity can be secured for the necessary eight hours’ sleep at night. 
Not more than two meals can be taken when a person complies with 
all the laws of health. 

If more than two meals are required by any one, it is by those 
who are engaged for twelve or more hours per day in severe physical 
labor. Such persons are better prepared to digest a third meal than 
those whose occupation is mental or sedentary, and they may at least 
take it with less detriment, though we are still doubtful whether a 
third meal is needed, even for such. 

Eating when Tired.— This is one of the most certain causes of 
derangement of digestion, and one to which a very large number of 
cases of dyspepsia may be traced. The third meal of the day is al¬ 
most always taken when the system is exhausted with the day’s la¬ 
bor. The whole body is tired, the stomach as well as the rest. The 


EATING WHEN TIRED. 


271 


idea that by the taking of food the stomach or any other part of the 
system will he strengthened, is a mistake. When the stomach “ feels 
faint and tired ” at night, as many people complain, what it wants is 
not food, hut rest. An eminent writer on indigestion says very truth¬ 
fully, “ A tired stomach is a weak stomach.” When the stomach feels 
“ weak and faint,” rest is what is demanded, and is the only thing that 
will do it good; yet many people insist on putting more food into it, 
thus compelling it to work when it ought to be allowed to remain in¬ 
active until rested. The arm wearies by constant exercise, and so 
does the stomach, which is largely composed of muscles as well as the 
arm. Both secretion and muscular activity must be much lessened in 
a tired stomach, and the habitual disregard of this rule must be dis¬ 
astrous to the best digestion. 

Violent exercise at any time just before or just after eating is in¬ 
imical to good digestion, for the reason already assigned when the ex¬ 
ercise is taken just before the meal, and because the vital energies are 
diverted to other parts—thus robbing the stomach of its necessary 
share—when the exercise is taken immediately after eating. An 
English physiologist performed an experiment which well illustrates 
the truth of this position. Having fed a dog his usual allowance of 
meat one morning, he took him out upon a fox hunt, and kept him 
racing over the country until night, when, having killed the animal, 
he examined his stomach at once and found the meat in the same con¬ 
dition in which it entered his stomach, no digestion having taken 
place. In another dog, fed with the same kind of food, but left quiet 
at home, digestion was found to be complete. 

The hurry and press of business among Americans is allowed to 
override every consideration of health. It seems never to enter the 
thoughts of the average business man that any time is required for 
digestion. Rushing to his dinner from the plow, the workshop, or the 
counting-room, he swallows his food with all possible dispatch, and 
rushes back to his work again, begrudging every moment spent in 
meeting the requirements of nature. Many years ago, it was a custom 
in Edinburgh to suspend all business in the middle of the day for two 
hours, so as to allow ample time for meals. A similar custom once 
prevailed in Switzerland, we have been informed; but we presume 
that such a sensible custom is now considered too old-fashioned to be 
tolerated. 

It should be remarked that severe mental labor immediately be¬ 
fore or after, and especially during meals, is even more injurious than 


272 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


physical employment. The habit many business men have of anx¬ 
iously scanning the newspapers during their meals and when going to 
and from their places of business, is a bad one. A full hour, at least, 
should be taken for the midday meal; and if an hour’s rest can be se¬ 
cured before eating, improved digestion would well repay the time 
spent in re-inforcing the vital energies. For persons of weak diges¬ 
tion, the rest before eating is in most cases indispensable. 

The famous L'Homme serpent (man snake), of Paris, who aston¬ 
ished the world by his agility and wonderful contortions, ate but two 
meals a day of vegetable food, and invariably abstained from food for 
twelve hours before performing, a plan which was undoubtedly mutu¬ 
ally advantageous to his muscles and his stomach, as his exercises re¬ 
quired great muscular effort. 

Sleeping after Meals. —While rest from accustomed exercise after 
eating is important, it should be noted that sleep at this time is equally 
as bad as vigorous exercise of either mind or body. Good digestion can¬ 
not take place during sleep. While it is true that digestion is an invol¬ 
untary act, it should be recollected that it is dependent upon the activ¬ 
ity of the nervous system for its proper performance. The same nerve 
which secures activity of the respiratory organs, the pneumogastric, 
controls the muscular activity of the stomach and intestines. During 
sleep, from the lessening of nervous activity both the respiration and the 
circulation are greatly lessened in vigor. It is but reasonable to suppose 
that the activity of the digestive organs is decreased at the same time, 
being controlled by the same nerves. Actual experiment shows this to 
be true. Most people who lie down and sleep an hour or two soon after 
taking food, awake feeling anything but refreshed. The suspension of 
the process to a considerable degree during sleep causes imperfect diges¬ 
tion with its numerous unpleasant symptoms. In the case of old people 
it may sometimes be beneficial, or at least not harmful, to secure a few 
minutes’ sleep after eating, before digestion is well begun, but it must not 
be long continued. 

In order to secure the best conditions for digestion after eating, an 
individual should take gentle exercise of some kind, as walking, carriage 
or horseback riding While violent exertion seriously interrupts the di¬ 
gestive process, a moderate degree of physical exercise facilitates the 
process by increasing the muscular activity of the digestive organs and 
thus encouraging both secretion and absorption. 


LATE SUPPERS. 


273 


Late Suppers. —Eating late at night, when the muscular and nerv¬ 
ous systems are exhausted by the labor of the day, and then retiring 
soon to rest, is one of the most active dyspepsia-producing habits to 
which modern society is addicted. As before explained, “ a tired stom¬ 
ach is a weak stomach; ” and in addition, we may add, a sleepy stomach 
is a sluggish one. Secretion must of necessity be deficient in both quan¬ 
tity and quality, owing to the exhausted condition of the system; and 
with the further obstacle afforded to prompt digestion by the slowing of 
the vital operations during sleep, it is almost impossible that there 
should be other than disturbed digestion and disturbed sleep in conse¬ 
quence. It is under these circumstances that people often suffer with 
obstinate insomnia, bad dreams, nightmare, and similar troubles, from 
which they arise in the morning unrefreshed, and unrecuperated by 
Nature’s sweet restorer, the work of assimilation, by which repair takes 
place, having been prevented by the disturbed condition of the nerves. 

No food should be taken within three or four hours of retiring. 
This will allow the stomach time to get the work of digestion forward 
sufficiently to enable it to be carried on to completion without disturb¬ 
ance of the rest of the economy. The last meal of the day, if three 
meals are taken, should be a very light one, preferably consisting of 
ripe fruit and simple preparations of the grains. The custom which 
prevails in many of the larger cities of making dinner the last meal of 
the day, eating of articles the most hearty and difficult of digestion as 
late as six or even eight o’clock, is one that ought to be discountenanced 
by physicians. It is only to be tolerated at all by those who convert 
night into day by late hours of work or recreation, not retiring until 
near midnight. But in such cases, a double reform is needed, and so 
there can be no apology offered for this reprehensible practice on any 
physiological grounds. 

Too Many Yarieties of Food. —Many dyspepsias arise from the 
eating of too many kinds of food at the same meal, another growing 
custom in modern times which deserves to be distinctly condemned. At 
great dinners in honor of distinguished personages, when friends are to 
be entertained, and in the majority of well-to-do families as a general 
custom, the eaters are tempted to gluttony by having presented to their 
palates a great variety of complicated dishes, almost any one of which 
would be too much for the digestive organs of most inferior animals. 
On the occasion of the giving of a great dinner to some notable, we have 
known instances in which more than a hundred dishes were served in 
18 


274 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


successive courses. Such gormandizing soon breaks down the most vig¬ 
orous digestive organs, since it adds to the labor of digesting food which 
is improperly cooked, a larger variety than the digestive juices are capa¬ 
ble of bringing into a fit state for absorption. Careful experiments have 
shown very clearly that different classes of food require a particular 
quality of digestive juices for their digestion. For instance, a gastric 
juice that will digest animal food the best, is inferior for the digestion of 
vegetable food, and vice versa. The obvious conclusion to be drawn 
from this fact is that the simpler the dietary, the more perfectly will the 
digestive process be performed. For persons whose digestive powers are 
naturally weak this is a matter of special importance. Such w r ill find it 
w T ell to avoid eating meat and vegetables together. Meat and grains 
may be taken together, but not meat and vegetables, by persons of 
weak digestion, the latter being much more difficult of digestion than 
either of the others. If the bill of fare taken at a single meal were con- 
fined to three or four articles of food, there would be few r er dyspep¬ 
tics scanning the newspapers for some patent nostrum to “ aid diges¬ 
tion.” 

Hot and Cold Bathing after Meals. —Especial mention should 
be made of the injury to the digestive organs quite certain to result 
from taking either a hot or a cold bath soon after eating, as few' peo¬ 
ple are aware of the danger of laying the foundation for years of dis¬ 
comfort in this w r ay. If the bath be a hot one, the stomach will be 
deprived of the blood necessary to support the rapid secretion of gas¬ 
tric juice for the digestion of the food, by the sudden relaxation of 
the capillaries and arterioles of the skin, drawing the blood to the sur¬ 
face of the body. A cold bath, on the other hand, or any sudden ex¬ 
posure to cold, may, by causing contraction of the blood-vessels of the 
surface of the body, cause sudden congestion of the stomach, which is 
equally fatal to good digestion. Very nearly the same danger exists 
from the taking of baths just before a meal. 

The practice very common among boys and young men, of going 
into the water in the summer time regardless of the condition of the 
stomach or of other states of the body, is a bad one. With many it is 
a very usual practice two or three times a week if not more often, to 
go at once into the water after the evening meal, not allow'ing even 
time for the work of digestion to become established. No bath in¬ 
volving any considerable portion of the body should be taken within 
two hours of a meal. 


OVEREATING. 


275 


Errors in Quantity of Food. —If errors in the manner of taking 
food are active causes of indigestion, mistakes in quantity are still 
more potent in this direction. It should be noted, however, that er¬ 
rors of this class are very closely connected with errors in the manner 
of eating, and in the quality of food taken. It is generally true with 
physical as well as moral transgression, that one bad habit implies an¬ 
other; and especially is this the case in reference to dietetic errors. 
A person who eats too fast is likely to eat more than is necessary; 
and the same is true if too large a variety of food is partaken of, or 
food rendered exciting and stimulating by seasoning with irritating 
condiments. 

Overeating. —Intemperance in eating is, in our opinion, responsi¬ 
ble for a greater amount of evil in the world than intemperance in 
drinking. We do not fear to make this statement, since we believe it 
can be clearly shown that intemperate eating is, in the first place, one 
of the most potent causes of intemperance in drinking, and, secondly, 
that it is one of the greatest obstacles in the way of the reformation 
of those who have become victims of alcoholic intemperance. 

If we may believe the statements of historians, gluttony is by no 
means a modern vice. Indeed, there is quite good ground for believ¬ 
ing that overeating, while a very general fault, is rarely if ever car¬ 
ried to the enormous excess to which some of the luxurious Roman 
emperors indulged, as for instance, the Emperor Maximus, who con¬ 
sumed forty pounds of flesh in a day; or Caligula, whose custom was 
to eat until compelled to desist from having distended his stomach to 
its utmost capacity, and then taking an emetic to enable him to re¬ 
peat his gormandizing. 

The evil consequences of excess in eating are at first simply im¬ 
perfect digestion, the overtaxed organs being unable to accomplish 
the complete digestion of the alimentary mass. In consequence of 
the delay which occurs, changes take place by which acids are devel¬ 
oped which irritate the mucous membrane, together with gases by 
which the stomach is distended and its muscular walls weakened and 
partially paralyzed. In course of time, inflammation of the gastric 
membrane is developed, and permanent dilatation of the stomach 
occurs. 

At first, an individual who overeats will be likely to accumulate 
flesh quite rapidly; but very soon the digestion becomes so much dis¬ 
turbed that no gain takes place, and, indeed, the patient not infre- 


276 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


quently becomes considerably emaciated even while daily taking large 
quantities of food. When the opposite is the case, the blood is filled 
with crude, imperfectly elaborated material, which, when assimilated, 
produces a poor quality of tissue. 

Eating too Little. —A far less common fault than that last men¬ 
tioned, is eating too little. The instances that occur are usually in 
the cases of those who have attempted to subject themselves to a rigid 
dietetic regimen for the prevention or cure of disease, and who, from 
having only a partial view of the subject, entertain extreme notions. 
By the weakening of the system which necessarily occurs when an 
insufficient amount of nutriment is received, the stomach also becomes 
weak and debilitated, its secretions and muscular efforts being greatly 
impaired in both quantity and quality. This is well seen in persons 
who have been long deprived of food. When allowed to eat, they are 
unable to digest but the smallest quantity of food; and though the 
system is famishing for nourishment, an amount of food equal to that 
taken at an ordinary meal would be almost as fatal as a dose of 
strychnia. 

How Much Should a Person Eat 1—Hundreds of times have we 
been asked this question; but we have never been able to give any 
other answer than might be suggested bv the common sense of the 
questioner, without medical assistance. The only reply that can be 
made to this question is, just so much as the system needs and the 
digestive organs can digest. In general, an individual may take as 
much food as he can digest; but often there are conditions in which 
he cannot digest as much as he really needs. For instance, when an 
individual is called upon to exert all his energies of brain and muscle, 
to strain every nerve to its utmost to compass a certain object of 
great importance, to cope with an emergency, he may be for the time 
being quite unable to digest sufficient food to make good the waste 
that must necessarily occur. He will lose flesh and strength under 
such circumstances; and often a failure of the appetite at such a crisis 
indicates the inability of the stomach to digest, from the deficient se¬ 
cretion of gastric juice. It is on this account that persons who are 
for a time called upon to make great exertions often break down 
their digestion. Thinking that they need abundance of nutriment, 
which is true, they eat as heartily as when required to perform only 
their ordinary work, not considering their diminished power to digest 


QUANTITY OF FOOD REQUIRED. 


277 


and appropriate food, and in a short time find their digestive organs 
unable to digest well even a small amount of food. 

We are satisfied that it is in this way that many lawyers, physi¬ 
cians, and other professional men, break down. If, when called upon 
to do a large amount of extra work, the individual would lessen the 
quantity of food eaten, instead of increasing it, he would conserve his 
vital forces much more than by pursuing the opposite course. When 
required by the press of business to do extra work, often working for 
several days in succession with very little sleep, we have been in the 
habit for several years of limiting the amount of food taken to not 
more than half the usual allowance, and sometimes to even a less 
quantity. The result has invariably been all that could be desired; 
since, although we have often lost several pounds of flesh during an 
ordeal of this kind, when it is past, and we return to our usual 
routine of work, we bring back from the effort our digestion intact, 
and are able to digest the amount of food necessary for recuperation, 
so that a few days suffice to restore us to our usual weight, and with¬ 
out loss of either strength or time. 

It is evident that the diet of each individual must be regulated in 
quantity according to his occupation. It must also be adapted to his 
age. A man engaged in severe physical labor, while he really re¬ 
quires less food, may be able to dispose of more food than one who 
labors with equal intensity in some mental pursuit. The body is 
wasted much more rapidly by vigorous brain labor than by physical 
exercise. Indeed, it is asserted by our best authorities in physiology, 
that three hours of severe brain labor are equal in exhausting effects 
upon the system to ten hours of physical labor or muscular effort. It 
is evident, then, that a man who works his brain constantly for ten 
or twelve hours a day really needs more food to sustain his strength 
than a man who employs his muscles for the same length of time. 
But, as before remarked, the muscle laborer may be able to dispose of 
more food than the brain laborer, though he needs less, since his vital 
forces are not so completely exhausted by his work. In other words, 
the occupation of the muscle worker being less exhaustive than that 
of the brain worker, he can overeat with greater impunity than can 
the latter. Each should eat but the quantity actually required, if he 
would enjoy the maximum of health and vigor; but for the man 
whose vital energies are daily exhausted by mental effort, any excess 
in eating is certain to be most disastrous. We have examples of great 


278 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


literary men who have been great eaters ; but it is a noticeable fact 
that these persons, in many instances, while celebrated for their pro¬ 
ductions, often worked very leisurely, their fame being really more 
justly attributable to brilliant genius than to great application. In 
several cases, too, as in that of Charles Dickens, who is said to have 
been a large eater, the hours spent in brain labor were chosen from 
the best of the day, many hours being spent in physical exercise, by 
which means the integrity of the digestive organs was maintained 
much better than would otherwise have been the case. In not a few 
instances, too, those great literary men who were noted eaters died 
early, their physical stamina being exhausted by the double draft 
made upon it. Newton, when engaged in the most severe portion of 
his wonderful labors in demonstrating the law of gravitation by com¬ 
putations respecting the orbit of the moon, confined himself to a spare 
diet of bread and water. 

The amount of food required by an individual, as already inti¬ 
mated, varies at different periods of life, according to the degree of 
vital activity. In infancy and childhood, when the vital activities 
are at their highest degree of intensity, when growth and develop¬ 
ment are to be maintained in addition to supporting the wastes of 
the system, the demand for food is greater in proportion to the size 
of the individual than at any subsequent time. In adult life, when 
waste and repair are about equally balanced, a sufficient amount is 
needed to make good the daily loss from the various mental, physical, 
and other vital activities, which can only be supported at the expense 
of tissue. Any larger quantity than this is excess. 

In old age, when the assimilative powers are weakened by declin¬ 
ing years, the amount of food which can be assimilated by the indi¬ 
vidual is even somewhat less than what is really needed; hence, as 
age advances, the quantity of food should be gradually diminished. 
Very many old people break down much sooner than they would 
otherwise do were they more careful in this regard. When they lay 
aside their vigorous, active life, they should also curtail the quantity 
of their food. By this act of temperance, they might preserve intact 
to a much later period the integrity of their digestive organs, and so 
add years to their lives. 

In not a few instances, the foundation of dyspepsia is laid by 
some mechanical injury, as a sprained ankle, a broken limb, or a se¬ 
vere bruise or cut, which requires rest from active exercise for a few 


QUANTITY OF FOOD REQUIRED. 


279 


weeks. Not considering the fact that much less food is demanded 
when an individual is not engaged in active labor of any sort than at 
other times, the individual continues to eat heartily, and soon finds, that, 
from sheer exhaustion, the digestive organs refuse to do their work. 
On this account it should he made a uniform custom to eat lightly on 
the weekly rest-day. The hearty Sunday dinners in which many 
people indulge, making the day an occasion of feasting rather than a 
rest-day, cannot be too much condemned. The custom is without 
doubt responsible for many other forms of Sabbath-breaking, as no 
individual can have a clear perception of right and a quick sense of 
wrong when laboring under the incubus of an overloaded stomach. 
For the hearty meal usually taken, it would be well to substitute a 
light one consisting mostly of fruits and grains. This plan, if pur¬ 
sued, would do away with much of the drowsiness in church, of which 
many people and not a few pastors have abundant reason to complain. 
The intellect would be much clearer, and so better able to appreciate 
the privileges and comforts of religion. The sooner people recognize 
the fact that stomachs have much to do with religion, and that true 
religion includes the government of the appetite, and frowns upon 
abuse of the stomach as well as upon abuse of a fellow-man, the bet¬ 
ter it will be for both their stomachs and their religion. We are not 
sure but that many gloomy theological dogmas were born of bad 
stomachs and inactive livers; and we are very certain that one of the 
best preliminary steps toward converting a sinner is to reform his 
stomach. 

Each individual must be to a considerable extent his own guide 
respecting the exact amount of food to be taken at a single meal. If 
the appetite has been so long abused that it is no longer a safe guide, 
then reason must rule. The individual should, at the beginning of 
the meal, determine just how much he will eat, and when the spec¬ 
ified quantity is taken, he must resolutely stop eating, leaving the 
table if necessary, to escape temptation. The practice of serving 
fruit, puddings, nuts, confectionery, and tidbits of various kinds, as 
“ dessert,” is a pernicious one. In the first place, it is an inducement 
to overeat, since it is quite probable that enough has been eaten be¬ 
fore the dessert is served. If the articles offered are wholesome, they 
should be served and eaten with the meal, as a part of it, and not at 
its close, in addition to the meal. Furthermore, it is generally the 
case that most of the articles served at dessert are wholly unfit to 


280 


ANATOMY , PHYSIOLOGY, AND HYGIENE. 


be eaten at any time, and so should be discarded. Dessert is really 
an ingenious device to induce people to make dyspeptics of them¬ 
selves by eating more than they need. 

A man who desires to be at peace with his stomach should learn to 
“ stop when he has enough,” no matter how strongly he may be tempted 
to do otherwise. There is much more truth than poetry in the old 
Scandinavian proverb, “ Oxen know when to go home from grazing; 
but a fool never knows his stomach’s measure.” But experience, a dear 
school, ought after a time to teach the most unobserving person the 
amount of food his stomach will bear without discomfort, and without 
injury. If a person in fair health finds that after eating of whole¬ 
some food, he is troubled with fullness of the stomach, dullness over 
the eyes, “ sour-stomach,” eructations, or flatulence, he may be very 
sure that he is eating too much, and he should continue to diminish the 
amount taken at each meal until the symptoms mentioned disappear. 

By reference to the table given on page 870, it will be possible to 
ascertain with ease the amount of nutriment consumed in any given 
quantity of different varieties of food. It is worthy of remark that 
the grains, as shown in the table above mentioned, are by far the most 
nutritious of all the various classes of food. It will be observed, for 
instance, that oatmeal, Indian meal, and peas contain three times as 
much real nutriment as lean beef. When economy must be considered 
in the selection of food, this is a very important consideration. This 
becomes doubly evident when we consider that it takes eleven pounds 
of vegetable food, including Indian meal, dry hay, etc., to make one of 
beef. Thus it appears that as nutriment one pound of oatmeal at first¬ 
hand is as valuable as thirty or more pounds taken at second-hand, 
through the medium of beefsteak. 

Deficient Food Elements. —While the food may be abundant in 
gross quantity, it may be deficient in some one or more of the various 
important elements which go to make up the food. If the food is defi¬ 
cient in farinaceous and fatty elements, the individual will soon show 
signs of suffering in consequence. A lack of the nitrogenous elements 
will occasion still more marked effects, the stomach losing its tone and 
vigor, giving rise to acidity, flatulency, and various associated disturb¬ 
ances. The deficiency of the coarser, innutritious elements of the food, 
is also very soon felt by diminished activity of the stomach and bowels, 
both in secretion and in muscular action. Hence the great importance 
of choosing carefully and judiciously the articles of food to be taken, es- 


DEFICIENT FOOD ELEMENTS. 


281 


pecially when a regular dietary is to be followed. Such a selection 
should be made as Avill supply to the system all the elements of nutrition 
in proper quantity. To employ a dietary in which any one of the nu¬ 
tritive elements is deficient, although the quantity of the food may be 
all that the digestive organs can digest, is as really starvation, and will 
as certainly occasion the same results ultimately, as total deprivation of 
food. To attempt to live on white bread and butter and strong tea or 
coffee, is as certain to impoverish the blood as refraining from eating al¬ 
together, the only difference being in the length of time required to 
bring about the result. Thousands of pale-faced, ansemic, thin-blooded, 
nerveless, dyspeptic women owe all their troubles to an impoverished diet. 
Tea drunkenness, in which an individual attempts to subsist on the Chinese 
herb almost wholly, is a not uncommon thing ; and in consequence of 
its pernicious influence, the sagacious physician not infrequently finds 
as well marked cases of scurvy among ladies of the higher classes of so¬ 
ciety as among the poorly fed sailors of the whaling vessel after a long 
voyage with prolonged confinement to a monotonous saline diet. Young 
ladies who attempt to exist with little other food than tea, pastry, and 
confectionery, need not wonder that they grow to be lank and sallow 
and hollow-eyed dyspeptics. Under such a regimen, the most hardy 
quadruped would succumb. 

Many parents weaken the digestive organs of their little ones for 
life by feeding them when very young upon such insufficient diet as 
corn-starch or arrowroot gruel, and similar preparations, and when they 
become older, upon fine-flour bread. Repeated experiment has shown 
that a dog will die of starvation in a month when fed upon white or 
fine-flour bread alone. Fed upon bread made of the whole grain, or 
graham bread, dogs as well as other animals suffer no deterioration in 
weight or in strength. The difference between fine flour and graham 
flour is largely in the proportion of gluten which they contain. Fine 
flour is made from the innermost portion of the grain, which is almost 
pure starch, thus excluding the brain, nerve, and muscle nourishing ele¬ 
ments which are found chiefly in the portions of the kernel that lie 
next the outer husk. Whole-wheat flour also contains portions of inriu- 
tritious matter which, under most conditions, are advantageous, encour¬ 
aging both secretion and muscular activity of the bowels, and thus pre¬ 
venting constipation, which is often a forerunner of more serious disease 
of the digestive organs. There are cases in which the coarser portions 
of the bran are inj urious by causing irritation; but these cases do not 
often occur. 


282 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


While it is necessary to have all of the elements of the food in 
proper proportion, it is of first importance that the nitrogenous ele¬ 
ments should be sufficient in quantity, even if it should be necessary to 
take an excess of the farinaceous elements to secure the proper amount, 
since it is of these elements that the vital portions of the body are 
formed. By reference to the table given on page 880 it may be ascer¬ 
tained what quantity must be taken of the different kinds of food in or¬ 
der to obtain a sufficient supply of nitrogenous elements. 

The Quality of Food. —Man, like other animals, is made of what 
he eats; hence the German proverb is literally true, that “ as a man 
eateth, so is he,” and we may well credit the assertion of an eminent au¬ 
thor that the general tendency of thought in any nation may be deter¬ 
mined by the character of the national diet. True as this principle is 
when applied to the body in general, it is especially true as referring to 
the stomach. No organ is so directly and so profoundly affected by the 
quality of the food as the stomach. 

Bad Cookery.— The real object of cooking is to render the ele¬ 
ments of food more digestible. It is intended, indeed, to be a sort of 
partial preliminary digestion of the food; but the numerous devices 
of cooks and caterers,—complex compounds and indigestible mixtures, 
—have so far subverted the original design of the process as to render 
cooking a means of making food indigestible as often as otherwise. 
Altogether too little attention is paid to the subject of cookery as a 
science. In the majority of cases the task of preparing food for the 
palate—the stomach is seldom thought of—is intrusted to ignorant 
servant girls or colored cooks who compound mixtures by “ the rule of 
thumb,” and without any reference whatever to the physiological wants 
of the body. We are glad to see a slight indication of reform in this 
direction in the establishment of schools of cookery in the larger cities, 
and lectureships on the subject in some of our female seminaries. To 
become a good cook requires as much native genius and far more prac¬ 
tical experience than to become a musician or a school-teacher, or even 
to enter some of the learned professions. The position of cook ought 
to be made so respectable and lucrative that it will attract persons of 
sufficient mental capacity and culture to make the art subservient to 
the purposes for which it was first employed and designed. A poor 
cook in a family is a worse enemy to the health, the comfort, and even 
the morals of the household, than would be a swamp generating 
malaria a half-mile away, a cesspool fever-nest at the back door, 
small-pox across the street, or a Chinese Joss-house in the next block. 


INJURIOUS FOODS. 


283 


Fried Food .—Of all dietetic abominations for which bad cookery 
is responsible, fried dishes are the most pernicious. Meats, fried, 
fricasseed, or otherwise cooked in fat, fried bread, fried vegetables, 
doughnuts, griddle-cakes, and all similar combinations of melted fat 
with other elements of food, are most difficult articles of digestion. 
None but the most stalwart stomach can master such indigestibles. 
The gastric juice has little more action upon fats than water. Hence, 
a portion of meat or other food saturated with fat is as completely 
protected from the action of the gastric juice as is a foot within a 
well-oiled boot from the snow and water outside. It is marvelous 
indeed that any stomach, under any circumstances, can digest such 
food, and it is far from remarkable that many stomachs after a time 
rebel. 

It is principally for this same reason that “ rich ” cake, “ shortened ” 
pie-crust, and pastry generally, as w r ell as warm bread and butter, so 
notoriously disagree with weak stomachs, and are the efficient cause 
in producing disease of the digestive organs. The digestion of the 
food being interfered with by its covering of fat, fermentation takes 
place. The changes occasioned in the fat develop in the stomach ex¬ 
tremely irritating and injurious acids, which irritate the mucous mem¬ 
brane of the stomach, causing congestion, and sometimes even inflam¬ 
mation. 

Uncooked Food. —Raw food, and food which is insufficiently 
cooked, is a frequent cause of indigestion. This is especially true of 
uncooked vegetables. Man is naturally a frugivorous animal, and is 
able to make use of vegetables and many grains as food only by the 
aid of cookery. The starch of vegetables is much more difficult of 
digestion than is that of fruits. All starch, in fact, is much easier of 
digestion if subjected to the action of heat before being eaten. By the 
action of heat, the starch granules, which consist of the starch proper 
inclosed in little capsules, are ruptured, and thus the digestive juices 
can readily come in contact With and digest the starch. When starchy 
substances are eaten raw, extra work is laid upon the organs of di¬ 
gestion, and indigestion follows. It is for this reason that raw fruit 
and green vegetables occasion so much disturbance of the stomach and 
bowffis, these immature foods containing large quantities of starch in 
a very indigestible state. By cooking, unripe fruit and vegetables 
may be in a great degree deprived of their injurious properties. In 
Scotland, the eating of oatmeal imperfectly cooked is a very common 


284 


ANATOMY , PHYSIOLOGY, AND HYGIENE. 


practice, the result of which is an almost universal suffering from a 
peculiar form of indigestion due to it. Nearly all kinds of food are 
much more easy of digestion after cooking than before, providing the 
cooking is performed in the proper manner. For vegetables and 
grains, cooking is especially necessary. 

Decayed Food. —Much harm comes from eating food which has 
made appreciable advancement in the direction of decay. This is true 
of both vegetable and animal food. By the process of decomposition, 
poisonous elements are developed in animal and vegetable substances 
which do not naturally exist there. If decomposition is far advanced, 
these poisons may exist in such quantity as to produce immediate ill 
effects, sometimes occasioning death in a few hours. Instances of this 
sort have often occurred from eating canned meats which had spoiled, 
or which had been kept for a short time after opening. The practice 
in vogue in some countries, and to some extent in this, of keeping meat 
for some days before eating, so as to give it tenderness and a “ high ” 
flavor, is a most pernicious one. Better far, for health, is the horrible 
Abyssinian custom of eating the flesh while still warm and quivering. 

For persons with slow digestion, such food is especially bad, since di¬ 
gestion is so slow that decomposition is not corrected, as it is to some 
extent in a healthy stomach, by the gastric juice, but is allowed to con¬ 
tinue with all its serious consequences. If no immediate effects are seen 
to follow the use of such food, the poisons generated may be absorbed 
and appear hi some later form analogous to blood poisoning. The stom¬ 
ach of a hyena may be able to digest the putrid flesh of a decaying 
carcass ; but man’s stomach was not intended for scavenger use, and re¬ 
quires fresh, untainted food. 

Soft Food. —The structure of man’s teeth indicates that he was in¬ 
tended to employ a diet consisting of food with sufficient consistency to 
require vigorous mastication. His jaws are armed with thirty-two 
strong teeth, compactly arranged in his mouth in such a manner as to 
make them most available for use. Obeying the general law governing 
all organized structures, by which organs develop or degenerate accord¬ 
ing as they are used or allowed to remain inactive, the teeth retain their 
health if vigorously employed in the mastication of solid food, but rap¬ 
idly undergo decay when not thus used. This is well seen in cows which 
are fed on “ distillery slops.” The teeth of such animals decay and drop 
out for want of use, while those of cattle which keep their teeth actively 
employed in chewing the cud, are preserved intact. The same is true of 


EXCESSIVE USE OF SUGAR AND FATS. 


285 


human beings. Eating soups, gruels, and other soft food, to the exclu¬ 
sion of articles requiring mastication, ruins the teeth at the same time 
that it disorders the stomach through the taking of too much fluid, and 
deficient insalivation. 

Too Abundant Use of Fats. —Unfortunately for the poor stom¬ 
ach, the opinion prevails almost everywhere that food made “ rich ” 
with fat is the most nourishing. Undoubtedly, fat is an element of 
nutrition, and can be digested and assimilated when taken in proper 
quantities and in a proper manner; but the excessive use of fats of 
various kinds—lard, suet, butter, and other animal and vegetable fats 
or oils—is a prolific cause of certain forms of indigestion, especially 
that known as bilious dyspepsia. Eminent physiologists determined 
by careful experiment many years ago the fact that the large use of 
fats greatly lessens the biliary secretion, the quantity of bile be¬ 
ing diminished in some instances to a very small fraction of the 
amount secreted when only pure water or food containing little fat 
was taken. When it is remembered that the bile is an essential ele¬ 
ment for the digestion of fat, it will be seen that a diminution of this 
digestive fluid, in connection with the taking of an extra quantity of 
oleaginous matter, is a most unfortunate circumstance, since it is thus 
absent when most needed. This fact sufficiently well accounts for the 
distressing symptoms which accompany the excessive use of fats by 
those whose digestion has been already weakened by abuse of this 
sort. The diminished quantity of bile eliminated by the liver is also 
sufficient cause for the condition established by the over-use of fats, 
vulgarly known by the expressive term, “bilious.” The elements 
which ought to be eliminated from the system are retained, clogging 
the vital machinery, and giving rise to the many unpleasant symp¬ 
toms enumerated hereafter in describing “ bilious dyspepsia.” 

If fats are to be used at all, it is much preferable to employ them 
cold, as butter taken on bread at the table, rather than cooked in the 
food, by which the fat elements permeate and render difficult of di¬ 
gestion the whole mass of food. 

The Use of Sugar in Excess. —While sugar, like fat, is a true 
alimentary principle, capable of aiding in the maintenance of life 
when employed with the other elements of food, used in excess it be¬ 
comes a serious source of disease. Employed alone, it is utterly inca¬ 
pable of supporting the vital activities of the body, being, in this re¬ 
spect, analogous to starch, its food equivalent. The popular idea that 


286 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


sugar nourishes the nerves or the brain, makes the teeth sound, and 
is both harmless and wholesome, is quite a mistake, as many an inno¬ 
cent little one whose fond parents shared in the general error, has 
found out to the regret and sorrow of his friends. 

The different forms of sugar, molasses, sirup, treale, honey, etc., 
are essentially the same in their effects, except that molasses and 
honey sometimes contain peculiar elements which to some persons 
seem to be almost active poisons. This is especially true of honey. 

The injury from the use of sugar, or other saccharine substances, 
is occasioned, first, by the readiness with which it undergoes fermen¬ 
tation when subjected to warmth and moisture. In the stomach it 
finds all the conditions necessary for inducing fermentation; and were 
it not that saccharine substances in solution are usually so quickly ab¬ 
sorbed that it is difficult for the chemist even to detect their presence 
in the stomach, this change would always occur. When a larger 
quantity is taken than can be absorbed promptly, or when taken in 
such form as to make ready absorption impossible, as in the form of 
preserves and sweet-meats of various sorts, acid fermentation does oc¬ 
cur, and with serious results not only to the stomach, but to the 
whole system. The fermentation set up not only develops acids and 
gases from the sugar, but, being communicated to the other elements 
of the food,—the starch, and especially the fatty elements,—still worse 
forms of fermentation or decomposition occur, and the food is thus 
rendered unfit to nourish the body, while the mucous membrane of 
the stomach and intestines is irritated by the contact of unnatural, 
corroding elements in the food; and through their absorption, the 
whole system becomes affected. 

The excessive use of sugar also greatly overtaxes the liver, which 
has an important part to act in its digestion, distracting it from its 
legitimate function, and thus leaving the elements which it ought to 
eliminate, to accumulate in the system. Thus an individual may be¬ 
come “ bilious ” from the over-use of sugar as well as from excess in 
the use of fats. 

Condiments. —By condiments are meant all substances added to 
food for the mere purpose of rendering it more palatable, though pos¬ 
sessing no positive nutritive value in themselves. Mustard, vinegar, 
pepper, cinnamon, and various other spices, are included in this cat- 
egory, together with salt, although the last-named article is by some 
held to be of the nature of a food, supposing it to supply some want 
in the body. 


CONDIMENTS. 


287 


Mustard, pepper, pepper-sauce, cinnamon, cloves, cardamoms, and 
similar substances, are of an irritating, stimulating character, and 
work a twofold injury upon the stomach. By contact, they irritate 
the mucous membrane, causing congestion and diminished secretion of 
gastric juice when taken in any but quite small quantities. This fact 
was demonstrated by the observations of Dr. Beaumont upon St. 
Martin. After several years’ careful study of the relations of various 
foods, drinks, etc., to the stomach. Dr. Beaumont stated in summing- 
up his experiments that “stimulating condiments are injurious to the 
healthy stomach.” He often saw congestion produced in the mucous 
membrane of St. Martin’s stomach by eating food containing mustard, 
pepper, and similar condiments. 

When taken in quantities so small as to occasion no considerable 
irritation of the mucous membrane, condiments may still work injury 
by their stimulating effects, when long continued. The stomach, being 
at first excited to more than natural activity, afterward suffers from 
reaction, and is left in an inactive, diseased state, incapable of secret¬ 
ing sufficient gastric juice to supply the needs of the system in digest¬ 
ing food. This final result is often averted for some time by increas¬ 
ing the quantity of the artificial stimulus, in the form of pepper, mus¬ 
tard, salt, etc., but nature gives way at last, and chronic disease is the 
result. 

In the case of salt, there are several further objections to be urged, 
which are at least cogent against its excessive use; and by excessive 
use we mean a quantity which causes thirst either at or after meals, 
occasioned by the feverish state of the stomach induced by the caustic 
properties of the saline element. 

1. Salt is antiseptic. As already seen, anything which prevents 
fermentation will interfere with the action of the gastric juice. 
Hence salt, in any except very small quantities, must materially inter¬ 
fere with digestion. 

2. It is an irritant, not only to the stomach but to other parts of 
the system as well, as is indicated by the quickened pulse, thirst, and 
other symptoms of a febrile character experienced by a person after 
taking a slightly larger quantity than usual. 

3. Being a purely mineral substance, in no degree prepared, by as¬ 
sociation with organized life in plants, for assimilation as is necessary 
in the case of all mineral substances, it is exceedingly doubtful 
whether it is a food in the sense that fruit, vegetables, grains, or their 


288 


ANATOMY , PHYSIOLOGY, AND HYGIENE. 


several nutritive elements, are foods, and whether it can be assimilated 
or made to take part in the vital processes of the body in any way, in 
larger quantities than it is found in food. 

4. Experimental evidence shows that human beings, as well as an¬ 
imals of all classes, live and thrive as well without salt as with it, 
other conditions being equally favorable. This statement is made 
with a full knowledge of counter arguments and experiments, and 
with abundant testimony to support the position taken. 

We may, in conclusion, remark that though we do not, except in 
rare instances, advise the entire discontinuance of the use of salt, on 
account of its having been so long employed as an ingredient of food, 
we believe that it may be greatly reduced in quantity by all who use 
it, without detriment, and with real benefit. The manner in which it 
is treated by the system, being retained in the blood instead of being 
deposited in the solid tissues to any extent, and washed out through 
the skin, mucous membrane, kidneys, and liver, and thus rapidly 
eliminated in proportion to the quantity taken, is at least a hint that 
a very large amount is not needed. 

Salted food is generally known to be very hard of digestion, and 
when it is taken for a long time, the stomach often fails. A piece of 
fresh fish which will digest well in one hour and a half, requires four 
hours after salting, according to Dr. Beaumont. 

Pickles. —Cucumbers, peaches, green tomatoes, and numerous 
other fruits and vegetables, are sometimes preserved by saturation 
with strong vinegar. Sometimes whisky or some other alcoholic 
liquor is added to increase the preservative property of vinegar. The 
same process which makes it impossible for a fruit or vegetable to 
ferment or decay, makes its digestion equally difficult, as already ex¬ 
plained. Pickles are exceedingly unwholesome as articles of food, and 
often cause acute dyspepsia in those who eat of them. Young ladies 
addicted to the free use of pickles may be assured that they must 
certainly part with their favorite dainty or bid farewell to good di¬ 
gestion. Cucumbers preserved with salt or vinegar are next to im¬ 
possible of digestion. The proverbial unhealthfulness of this vegetable 
is a popular notion based .on experience with the article prepared with 
vinegar and salt. Those chemical agents harden the delicate struct¬ 
ures of the vegetable, and render it almost unapproachable by the 
digestive juices. The pure vegetable, unsophisticated by condiments, 
is as harmless as other green vegetables. We would not hesitate to 
eat it freely thus, if need be, and in “ cholera times.” 


TEA AND COFFEE. 


289 


Yinegar. —As the use of vinegar is continually increasing, atten¬ 
tion should he called to the fact that it may be a cause of disease. 
Ordinary vinegar contains about five per cent of acetic acid, its prin¬ 
cipal ingredient. Like alcoholic liquors, vinegar is a product of fer¬ 
mentation, being the result of carrying a little farther the same proc¬ 
ess by which alcohol is produced. Yinegar is much more irritating 
to the digestive organs than an alcoholic liquor of the same strength. 
It is extremely debilitating to the stomach when much used, though 
for the time being exciting. Yinegar is not infrequently employed 
in considerable quantities by young ladies who are anxious to look 
pale and interesting, and it never fails to produce the desired effect. 
It can be well recommended for such a purpose, since it so greatly 
impairs the digestion as to soon interfere seriously with nutrition. 
The moderate use of a light wine or of ale or beer is much less de¬ 
structive to the digestive organs than the large use of vinegar which 
is not uncommon among hearty eaters. There is really no need of 
resorting to so inferior a source for a mild acid, as we have the want 
met most perfectly in lemons, limes, citrons, and other acid fruits. 
As a dressing for some kinds of vegetable food, lemon juice is a per¬ 
fect substitute for vinegar. 

We have maintained this position respecting the use of vinegar for 
several years, notwithstanding it has been highly recommended by not 
a few eminent writers on food and dietetics. Yery recently, however, 
M. Richet, at the head of an august body of French savants, comes for¬ 
ward maintaining that by careful experiment he has proved that these 
things are “ bad food for the stomach.” He does not hesitate to pro¬ 
nounce vinegar and tartaric acid prolific causes of dyspepsia, and 
highly condemns the use of vinegar and pickles by young ladies. It is 
no wonder that young ladies who indulge in these unwholesome articles 
of food grow “ pale and interesting ” with dyspepsia. According to M. 
Richet, the use of acetic and tartaric acids causes a decrease in the secre¬ 
tion of gastric j uice, without which no digestion can take place. 

Tea and Coffee. —In classing these favorite beverages with causes 
of dyspepsia, we shall certainly call forth a loud protest from the numer¬ 
ous devotees of “ the fragrant cupand among the number of those 
who argue for their use we shall find numerous learned professors, as 
well as nearly the whole sisterhood of the wives, maidens, mothers, and 
grandmothers of the nation, along with a good proportion of the hus¬ 
bands, fathers, brothers, and grandfathers as well. Nevertheless, it can 

19 


290 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


be easily shown that whatever action may be assigned to these bever¬ 
ages, it is unfavorable to digestion, rather than otherwise. Leaving out 
of consideration the objections which may be urged against the use of 
tea and coffee on other grounds, the following may be offered as reasons 
why they are objectionable on account of exerting an injurious influence 
upon the digestive organs:— 

1. Both tea and coffee contain an element resembling tannin, which 
precipitates or neutralizes the pepsin of the gastric j uice, and so weakens 
its digestive power. 

2. Theine and caffeine, the active principles of tea and coffee, are 
toxic elements which at first increase and then diminish vital action, 
thus occasioning debility of the digestive organs from long-continued 
use. 

3. Both tea and coffee are objectionable on the same ground as other 
beverages in connection with meals, on account of disturbing the di¬ 
gestion by dilution and consequent weakening of the gastric juice, and 
overtaxing the absorbents, delaying the digestion of the food and thus 
giving rise to fermentation. When taken hot, as is the usual custom, 
these beverages, as do others, at first stimulate but ultimately relax and 
debilitate the stomach. 

The objections mentioned as applying to tea and coffee may be urged 
with equal force against cocoa and chocolate, the effects of which differ 
from the effects of tea and coffee chiefly in degree. 

For the other injurious effects of tea and coffee, see chapter on “Stim¬ 
ulants and Narcotics.” 

Alcohol. —We have not space in this connection to dwell at 
length upon the damaging effects of alcohol upon the human system, 
nor in fall detail of its effects upon the stomach. The following facts, 
however, are well worth the consideration of those who believe in the 
use of alcohol either moderately or with greater freedom:— 

1. Alcohol itself is an active poison, which when received into the 
stomach in a concentrated state is almost as quickly fatal to life as is 
prussic acid or strychnia. It precipitates the pepsin of the gastric j uice, 
rendering it inert. 

2. It irritates the gastric mucous membrane when taken in any but 
extremely small quantities, even beer and the weaker liquors having 
this effect when long continued. 

3. The ultimate effect of alcohol is to cause degeneration of the se¬ 
creting glands of the stomach, by which its utility as a digestive organ 
is destroyed. 


TOBACCO. 


291 


Dr. Beaumont’s observations on the effects of alcohol are very posi¬ 
tive and distinct in their indications. St. Martin being an intemperate 
man, occasionally indulging freely in drink, Dr. Beaumont had an op¬ 
portunity of observing the effects of its use, as he was able to look di¬ 
rectly into his stomach by the aid of a strong light, through the window 
provided by the remarkable accident from which he had suffered. After 
he had been drinking freely for several days, Dr. Beaumont found the 
mucous membrane exhibiting inflamed and ulcerous patches, and the se¬ 
cretions very greatly vitiated, the gastric juice being diminished in 
quantity, viscid and unhealthy, although St. Martin did not complain 
of any unusual feelings, his appetite being apparently unimpaired. The 
condition became still more aggravated for two days, when the Doctor 
found that “ the inner membrane of the stomach was exceedingly mor¬ 
bid, the erythematic appearance more extensive, and the spots still 
more livid. From the surface of some of them exuded small drops of 
grumous blood ; the aphthous patches were large and very numerous,— 
the mucous covering thicker than common, and the gastric secretions 
very greatly vitiated. The gastric fluids extracted were mixed with a 
large proportion of thick, ropy mucus, and a considerable muco-purulent 
discharge slightly tinged with blood, resembling the discharge from the 
bowels in some cases of dysentery ” 

It will be remarked that notwithstanding the very serious condition 
of his stomach, St. Martin was unconscious of any great disturbance 
there. This was partly due, no doubt, to the paralyzing effect of alco¬ 
hol upon the nerves of sensibility. It is owing to this fact that so many 
suppose that alcoholic drinks have no specially bad influence upon the 
stomach, when really their stomachs are well-nigh useless from disease 
but too insensible to indicate their condition. 

Liquor of any sort taken upon an empty stomach is especially 
inj urious. 

Tobacco. —Not infrequently, though less often than is the case with 
alcoholic liquors, this narcotic drug is recommended as a remedy for dys¬ 
pepsia. Nevertheless, in the case of tobacco as in that of alcohol, the rem¬ 
edy suggested is itself an active cause of stomach disease. Only on the 
similia similibus plan could either one be reasonably employed. Both 
smoking and chewing weaken and debilitate the digestive organs, though, 
both of these practices are thought by those who indulge them to stimu¬ 
late the process of digestion, which they probably do for the time being 
but only at the expense of subsequent injury. Snuff-taking, especially, 


292 


AX ATOMY, PHYSIOLOGY, AND HYGIENE. 


produces gastric irritability, probably by reflex sympathy of the mu¬ 
cous membrane of the stomach with that of the nasal cavity, which is 
irritated by the direct contact of the acrid drug. 

The immense waste of saliva occasioned by chewing and smoking 
may fairly be considered as one of the means by which the system sus¬ 
tains loss and injury through the use of tobacco. Those who chew or 
smoke to prevent excess of fat, should understand that any drug which 
will exert such an influence upon the system must be a powerfully de¬ 
structive agent. Those who succeed in keeping down fat by the use of 
tobacco may depend upon it that they are doing so only at the ruinous 
expense of their digestive organs, and may look forward with certainty 
to the breaking down of their nervous systems. 

Hard Water. —So little attention has been paid to this really 
common cause of indigestion by writers on this subject, that we can¬ 
not forbear mentioning it here. Experience has often proved that 
the use of hard water impairs the integrity of the stomach sooner or 
later when long continued; and in numerous instances its effects are 
almost immediate upon persons who visit a hard-water district, 
having been accustomed to the use of soft water. These injuri¬ 
ous effects are undoubtedly attributable to the lime and magnesia 
which are contained in water called hard. These alkalies, as already 
seen in considering the physiology of digestion, neutralize the gastric 
juice, and thus work their mischief. There is little necessity for the 
use of hard water in any part of the country. Where there are not 
soft-water wells or springs, rain-water may be caught and preserved 
in cisterns, and by filtration through carbon filters it can be made 
pure and palatable for drinking and cooking purposes. There is no 
foundation for the theory that hard water is in any respect more 
excellent for use than pure soft water. 

Alkalies. —Soda, saleratus, and the numerous compounds of 
these substances with ammonia, alum, cream of tartar, etc., are all 
objectionable on the same grounds as hard water. Being alkaline, 
they antagonize the action of the acid gastric juice, and thus 
weaken digestion. There is no more active dyspepsia-producing 
agent than soda and saleratus biscuit, one of the most common 
articles of food to be found on the tea-table of rich and. poor in this 
country. Doubtless, well-prepared baking-powders are much pref¬ 
erable to soda and cream of tartar or saleratus and sour milk, mixed 
by the cook in accordance with the not remarkably accurate “ rule 


PERVERTED APPETITES. 


293 


of thumb,” through which bungling chemistry the biscuit often pre¬ 
sent a golden hue which may be attractive to the eye, but gives to 
the tongue quite too distinct a flavor of soda and potash to be 
agreeable to a fastidious taste, to say nothing of the probable effect 
upon a stomach not impregnable against the attacks of chemical 
agents. In baking-powders, the various ingredients are so mixed as 
to leave nearly neutral products, and yet these compounds are 
scarcely less pernicious in their influence upon digestion than the 
original chemicals from which they are formed. We deem the wide¬ 
spread and growing use of these chemical bread-making agents bad 
omens for the digestion of the next generation; though we read¬ 
ily grant that if the alternative is between heavy bread and bread 
made “ light ” with baking-powder, the latter is preferable. 

Perverted Appetites. —Strangely perverted tastes, as shown in a 
fondness for earthy and other inorganic or innutritious substances, 
while sometimes the result of dyspepsia, are often the cause of stom¬ 
ach disorders, being the result of nervous or mental disease, or being 
adopted as a habit through example. In South America there are 
whole tribes of human beings who habitually eat considerable quanti¬ 
ties of a peculiar kind of clay. Several North American tribes have 
the same habit, being known as clay-eaters. A similar propensity 
sometimes appears among more civilized human beings, being almost 
exclusively confined, however, to young women, chiefly school-girls, 
who acquire the habit of chewing up slate pencils, and gradually be¬ 
come so fond of such earthy substances that they have in some in¬ 
stances been known to eat very considerable quantities of chalk, clay, 
and similar substances. While indicating a depraved state of the 
system, and often of the mind also, this practice has a very pernicious 
effect upon the stomach, which is not intended, as is that of the fowl, 
to receive inorganic matter of that sort. 

The amount of abuse of this sort which the stomach will stand, 
however, is quite astonishing. Dr. Pavy tells a story of an American 
sailor who saw a juggler pretending to swallow pocket-knives. With 
the characteristic recklessness of a sailor, and supposing that the 
knives were really swallowed, he attempted to do the same thing 
himself, and succeeded in getting down four. Three of these were 
passed off in two days, but he never saw the other. Six years after, 
he swallowed fourteen knives in two days, and was taken to a hos¬ 
pital, where “ he got safely delivered of his cargo.” He was not so 


294 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


fortunate on a subsequent occasion, when he paid dearly for his folly, 
lingering in misery for some time until he died, when his stomach 
was found to contain a number of rusty knife-handles, blades, springs, 
etc., being greatly contracted and corrugated in consequence of the 
violence which had been done to it. 

The habit of swallowing cherry pits, apple and other small seeds, 
is a very reprehensible one. Such objects not only disturb the stom¬ 
ach, but sometimes find lodgment in the. appendix at the lower end 
of the coecum, giving rise to inflammation and death. As a general 
rule, the innutritious parts of foods, as the skins of fruits and vegeta¬ 
bles, the seeds and cores of apples, and similar parts, should be care¬ 
fully separated from the nutrient portions and discarded. 

Adulterations of Food. —The numerous adulterations of food 
which are now so extensively practiced must be recognized as a not 
unimportant cause of functional disease of the stomach. Alum in 
bread and in baking-powders; lead in drinking-water which has 
passed through lead water-pipes, or has been stored in lead cisterns, 
or collected from a roof covered with sheet-tin containing lead; lead 
occurring in the tin cans used for preserving fruit, or in tin pans or 
other tinned ware, or in the glazing of kettles; vinegar containing 
sulphuric and other strong mineral acids; pickles boiled in copper or 
brass vessels and thus poisoned with copper; sugar adulterated with 
glucose—or sugar made from corn, refuse starch, etc.—and containing 
iron, sulphuric acid, tin, etc.; flavoring extracts made by purely chem¬ 
ical processes, and containing not a drop of the extract of the fruit 
after which they are named; chalk and water in milk,—these, with 
numerous other equally harmful adulterations, work havoc with the 
stomachs of people who are so unfortunate as to be victimized. 

Unseasonable Diet. —The failure to recognize the necessity of 
adapting the diet to the season and climate is a prolific source of a 
certain class of dyspeptic disorders. This is especially noticeable 
when the use of large quantities of carbonaceous food, especially fats 
and sugar, which may be used in the winter with comparative im¬ 
punity, is continued into the warm season of the year, or when a diet 
of this sort is continued in a warm climate by persons who have been 
accustomed to it in a cold country. It is this sort of transgression of 
the laws of digestion that gives rise to “ biliousness,” “ bilious dys¬ 
pepsia,” etc., in many persons. Large quantities of fat and sugar are 
not well tolerated by the stomach at any time ; and in warm climates, 


NEGLECT OF THE BOWELS. 


295 


and the warm season of cold and temperate latitudes, they are ex¬ 
ceedingly injurious. 

Pressure upon the Stomach. —The stomach is remarkably sen¬ 
sitive to pressure. It even sometimes becomes temporarily paralyzed 
by excess in eating, or by the accumulation of gas from fermentation, 
by the distension of its walls. It is equally liable to injury of a sim¬ 
ilar sort from external causes. A sudden blow upon the stomach has 
been known to produce almost instant death. In ladies, the wearing 
of corsets, and tight-lacing with or without the corset, are common 
causes of dyspepsia as well as of other serious diseases. Wearing of 
the pantaloons drawn tightly, and without suspenders, has a similar 
effect in men. The soldiers of the Russian army once suffered so much 
from this cause that it became necessary to correct the evil by a royal 
edict for the purpose. Very soon after the evil practice was discon¬ 
tinued, the effects disappeared. Book-keepers and school children 
from sitting at a desk, seamstresses and tailors from stooping over at 
their work, shoe-makers, weavers, and washer-women, from direct 
pressure upon the stomach incidental to their work, suffer from dis¬ 
turbance of that organ. 

Drugs. —The continued use of drugs of several sorts, and espe¬ 
cially of patent medicines, “ bitters,” and “ purgatives,” particularly 
the latter, has a very damaging effect upon the stomach and bowels. 
Too much cannot be said lo discourage the use of laxatives, purgatives, 
“ liver pills,” etc. While sometimes beneficial, agents of this sort, if 
used for any length of time, are quite certain to work mischief. Pur¬ 
gatives should never be used except as temporary palliatives. If the 
bowels require artificial aid, the enema is far preferable; and yet this 
plan also has its inconveniences, and results badly if too long contin¬ 
ued. In general, the less drugs one takes the better. Patent nos¬ 
trums should be shunned as the most virulent poisons, which in many 
instances they are. 

Neglect of the Bowels. —Neglecting to heed the calls of nature 
promptly and regularly is an abuse of the digestive organs which 
should not be overlooked. The bowels are as much a part of the ali¬ 
mentary canal as is the stomach; and they have an important part to 
act in absorbing the digested food. They are also important excreting 
organs, some of the worst poisons generated in the system passing off 
through them. The feces are made up, not chiefly of the remains of 
food, as many persons suppose, but of impurities thrown out of the 


296 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


system by the intestinal mucous membrane. When these excrementi- 
tious substances, the foulest in the body, are retained, they are to some 
extent reabsorbed, thus poisoning the system. Every physician is 
familiar with the peculiar fecal odor of the breath of a costive child, 
an evidence of the absorption referred to. 

The bowels naturally move once a day with most people, and com¬ 
monly soon after breakfast. A few persons habitually move their 
bowels only every other day, without injury, while some persons find 
it necessary to relieve the bowels twice in twenty-four hours. How¬ 
ever the habit may be, it should be regular. Every person should 
have a definite time for attending to the relief of the bowels as system¬ 
atically and punctually as in taking meals. This is a matter of very 
great importance; piles, or hemorrhoids, fissure and fistula, prolapsus 
of rectum and also of the womb, and a host of other evils, begin in 
constipation of the bowels. 

To encourage the needed regularity and promptness in attending 
to the bowels, it is important that comfortable accommodations for the 
purpose should be provided. The custom of building a small, loose 
shed at a considerable distance from the house is a bad one, as it sub¬ 
jects women and children, especially, to unpleasant and even danger¬ 
ous exposure during the cold months of the year. Still more to be 
deprecated is the custom, quite prevalent in the West, of dispensing 
with privy accommodations altogether. The closet should be near 
the house, and should be made warm and convenient, and properly 
screened. If judiciously taken care of, it need not be a nuisance or a 
cause of disease, even if adjoining the house or within it. The earth- 
closet plan is an excellent arrangement for winter. 

A very eminent medical gentleman, a man of long experience as a 
specialist in the treatment of diseases of women, affirms his belief that 
not a. few of the serious maladies from which women suffer are due to 
neglect of the bowels. 

The best remedies for constipation are given under the proper 
head. 

Mental Influence. —The digestive process is very greatly under 
control of the mind. The connection between the mind and the 
stomach is so intimate that Yan Helmont maintained for a lon£ time 
that the stomach was the seat of the soul. By any strong emotion 
the whole digestive apparatus may suddenly cease to act. Fear, rage, 
and grief check the salivary secretion, and without doubt the gastric 


HYGIENE OF THE TEETH. 997 

* 

also. Through the mind, the appetite may be either encouraged or 
quite destroyed. 

A man who sits down to his dinner with his mind depressed with 
business cares, the embarrassment of debts, or the anxiety of doubtful 
speculations, cannot hope to digest the most carefully selected meal. 
The woman who dines with her mind disturbed with discontent, fret¬ 
fulness, and worriment, is certain to suffer with indigestion. Domestic 
infelicity may well be counted as at least an occasional cause of di¬ 
gestive derangements. Meals eaten in moody silence are much more 
apt to disagree with the stomach than those which are accompanied 
by cheerful conversation. A hearty laugh is the very best sort of 
condiment. Cheerfulness during and after meals cannot be too highly 
rated as an antidote for indigestion. 

Hygiene of the Teeth. —Defective teeth, by interfering with the 
complete and thorough mastication of food, seriously impair the di¬ 
gestion. On the other hand, impairment of digestion, and perversion 
of the secretions, is a very common cause of decay of the teeth. Thor¬ 
ough mastication is essential to good digestion; and no one can hope 
to preserve a good digestion while munching food with toothless gums, 
or subsisting on a dietary that requires no use of teeth. 

So rapid is the increase of degeneration of the teeth in modern 
times, that we have asked ourselves more than once the question, Mill 
the American race become toothless ? Not quite, perhaps; at least not 
so long as artificial dentures can be manufactured from such a variety 
of substances and made to answer so useful a purpose as masticators. 
Indeed, some people already afford two sets of teeth—a set for every 
day, for rough usage, and an extra-fine set for exhibition on special 
occasions. But at the present rate of deterioration, not many more 
generations will appear before we shall find a toothless race, ship¬ 
wrecked in health, with digestion bankrupt, and “nerves” the dom¬ 
inant feature. 

Barely indeed, do we find a person at thirty years of age with a 
set of sound teeth. Far moro often do we find young lads and girls 
of ten to sixteen years of age whoso teeth are mere shells of decaying 
tissue, rotting away with almost visible rapidity, depositories of de¬ 
caying particles of food, and millions of wriggling animalcules, and 
the sources of contaminating elements which deteriorate digestion, 
and of offensive odors which contaminate the breath. In confirmation 
of these statements respecting the condition of American masticators 


208 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


it may be mentioned that there are 12,000 dentists in the United 
States, who annually extract twenty million teeth, manufacture and 
insert three million artificial teeth, and hide away in the cavities of 
carious teeth three tons of pure gold, to say nothing about the tons of 
mercury, tin, and other metals employed in “ fillings.” 

For the preservation of the teeth we offer the following rules, 
which, if thoroughly carried out, will certainly secure good results un¬ 
less the teeth are ruined by incurable constitutional disease:— 

1. See that the teeth are properly developed. To this end, supply 
the child while an infant, and even after, with an abundance of food 
which is rich in “salts,” such as peas, beans, graham bread, oatmeal, 
and the like, and carefully watch the first set of teeth as they are 
developed and give place to the permanent set. 

2. Have a tooth filled as soon as the smallest appearance of decay is 
discovered; and in order to discover the very beginnings of decay, ex¬ 
amine them frequently, or have a dentist do so. If a child complains 
of toothache, take him to a good dentist at once, for something is cer¬ 
tainly wrong. It is a mistake to suppose that it is not worth while to 
have first teeth filled, since others will come in their place. Unless the 
tooth is about to be displaced by the permanent tooth, it should be filled, 
for the benefit of the coming permanent tooth as well as for the present 
health and comfort of the child. 

3. Cleanse the teeth night and morning, as well as after each 
meal, taking care to remove all particles of food, brushing and rinsing 
well. Use soap and powder at least once a day. Give attention to the 
back teeth, and the inside as well as the front teeth, which are apt to re¬ 
ceive chief attention for the sake of appearance, when they need the least. 

4. Never allow mineral acids of any kind, nor such preparations as 
chloride or sulphate of iron, to touch the teeth, as they will destroy the 
enamel. 

5. Avoid allowing gritty substances to come in contact with the 
enamel, as they will scratch and mar it, and perhaps cause the beginning 
of decay. 

6. If possible, never lose a tooth. An eminent physician once said 
that we lose a year of life every time we part with a tooth. They are 
too valuable to lose when by a trifling expense they may be saved. 

7. Never employ traveling dentists nor purchase or use patent com¬ 
pounds for the teeth. Many of them contain substances which will de¬ 
stroy the enamel or induce disease of the gums. 


CARE OF TEE TEETH. 


299 


8. Never carry “old stumps ” in the mouth. If they cannot be filled, 
have them extracted. Nothing is much more repulsive than a mouth 
full of stumps of rotten teeth. We would much rather encouuter the 
decomposing carcass of a dead dog than a person with such a mouth; 
for we could easily run away from the former, but might be compelled 
to tolerate the presence of the latter notwithstanding the nuisance. 

9. If the teeth are utterly in ruins and can in no way be repaired 
so as to make them really serviceable, they should be replaced by 
good artificial teeth. It should be borne in mind, however, that 
the natural teeth are much superior to any artificial substitute; 
and hence they should not be sacrificed without making all possible 
efforts to save them. Many times dentists advise the drawing of 
teeth for the purpose of securing the opportunity to make a new set; 
hence it is important that advice should be sought from a skillful and 
trustworthy source. 

10. Artificial teeth must be cared for with as much scrupulous 
regularity and thoroughness as natural teeth in order to preserve the 
health of the mouth. They should be removed from the mouth at 
night and placed in a glass of water, and in the morning should be 
thoroughly cleansed with fine soap or with a solution of chlorinated 
soda, which can be obtained of any druggist. Artificial dentures 
should also be removed from the mouth and thoroughly cleansed 
after each meal. 


300 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


SECRETION AND EXCRETION. 


The nutrition or maintenance of the body in health, involves two 
essential processes, assimilation and disintegration, or dis-assimila- 
tion. Assimilation is the process by which the nutritive material fur¬ 
nished to the tissues in the blood is made into tissue, each tissue possessing 
the power to renew itself from the elements found in the blood. Dis- 
assimilation is the process of tissue waste or breaking down. Every 
act, thought, sensation, no matter how slight, results in the waste or 
breaking down of tissue. As accessory to these two great processes, we 
have secretion and excretion. Secretion is the formation from the 
blood of something which did not exist in it, but which is produced by 
transformation of some of the elements which it contains, for the pur¬ 
pose of aiding in some vital process. Assimilation is really a secretory 
process, each tissue possessing the power to secrete tissue like itself. 
Excretion is the removing from the blood of the products of tissue 
waste which are washed out of the tissues by the venous blood. 

Secretions. —The principal secretions are the following : 1. The 
digestive fluids, comprising the saliva, gastric juice, bile, 'pancreatic 
juice, and the intestinal juices, all of which have been described ; 2. 
Serous fluids, produced by serous membranes for the purpose of lubri¬ 
cation ; as by the peritoneum, which lines the abdominal cavity and 
covers the intestines; the pericardium, which incloses the heart; the 
pleura, which covers the lungs and lines the chest; the membranes of the 
brain, etc.; 3. Synovial fluid, which is formed by the synovial mem¬ 

branes of joints for the purpose of lubrication; 4. Sebaceous matter, 
which is formed by minute glands in the skin and some parts of the 
mucous membrane for the purpose of protecting the skin, and keeping 
it in a supple condition ; 5. Various other fluids formed by small glands 
which are imperfectly understood, as the pineal gland and pituitary body 
of the brain. 

Excretions. —The principal excretory products are the siveat, mu¬ 
cus, urine, bile, and carbonic acid, eliminated respectively by the skin, 
the mucous membrane, the kidneys, the liver, and the lungs. The ex¬ 
cretions are not produced by the organs named, but by the tissues, the 



THE SKIN—SWEAT-GLANDS. 


301 


organs mentioned simply serving to separate the various morbid ele¬ 
ments from the blood. 

Without going into the minute details of the subject, we will now 
consider the structure and functions of the principal secreting and ex¬ 
creting organs which have not been already described. 

The Skill. —The general structure of the skin has been described 
in connection with the consideration of the sense of touch (see page 166), 
and hence we need consider here only the points there omitted; viz., the 
secreting and excreting organs of the skin, and the hair and nails. A 
reference to Plate IV will give quite a clear idea of the relations of the 
sweat glands, the hair, and the sebaceous glands, to the general frame¬ 
work of the skin. The area of the skin in an adult is twelve to sixteen 
square feet. 

Tli© Sweat Glands. —A close examination of the little ridges found 
upon the palms of the hands, by the aid of a small magnifying-glass, 
will reveal what appear to be fine transverse lines crossing the ridges at 
short intervals. A closer inspection shows that the apparent lines are 
really extremely minute openings, guarded by delicate valves. These 
are the mouths of the perspiratory ducts, which convey to the sur¬ 
face the product of the sweat glands. The gland itself is merely a 
coiled tube, situated deep down in the true skin, and surrounded with a 
net-work of blood-vessels. The duct is simply a continuation of the 
same tube upward through the cuticle to the surface. It passes out 
upon the surface of the skin obliquely, thus leaving a small portion of 
the cuticle overlapping its orifice, forming a sort of valve. 

The number of these delicate glands is enormous. It has been care¬ 
fully estimated to be about 2,300,000 in a single individual. The length 
of each is about one-fifteenth of an inch, making their aggregate length 
about two and one-half miles. 

Between two and three pounds of sweat is thrown off* each day. 
The perspiratory secretion consists of water holding in solution various 
excretory principles, the chief of which is urea, which is also elimi¬ 
nated by the kidneys, and is one of the most important excretory 
products. The amount of urea varies somewhat with the amount elim¬ 
inated by the kidneys. The sweat also contains a large proportion of 
chloride of sodium. In certain parts of the body, particularly the arm- 
pits and between the toes, the sweat glands are more numerous than in 
most other parts, and the perspiration often has a peculiar and offensive 


302 


ANATOMY , PHYSIOLOGY , . 4 N.D HYGIENE. 


odor. The sweat secretion is usually acid; but when so strongly odor¬ 
ous it is found to be alkaline. 

• 

The Hair. —With the exception of the palms of the hands and the 
soles of the feet, the whole surface of the body is covered with hairs, 
which vary much in length and thickness in different parts of the body. 
The majority are soft and fine, those upon the head and a few other 
parts of the body being long and silky. The hairs found upon the head 
average about xro of an inch in diameter, varying from to - 3 - 5 V 0 of 
an inch. Dark hair is usually coarser than light. The color of the 
hair is due to pigment of the same nature as that which gives color to 

the eye and skin. The number of hairs 
upon the entire head is about 120,000. 
Straight hairs are nearly round. That 
which is curled is elliptical. The hair 
of the negro is flat. Hair possesses the 
peculiar property of becoming strongly 
electric when rubbed. This is especially 
manifested in cold, dry weather. When 
combed in the dark, sparks may be seen 
to issue from it. This may be well seen 
in rubbing the back of a cat, stroking to¬ 
ward the head. 

Most hairs are hollow, beiim reallv 
hollow tubes, the outside being covered 
with a layer of overlapping cells. When 
viewed with a microscope, the hair looks 
rough and serrated. This peculiarity can 
be demonstrated by a simple experiment. 
Place two hairs between the thumb and 
finger with the roots the same way. Now make a slight side 
movement with the thumb and finger, thus rubbing the hairs alter¬ 
nately in different directions. Two smooth wires so treated would re¬ 
main in the position in which they were placed; but the hairs will be 
seen to move with each alternate movement of the fingers, and always 
toward the root. Now if one hair be changed so that its root is in the 
same direction as the tip of the other, the same rubbing will cause them 
to move in opposite directions. 

The hairs grow from little pouches in the skin. The root of a hair 
greatly magnified is shown in Fig. 130. The hair serves a useful purpose in 



Pig - . 130. The Root of a Hair, 
showing nutrient blood-vessels at the 
base. 





























FUNCTIONS OF TEE SKIN. 


303 


protecting the body, giving additional warmth in some places, and in 
hot climates protecting the head from the heat of the sun, being a good 
non-conductor. It also diminishes the friction of clothing. The mus¬ 
tache protects the lungs from dust. 

Connected with each hair follicle is a little band of involuntary 
muscular fibres, one end of which is attached to the follicle, the other to 
the skin near by. Under the influence of cold these muscles contract, 
puckering the skin and producing the peculiar appearance known as 
goose-flesh. 

Sudden Blanching of the Hair. —Cases have occurred, in which, 
under the influence of fear, grief, or some other strong emotion, the hair 
has turned white in a single night, a week, or some other short period. 
Examination of hair thus affected has shown that the cause of the 
change of color is the appearance in the hair of great numbers of minute 
air-bubbles. 

The Sebaceous Glands. — Connected with the hair follicles are lit¬ 
tle glands for the secretion of a fatty substance. These glands discharge 
their contents into the hair follicles, whence they reach the skin. 

The Nails. —These are horny plates which grow from a fold of 
skin near the ends of the fingers and toes. They are formed in a man¬ 
ner much similar to that in which the hairs are produced. Their object 
is to protect the ends of the fingers and toes. 

Functions of the Skin. —The skin performs a number of very 
important offices for the body. Perhaps the most important is that 
of excretion. Each of its millions of sweat glands is actively and con¬ 
stantly engaged in separating from the blood impurities which would 
destroy life if retained. These foul products are poured out through 
a corresponding number of minute sewers, and deposited upon the 
surface of the body to the amount of several ounces each day, or sev¬ 
eral pounds, if the whole perspiration be included in the estimate, as 
is commonly done. 

The skin is also an organ of respiration; it absorbs oxygen, and 
exhales carbonic acid gas, with other poisonous gases. The amount of 
respiratory labor performed by the skin is about one-sixtietli of that 
done by the lungs. In some of the lower animals, the whole work of 
respiration is performed by the skin. In the common frog, the respi¬ 
ratory action of the skin and of the lungs is about equal. 

Another important office of the cutaneous tissue is absorption. 


304 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


The absorption of oxygen has already been referred to; but it ab¬ 
sorbs liquids as well as gases, and to a much greater extent. By im¬ 
mersion in a warm bath for some time, the weight of the body may 
be very considerably increased. Dr. Watson, an English physician of 
note, reports the case of a boy whose weight increased nine pounds in 
twenty-four hours, solely by cutaneous absorption of moisture from the 
air. This extraordinary action was occasioned by disease. Seamen, 
when deprived of fresh water, quench their thirst by wetting their 
clothing with sea-water, the aqueous portion of which is absorbed by 
the skin. The lymphatic vessels are believed to be the principal 
agents in absorption. 

Another remarkable function of the skin is the regulation of tem¬ 
perature. By its density and non-conducting property it prevents the 
escape of necessary heat to a considerable degree. But when the 
amount of heat generated in the body becomes excessive, either from 
abnormal vital activities, or by exposure to external heat, the skin re¬ 
lieves the suffering tissues by favoring the escape of heat. This de¬ 
sirable end is attained through the evaporation of the moisture poured 
out upon the surface by the perspiratory glands. 

It has been estimated that the evaporation of water from the cu¬ 
taneous surface and from the mucous membrane of the lungs occasions 
the loss each minute of sufficient heat to raise a pint of water 100° F. in 
temperature. This is certainly a powerful cooling process. 

Lastly, we mention as a further function of the skin, and one 
which is not the least in importance, its utility as a sensitive surface. 
It is a well-established physiological fact that the mind is only a re¬ 
flection of impressions received from without, or at least that its char¬ 
acter is largely determined by the nature of the impressions made 
upon its organs of sensibility. The skin is the organ of touch, and of 
the various modifications of tactile sensibility. It is the most exten¬ 
sive organ of sensibility in the body, and is very closely connected 
with all the great nerve centers, so that it is perhaps the most effi¬ 
cient means through which to affect the general nervous system. Its 
intimate sympathy with internal organs is shown in the great number 
of diseases in which this organ evidently sutlers on account of disabil¬ 
ity of some internal part. 

The importance of the functions of the skin is shown by the fact 
that a person quickly dies when its action is interrupted. A coat of 
varnish or caoutchouc, applied over the whole skin, will kill a man al- 


CLEANLINESS. 


305 


most as quick as a fatal dose of strychnia. In illustrative experi¬ 
ments, horses, dogs, and other animals have been killed by obstructing 
the action of the skin by some similar means. A little boy was once 
killed by covering him with gold-leaf to make him represent an angel 
at a great celebration. 

The offensive odor of the perspiration, and the characteristic smell 
of the sweat-soiled under-clothing of a tobacco-user, are facts which 
well attest the value of the cutaneous functions in removing impuri¬ 
ties from the body. 

Cleanliness.— The skin is one of the most important depurating 
organs of the whole body. From each of its millions of pores con¬ 
stantly flows a stream laden with the poisonous products of disinte¬ 
gration. As the water evaporates, it leaves behind these non-volatile 
poisons, which are deposited as a thin film over the whole surface of 
the skin. As each day passes, the process continues, and the film 
thickens. If the skin is moderately active, three or four days suffice 
to form a layer which may be compared to a thin coating of varnish 
or sizing. The accumulation continues to increase, unless removed, 
and soon undergoes further processes of decomposition. It putrefies, 
rots, in fact, and develops an odor characteristic and quite too famil¬ 
iar, though anything but pleasant, being at once foul, fetid, putrid, 
pungent, uncleanly, and unpardonable. 

But the offense to the nose is not the extent of the evil. The un¬ 
clean accumulation chokes the mouths of the million little sewers 
which should be engaged in eliminating these poisons, and thus ob¬ 
structs their work. Being retained in contact with the skin, some 
portions are reabsorbed, together with the results of advancing decay, 
thus repoisoning the system, and necessitating their elimination a sec¬ 
ond time. 

Here water serves a most useful end if properly applied. It is un¬ 
excelled as a detergent, and by frequent application to the skin will 
keep it wholly free from the foul matters described. The necessity 
for frequent ablutions is well shown by the fact that nearly two 
pounds of a poison-laden solution, the perspiration, is daily spread 
upon the surface of the body. It is not an uncommon occurrence to 
meet with people who have never taken a general bath in their lives. 
Imagine, if possible, the condition of a man’s skin, at the age of sev¬ 
enty or eighty years, which has never once felt the cleansing effects of 
a thorough bath I 


20 


306 


ANATOMY, PHYSIOLOGY AND HYGIENE . 


One of the most serious effects of this accumulation of filth is the 
clogging of the perspiratory ducts. Their valve-like orifices become 
obstructed very easily, and depuration is then impossible. It is not 
wonderful that so many people have torpid skins. The remedy is ob¬ 
vious, and always available. 

How to 3Iake the Skin Healthy. —A man who has a perfectly 
healthy skin is nearly certain to be healthy in other respects. In no 
way can the health of the skin be preserved but by frequent bathing. 
A daily or tri-weekly bath, accompanied by friction, will keep the 
skin clean, supple, and vigorous. There is no reason why the whole 
surface of the body should not be washed as well as the face and 
hands. The addition of a little soap is necessary to remove the oily 
secretion deposited upon the skin. 

A lady of fashion, in enumerating the means for preserving beauty, 
says: “ Cleanliness, my last recipe (and which is applicable to all ages), 
is of most powerful efficacy. It maintains the limbs in their pliancy, 
the skin in its softness, the complexion in its lustre, the eyes in their 
brightness, the teeth in their purity, and the constitution in its fairest 
vigor. To promote cleanliness, I can recommend nothing preferable 
to bathing. The frequent use of tepid baths is not more grateful to 

the sense than it is salutary to the health and to beauty.By 

such means, the women of the East render their skins softer than that 
of the tenderest babe in this climate.” “ I strongly recommend to ev¬ 
ery lady to make a bath as indispensable an article in her house as a 
looking-glass.” 

When the foul matters which ought to be eliminated by the skin 
and quickly removed from the body are allowed to remain undisturbed, 
the skin becomes clogged and inactive, soon loses its natural lustre 
and color, becoming dead, dark, and unattractive. When bathing is 
so much neglected, it is no marvel that paints, powders, lotions, and 
cosmetics of all sorts, are in such great demand. A daily bath, at the 
proper temperature, is the most agreeable and efficient of all cosmetics. 

Bathing Protects against Colds.— It is an erroneous notion that 
bathing renders a person more liable to “ take cold, by opening the 
pores.” Colds are produced by disturbance of the circulation, not by 
opening or closure of the pores of the skin. Frequent bathing in¬ 
creases the activity of the circulation in the skin, so that a person is 
far less subject to chilliness and to taking cold. An individual who 
takes a daily cool bath has perfect immunity from colds, and is lit- 















































































Demodex Folliculonwi. 



A earns Scabei (Itch Mite.) 



Demodex Folliculnnun. 


Plate VI] I 










ARISTOCRATIC VERMIN. 


307 


tie susceptible to changes of temperature. Colds are sometimes taken 
after bathing, but this results from some neglect of the proper precau¬ 
tions necessary to prevent such an occurrence, which are carefully 
stated elsewhere in this work. 

Aristocratic Vermin. —Doubtless, not a few of those very refined 
and fastidious people who spend many hours in the application of all 
sorts of lotions and other compounds to the face and hands, for the pur¬ 
pose of beautifying those portions of the skin exposed to view—while 
neglecting as persistently those parts of the skin protected from observa¬ 
tion—would be very much surprised to learn the true condition of the 
unwashed portions of their cutaneous covering. They instinctively 
shrink with disgust from the sight of a vermin-covered beggar, in whose 
cuticle burrows the acarus scabiei (itch-mite), while troops of larger in¬ 
sects are racing through his tangled locks and nibbling at his scaly scalp. 
It is quite possible that many a fair “unwashed” would faint with 
fright if apprized of the fact that her own precious covering is the home 
of whole herds of horrid-looking parasites which so nearly resemble the 
itch-mite as to be at least a very near relative, perhaps half-brother or 
cousin. The name of this inhabitant of skins unwashed is as formida¬ 
ble as the aspect of the creature, though it does not require a microscope 
to display its proportions, as does the latter; scientists call it, demodex 
folliculorum. See Plate VIII. 

The demodex makes himself at home in the sebaceous follicles, where 
he dwells with his family. Here the female lays her eggs and rears her 
numerous family, undisturbed by the frictions of any flesh-brush, and 
only suffering a transient deluge at very long intervals, if such a 
casualty happens. In studying the structure of these little parasites, we 
have found several tenants occupying a single follicle, pursuing their do¬ 
mestic operations quite unmolested by any external disturbance. 

The demodex has been transplanted from the human subject to the 
dog; and it is found that the new colony thrives very remarkably, and 
soon produces a disease apparently identical with that known as “ mange.” 

We have not space to describe in detail these savage little brutes, 
with their eight legs, armed with sharp claws, bristling heads, sharp 
lancets for puncturing and burrowing into the skin, and their powerful 
suckers for drawing the blood of their victims. We care only to impress 
upon the mind of the reader the fact that neglect of bathing and friction 
of the skin is sure to encourage the presence of millions of these para¬ 
sites, and that the only remedy is scrupulous cleanliness of the whole 


308 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


person. Like their relatives, the itch-mite, they do not thrive under hy¬ 
dropathic treatment, and are very averse to soap and water. The best 
way to get rid of them is to drown them out. They do not produce the 
irritation which characterizes the presence of the itch insect, so that this 
evidence of their presence is wanting. But they are sure to be present 
in a torpid, unhealthy, unwashed skin, no matter how delicate or fastid¬ 
ious its possessor. 

Bathing a Natural Instinct. —All nature attests the importance 
of the bath. The rain is a natural shower bath in which all vegetation 
participates, and gains refreshment. Its invigorating influence is seen in 
the brighter appearance, more erect bearing, and fresher colors of all 
plants after a gentle rain. The flowers manifest their gratitude by ex¬ 
haling in greater abundance their fragrant odors. Dumb animals do 
not neglect their morning bath. Who has not seen the robin skimming 
along the surface of the lake or stream, dipping its wings in the cool 
waters, and laving its plumage with the crystal drops that its flapping 
pinions send glittering into the air ? No school-boy who has ever seen 
the elephant drink will forget how the huge beast improved the oppor¬ 
tunity to treat himself to a shower bath, and perhaps the spectators as 
well, for he is very generous in his use of water. 

If man’s instincts were not rendered obtuse by the perverted habits of 
civilization, he would value the bath as highly and employ it as freely as 
his more humble fellow-creatures, whose instinctive impulses have re¬ 
mained more true to nature, because they have not possessed that degree 
of intelligence which would make it possible for them to become so 
grossly perverted as have the members of the human race. Man goes 
astray from nature not because he is deficient in instinct, but because he 
stifles the promptings of his better nature for the purpose of gratifying 
his propensities. 

Clothing .—The natural requirements for dress are the following:— 

1. Modesty requires that the body should be clothed. 

2. Protection against sudden changes of temperature is required for 
the maintenance of health. 

The dusky savage who roams the tropical wilds of Central Africa 
finds no necessity for clothing. Modesty is to him unknown. The gen¬ 
ial climate of his native forests insures him against vicissitudes of tem¬ 
perature, and so he lives as he was born, protected only by the swarthy 
cloak which nature gave him. Civilization creates the first requirement 
for clothing, and the varying temperatures of the temperate and frigid 
zones create the second. 


ESSENTIAL QUALIFICATIONS OF CLOTHING. 


309 


Essential (Qualifications of Clothing.— In. order to properly meet 
the wants of the body in fulfilling the above requirements, clothing- 
must possess the following qualifications:— 

1 . It must allow unrestrained action of every organ of the body. 

2. It must secure equable temperature of all portions of the body. 

3. Its weight must be as light as possible without sacrificing other 
necessary qualities. 

4. It must be so adjusted to the body as to be carried with the slight¬ 
est possible effort. 

It will be admitted at once that clothing such as will meet the above 
requirements is not what is recommended by the fashion leaders of the 
day; but if ladies would forget fashion and make their garments in ac¬ 
cordance with the principles of sound common sense, they would soon be 
delighted to find themselves emancipated from the numerous ills which 
afflict them in consequence of their present mode of dress, as has been al¬ 
ready pointed out. It may be that circumstances will not always allow 
of the adoption of a dress which shall be wholly physiological in every 
respect, which is to be regretted. Custom has so long ruled that we are 
forced to yield a little to its mandates, though reluctantly. But it is 
quite possible for every woman to adopt a dress which shall be, in all 
essential particulars, free from serious defects, and that without sacrific¬ 
ing an iota of her native grace or modesty, or making a martyr of her¬ 
self or her friends. 

In the first place, the corset and all its substitutes and subterfuges, 
tight belts, and every other device for compressing the waist or any 
other part of the body can be at once discarded without the attention 
of any one being drawn to the fact unless it be by the more elastic and 
graceful step, the brighter color of the face, and the general improvement 
in health in all respects. Suppose the waist does expand a little—or a good 
deal, even—beyond the standard seventeen inches; is it any disgrace ? 
No, indeed. A woman ought to be proud of a large waist. A large 
waist indicates large lungs, and large vital organs, which, in turn, rep¬ 
resent the probabilities of long life. A small waist indicates precisely 
the opposite. Why should woman—the gentler sex—be compelled to 
wear a strait-jacket, like a madman or a criminal, while man is allowed 
to go untrammeled by any such impediment ? A strong popular senti¬ 
ment in favor of large waists would soon do away with the foolish emu¬ 
lation to look frail and slender. If required, a suitable garment may be 
made, to support the bust, which will fit the form neatly without com- 


310 


ANATOMY, PHYSIOLOGY , AND HYGIENE 


pressing any part. Able physicians declare that compression of this part 
of the body, and the wearing of an undue amount of clothing, thus pro¬ 
ducing a local increase of temperature, is the cause of many of the pecul¬ 
iar diseases of woman, acting through reflex influence upon internal or¬ 
gans. 

The next important step should be to regulate the clothing prop¬ 
erly. The whole body should be clad in soft flannel from neck to 
wrists and ankles nearly the year round. It is better to have the un¬ 
derclothing for the upper part of the body and that for the limbs 
combined in one garment. If arranged in two garments, they should 
only meet, and not overlap, as this gives too much additional heat 
over the abdominal organs. A woman’s limbs require as many thick¬ 
nesses as a man’s; and a garment which fits the limb closely will 
afford four times the protection given by a loose skirt. Thick shoes 
or boots with high tops, and heavy woolen stockings which are drawn 
up outside the undergarments clothing the limbs, complete the pro¬ 
vision for warmth. Leggins should be worn in cold weather. 

All the undergarments should be suspended from the shoulders by 
means of waists or suspenders. Waists are doubtless the better for 
the purpose. If several garments are to be suspended from the same 
waist, the rows of buttons to v. liich they are attached should be ar¬ 
ranged one above another, to avoid bringing several bindings together. 

The two most important particulars having been secured—freedom 
from compression and uniform temperature—the outside dress may 
receive attention. It should be as simple as possible, and consistent 
with the mental comfort of the wearer. Gaudy colors and conspicu¬ 
ous ornaments betray poor taste and a vain, shallow mind. Many 
flounces, folds, and heavy overskirts are objectionable on account of 
their weight, to say nothing of the useless expenditure of time and 
money which they occasion. 

The proper length of the skirt is a question of interest in this con¬ 
nection. How long shall it be ? If physiology alone were asked the 
question, the answer would be that women do not need long skirts 
more than men, and that they are really an impediment to locomo¬ 
tion, and often very inconvenient. Long-established custom says that 
women must wear skirts. Fashion says she must wear long skirts. 
Custom and fashion have prevailed so long that they have created an 
artificial modesty which seems to demand that woman’s dress shall 
differ from man’s by the addition of a skirt, at least, even if they are 


FALSE HAIR AND HAIR DYES. 


311 


alike in all other particulars. This being the case, the best we can do 
is to modify the skirt so that it will be as free from objections as pos¬ 
sible. The great evils of long skirts are, unnecessary weight, the ac¬ 
cumulation of moisture which is transferred to the feet and ankles, 
and sundry inconveniences to the wearer in passing over rough places, 
up and down stairs, etc. 

The obvious remedy for these defects is to curtail the length of 
the dress. The train must be discarded at once as too absurd and un¬ 
cleanly, with its filthy load of gleanings from the gutter, to be toler¬ 
ated. Any further improvement, to be of practical utility, must 
shorten the skirt to the top of the ankle; and a radical dress-reformer 
will want to make it a few inches shorter. 

A very serious mistake is made by those who adopt the reform in 
the length of the dress, even to the fullest extent, but make no reform 
in other respects. Such overlook the chief defects which need refor¬ 
mation, paying their whole attention to a point which, considered 
from a physiological standpoint, is of minor importance, although 
well deserving of all the attention it receives. 

False Hair and Hair Dyes.—The ungainly masses of unneces¬ 
sary material which fashion has heaped upon the heads of those who 
bow to her authority, are a frightful cause of diseases of the scalp and 
brain. The immense loads of hair, jute, or other material, which are 
attached to the head, cause a great increase of the temperature of the 
brain and scalp. The blood-vessels become congested, both externally 
and internally. The result of this constant surplus of blood is disease 
of the scalp and of the brain itself. Headache is an almost constant 
symptom of the injury which is being wrought by this improper treat¬ 
ment of the head. 

In consequence of the disease of the scalp, the hair soon becomes 
diseased, loses its brilliancy and color, becomes dry and harsh, and in 
many cases is lost altogether, complete and incurable baldness ensuing. 

The congestion of the brain which at first occasions only headache, 
when continued produces structural disease of that organ. The blood¬ 
vessels become weakened, and sometimes ruptured, when the patient 
either dies of apoplexy or lingers a miserable paralytic. 

When the head is encumbered with an unnatural mass of hair, and 
the brain is clogged by the excessive amount of blood and supei’natural 
heat which result, the mind cannot act freely and naturally ; hard study, 
deep thought, and continued mental exercise are impossible. This is the 


312 


ANATOMY, PHYSIOLOGY , AND HYGIENE. 


reason why fashionable young ladies find study so hard for them, and 
apparently injurious. The incubus of such a prodigious weight as 
many a fashionable lady carries upon her cranium would be quite suffi¬ 
cient to eclipse the mental powers of the most brilliant genius. No 
wonder that woman has sometimes failed in mental competition with her 
brothers in the schools. The wonder is that she lives and possesses even 
a modicum of mental vigor. Under equally favorable circumstances, 
woman should be man’s peer in mental power and development; but if 
she wishes to secure and maintain the equality of the sexes, which so 
many earnest women are just now demanding, she must throw away 
her chignons and waterfalls, shake off her “ rats and mice,” and don a 
simpler, healthier head-gear. 

The real hair that is sold to those whose tresses are considered too 
scanty is chiefly obtained from the bodies of dead persons, whose graves 
are plundered for the purpose by wretches who earn their living by this 
means. Vermin of various kinds often adhere to the hair, and infest 
the heads of those who wear it. Various imitations of hair also become 
the means of conveying loathsome parasites to the scalps of those who 
wear them. 

The use of hair dyes is a practice which the chemist and experience 
have both shown to be eminently dangerous. All hair dyes are poison¬ 
ous. No matter how strong the assertions of their harmlessness, they 
are utterly false. So-called vegetable hair dyes, hair invigorators, ton¬ 
ics, etc., are contemptible swindles. They contain mineral poisons. The 
greater portion of them contain lead. The effect of their use is not only 
to destroy the hair, and induce disease of the scalp, but to produce 
paralysis. Many cases of chronic headache have been occasioned by the 
use of these poisonous mixtures ; and in a number of cases, insanity has 
been the result. 

The use of these vile compounds, which are so widely sold and used, 
is usually as absurdly foolish as harmful. 

The Kidneys. —Figs. 131 and 132. These organs are located in 
the back part of the abdominal cavity, between the lower ribs and the 
upper border of the hip bone. In shape they resemble a kidney-bean, 
and each weighs four to six ounces. The greater portion of the kid¬ 
ney is made up of minute tubes, which terminate in the outer part of 
the organ in extremely minute round sacs, each of which contains a 
delicate, coiled capillary blood-vessel. It is by these bodies that the 
elements of the urine are separated from the blood. Ail the tubes 


TIIE LIVER AND BILE. 


313 



Fig:. 131. The Kidney, 
showing the arteries and veins 
of the organ; 13. the Supra-renal 
Capsule; and 3. the Ureter. 


lead toward the center of the organ, where they empty into a cavity 
called the pelvis of the kidney, which narrows down into a small ca¬ 
nal, the ureter, by which the urine is conveyed to the bladder, a 
pouch-like reservoir located in the lower part 
of the abdomen, from which the urine is 
discharged through another small canal, the 
urethra. 

The urine is chiefly composed of water, 
which carries in solution a large number of 
excrementitious principles, the chief of which 
is urea, one of the most abundant and most 
poisonous of all the waste elements of the 
body. When the liver is inactive, the urine 
usually contains some biliary elements. 

Sugar is also found in the urine soon after a 
meal in which an excess has been taken. 

The condition of the urine is an important 
means of ascertaining the state of the system, 
and hence we shall speak elsewhere of the 
various points to be learned by its chemical 
and microscopical examination. 

The Liver. —This is the largest gland in 
the body, weighing between four and five 
pounds. It is a little larger, proportionately, 
in women than in men. The liver is made 
up of minute, roundish lobules, about -fa of 
an inch in diameter, each of which is fur¬ 
nished with branches from the hepatic artery 
and also from the portal vein. The liver 
thus contains a double capillary net-work. 

In addition, there is a system of minute ducts 
or canals running through its whole sub¬ 
stance, by means of which the bile which is 
separated from the portal vein is drained off into a pouch upon its 
under surface, the gall bladder, or into the small intestine. 

The Bile. —This is a greenish, bitter, alkaline fluid, somewhat 
viscid in character. The amount produced each day is about two 
and one-half pounds. It is produced much more rapidly during di¬ 
gestion than at other times. 



Figr. 132. Showing the in¬ 
ternal structure of the Kidneys. 




314 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


As already observed, the bile is both a secretion and an excretion. 
As a secretion, it aids digestion. As an excretion, it removes from 
the body a poisonous substance called cholesterine, a waste product of 



ITig:. 133. Spleen. 


the nervous system. This, when concentrated, is found to be a resin¬ 
ous substance. It forms the chief part of many gall-stones. 

The functions of the liver are somewhat com¬ 
plicated. In addition to its secreting and excretory 
functions, it is thought to be a sugar-forming organ, 
and to be capable of completing the digestion of 
some elements of the food. It is thought by some, 
also, that it destroys and removes from the system 
worn-out red blood corpuscles. 

The Spleen. —Among other glands should also 
be mentioned the spleen (Fig. 133), a gland found 
in the left side of the abdominal cavity next to the 
left end of the stomach, to which it is attached. Its weight is about 
seven ounces. It belongs to a class of structures known as blood 
glands or ductless glands, because it has no duct. However, it re¬ 
ceives a very large supply of blood, and is supposed to have some¬ 
thing to do with the production or destruction of blood corpuscles. 
It may be removed from the body, in animals, without producing 
death. The effect of its removal in cats is to cause them to become 
very fat. It is also observed that they become very irritable after its 
removal. It is said that the farmers in some parts of England make 
a practice of removing the spleen in young calves in order to cause 
them to fatten faster. 


Other Blood Glands. —Under this head are also included the 
supra-renal capsules, which are attached to the upper part of the 
liver; the thyroid gland, situated at the upper part and on either side 
of the trachea; the thymus gland, found only in early life, at the 
lower part of the trachea; the pituitary body and the pineal gland, 
found in the central part of the brain. Of these glands little else is 
known than their location and structure. 


Animal Heat. —Warm-blooded animals possess the power to reg¬ 
ulate their own temperature independent of external temperatures, at 
least within certain limits. What are called cold-blooded animals do 
not possess this power, their temperature depending on that of the 
medium with which they are surrounded. The source of animal heat 
is the various vital changes constantly taking place in the body. 



ANIMAL HEAT. 


315 


This is shown by the fact that the amount of heat produced is exactly 
proportionate to the intensity of the vital changes. In health the 
temperature of the body is about 98|° F. When the system is under 
the influence of fever or an extensive inflammation of any sort,— 
which process greatly accelerates vital changes,—the temperature rises 
several degrees above the normal standard, sometimes as high as 110* 
F., though a temperature above 107° is considered to be almost cer¬ 
tainly fatal if long continued. This same principle is observed in 
lower animals and even in flowering plants. The latter absorb oxygen 
most rapidly when flowering; and in many instances it has been 
shown by careful experiment that the process of flowering in plants 
is accompanied with a marked production of heat. Birds absorb large 
quantities of oxygen, and have very active vital processes. In them 
the temperature of the body is several degrees higher than in man 
and quadrupeds. In fish and reptiles, on the other hand, in which 
the vital processes are much slower, the temperature is much lower, 
being, in fact, usually about that of the surrounding air or water in 
which they live, their heat production being actually too small to en¬ 
able them to maintain an independent temperature. A French phys¬ 
iologist experimented upon a marmot a few years ago, and found that 
when the animal was asleep, its temperature was only about 40° F., 
while it was 89° F. when awake. In all hibernating animals there is 
a marked decrease in the temperature while the animal is in a state 
of hibernation. 

There is good reason for believing that the friction of the blood in 
the blood-vessels is an important source of heat. Carefully con¬ 
ducted experiments show that the force exerted by the heart each 
twenty-four hours, which is all used up or transformed in the body, is 
equivalent to more than 1,000 degrees of heat, or sufficient to raise 
100 lbs. of water 10° F. in temperature. The fact that heat is pro¬ 
duced by conversion of the force expended in the circulation, is further 
shown by a series of experiments made by the eminent French phys¬ 
iologist, Bernard, for the purpose of ascertaining the temperature of 
the blood in various parts of the body. He found that the blood of 
the portal vein and that of the hepatic vein is warmer than that of 
any other part of the body, that in the hepatic vein showing the high¬ 
est temperature of all, which is undoubtedly attributable to the fact 
that the blood of this vein has passed through two sets of capillaries, 
so that its circulatory force has been almost wholly converted into heat. 


316 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


REPRODUCTION. 


Believing that ignorance on this subject lies at the root of some of 
the most serious diseases and the most degrading vices to which human 
beings are subject, we have not hesitated to introduce it here in order 
to do our part in enlightening the world with reference to the dangers 
from a source which, too often unsuspected, pours forth contamination 
and degradation, blighting the prospects of the most promising, and 
sparing none who place themselves knowingly or unwittingly within its 
reach. The greater portion of this chapter is in substance quoted from 
our work upon the subject entitled, “Plain Facts for Old and Young.” 

Reproduction is a function common to all animals and to all plants. 
Every organized being has the power to reproduce itself, or to produce, 
or aid in producing, other individuals like itself. It is by means of this 
function that plants and animals increase or multiply. 

When we consider the great diversity of characters illustrated in 
animal and vegetable life, and the infinite variety of conditions and cir¬ 
cumstances under which organised creatures exist, it is not surprising 
that modes of reproduction should also present great diversity both in 

general character and in detail. 

© 

Simplest Form of Generation. —Deep down beneath the waters 
of the ocean, covering its bottom in certain localities, is found a curious 
slime, which, under the microscope, is seen to be composed of minute 
rounded masses of gelatinous matter, or protoplasm. By watching 
these little bodies intently for a few minutes, the observer will discover 
that each is a living creature capable of moving, growing, and assuming 
a variety of shapes. Continued observation will reveal the fact that 
these little creatures multiply; and a more careful scrutiny will enable 
him to see how they increase. Each divides into two equal parts so 
nearly alike that they cannot be distinguished from each other. In this 
case the process of generation is simply the production of two similar 
individuals from one. 

A small quantity of slime taken from the surface of a stone near 
the bottom of an old well or at the seaside, when placed under the mi¬ 
croscope, will sometimes be found to contain large numbers of small, 
round, living bodies. Careful watching will show that they also mul- 



SEX. —HERMA PHBODISM. 


317 


tiply by division ; but before the division occurs, two cells unite to form 
one by a process called conjugation. Then, by the division of this 
cell, instead of only two cells, a large number of small cells are 
formed, each of which may be considered as a bud formed upon the 
body of the parent cell and then separated from it to become by 
growth an individual like its parent, and, like it, to produce its kind. 
In this case, we have new individuals formed by the union of two in¬ 
dividuals which are to all appearance entirely similar in every par¬ 
ticular. 

Sex. —Rising higher in the scale of being, we find that, with rare 
exceptions, reproduction is the result of the union of two dissimilar 
elements. These elements do not, in higher organisms, as in lower 
forms of life, constitute the individuals, but are produced by them ; 
and being unlike, they are produced by special organs, each adapted 
to the formation of one kind of elements. The two classes of organs 
usually exist in separate individuals, thus giving rise to distinctions 
of sex; an individual possessing organs which form one kind of ele¬ 
ments being called a male, and one possessing organs for the forma¬ 
tion of the other kind of elements, a female. The sexual differences 
between individuals of the same species are not, however, confined to 
the sexual organs. In most classes of plants and animals, other sex¬ 
ual differences are very great. In some of the lower orders of an¬ 
imals, and in many species of plants, the male and female individuals 
are so much unlike that for a long time after they were well known, 
no sexual relation was discovered. 

Hermaplirodism, —An individual possessing both male and fe¬ 
male organs of reproduction is called an hermaphrodite. Such a combi¬ 
nation is very rare among higher animals; but it is by no means uncom¬ 
mon among plants and the lower forms of animal life. The snail, the 
oyster, the earth-worm, and the common tape-worm, are examples of 
true hermaphrodites. So-called human hermaphrodites are usually 
individuals in whom the sexual organs are abnormally developed so 
that they resemble those of the opposite sex, though they really have 
but one sex, which can usually be determined with certainty. Only a 
very few cases have been observed in which both male and female organs 
were present. 

There is now living in Germany an individual who bears the name 
of a woman; but learned physicians have decided that the person is 
as much man as woman, having the organs of both sexes. What is 


318 


RATIONAL REMEDIES FOR DISEASE. 


still more curious, this person has the feelings of both sexes, having 
loved at first a man, and afterward a woman. There have been ob¬ 
served, also, a very few instances of individuals in whom the sexual 
organs of neither sex were present. It thus appears that a person may 
be of both sexes or of no sex at all. 

Sex ill Plants. —To one unacquainted with the mysteries of plant 
life and growth, the idea of attaching sexuality to plants seems very 
extraordinary; but the botanist recognizes the fact that the distinc¬ 
tions of sex are as clearly maintained in the vegetable as in the ani¬ 
mal kingdom. The sexual organs of the higher orders of plants are 
flowers. That part of the flower which produces seeds answers to the 
female ; another part, which is incapable of forming seeds, answers to 
the male. The fertile and sterile flowers are sometimes produced on 
separate plants. Very frequently, they are produced upon separate 
paits of the same plant, as in the oak, walnut, and many other forest 
trees, and Indian corn. In the latter plant, so familiar to every one, 
the “ tassel ” contains the male flowers, and the part known as the 
“ silk,” with the portion to which it is attached—which becomes the 
ear—the female or fertile flowers. In a large number of species, the 
male and female organs are combined in a single flower, making n 
true hermaphrodite. 

Sex ill Animals. —As previously remarked, individuals of opposite 
sex usually differ much more than in the character of their sexual or¬ 
gans only. Among higher animals, the male is usually larger, stronger, 
and of coarser structure than the female. The same contrast is ob¬ 
served in their mental characters. With lower animals, especially in¬ 
sects, the opposite is often observed. The female spider is many times- 
larger than the male. The male ant is small in size when compared 
with the female. Nevertheless, in all classes of animals the difference 
in the structure and the functions of the sexual organs is the chief 
distinguishing character. These differences are not so great, however, 
as they might at first appear. The male and female organs of repro¬ 
duction in man and other animals, which seem so dissimilar, when 
studied in the light shed upon this subject by the science of embryol- 
ogy, are found to be wonderfully alike in structure, differing far more 
in appearance than in reality, and being little more than modifications 
of one general plan. Every organ to be found in the one sex has an 
analogue in the other which is complete in every particular, correspond¬ 
ing in function, in structure, and usually in position. 


SEXUAL DIFFERENCES. 


319 


Other Sexual Differences.— In this country there is between five 
and six inches difference in height and about twenty pounds difference 
in weight between the average man and the average woman, the aver- 
age man being about five feet, eight inches in height, and weighino 1 
one hundred and forty-five pounds; while the average woman is five 
feet, two or two and one-half inches in height, and weighs one hun¬ 
dred and twenty-five pounds. The relation of the sexes in height and 
weight varies in degree in different countries, but is never changed. 
The average height and weight of American men and women is above 

that of the average human being. 

© © 

Men and Women Differ in Form. —The differences in form are so 
marked that it is possible for the skilled anatomist to determine the 
sex of a human being who has been dead for ages, by an examination 
of the skeleton alone. In man, the shoulders are broad, the hips nar¬ 
row, and the limbs nearly straight with the body. In woman, the 
shoulders are narrow and usually rounded, and set farther back, the 
collar-bone being longer and less curved, giving the chest greater 
prominence ; while the hips are broad. 

The consequence of these differences is that woman is generally 
less graceful and naturally less skillful in the use of the extremities 
than man, and hence less fitted for athletic sports and feats requiring 
great dexterity. A girl throws a stone awkwardly, less from want of 
practice than from a natural peculiarity of physical structure. A 
woman walks less gracefully than a man, owing to the greater relative 
breadth of her hips, requiring a motion of the body together with that 
of the limbs. In consequence of this peculiarity, a woman is less fit¬ 
ted for walking long distances. 

The Male and the Female Brain. —But there are other important 
physical differences to which we must call attention. Man possesses 
a larger brain than woman, but she makes up the deficiency in size by 
superior fineness in quality. The female brain differs from the mas¬ 
culine organ of mentality in other particulars so marked that one who 
has given the subject attention can determine with perfect ease the 
probable sex of the owner of almost any skull which might be pre¬ 
sented to him. This difference in the conformation of the skull is un¬ 
doubtedly due to a difference in mental character, which, in turn, de¬ 
pends upon a difference in cerebral development. 

Vital Organs of Man and Woman. —The anatomist also observes 
an interesting difference in the size of the various vital organs. For 


320 


ANATOMY, PHYSIOLOGY , AND HYGIENE . 


example, while a woman has a heart proportionally smaller than the 
same organ in man, she has a larger liver. Thus, while less well fitted 
for severe physical exertion by less circulatory power, she has superior 
excretory powers. 

This peculiarity of structure is perfectly harmonious with the fact 
which experience has established so often as to make the matter no 
longer a question, that woman is less fitted for severe muscular exer¬ 
tion than man, but possesses in a superior degree the quality known 
as endurance. With a less robust frame, a more delicately organized 
constitution, she will endure for months what would kill a robust man 
in as many weeks. More perfect elimination of the wastes of the 
body secures a higher grade of vitality. On no other hypothesis could 
we account for the marvelous endurance of the feminine part of the 
civilized portion of the human race, ground down under the heel of 
fashion for ages, “ stayed,” “ corseted,” “ laced,” and thereby distorted 
and deformed in a manner that would be fatal to almost any member 
of the masculine sex. 

The Reproductive Elements. —As has been previously observed, 
in all except the very lowest forms of life, two elements are necessary to 
the production of a new individual, or a reproduction of the species,—a 
male element and a female element. The special organs by means of 
which these elements are produced, brought together, and developed into 
the new individual in a more or less perfect state, are termed sexual or¬ 
gans, as we have already seen. As an introduction to the specific study 
of the sexual organs in the human species, let us briefly consider the— 

Sexual Orgaus of Plants. —As already remarked, flowers are the 
sexual organs of plants. Nothing is more interesting in the natural 
world than the wonderful beauty, diversify, and perfect adaptability to 
various conditions and functions, which we see in the sexual parts of 
plants. An exceedingly interesting line of study, which has occupied 
the attention of many naturalists, is the wonderful perfection displayed 
in the adaptability of the male and female parts of plants to each 
other. Without burdening the reader with unnecessary technicalities 
of detail, we will briefly notice the principal parts of vegetable sexual 
organs as illustrated in flowers. 

Complete flowers are made up of four parts, two of which, the 
stamen and pistil, are essential, while the other two, the calyx and 
corolla, are accessory. 

The calyx is that part which surrounds the flower at its outer and 


SEXUAL ORGANS OF ANIMALS. 


321 


lower part. It varies greatly in form 
and color, but is most frequently of a 
green or greenish color. 

Just within the calyx is the co¬ 
rolla, which usually forms the most 
attractive, showy, and beautiful part 
of the flower. The beautifully col¬ 
ored petals of the rose, geranium, 
dahlia, and similar flowers, form 
their corollas. In Fig. 134 is given 
a diagramatic view of the various 
parts of a perfect flower. 

Sexual Organs of Animals. —The 
male reproductive element is called 
a spermatozoon or zoosperm. The 
female element is called an ovum, 
literally, an egg. 

A spermatozoon somewhat resem¬ 
bles a tadpole in appearance, having, 
however, a much longer tail in pro¬ 
portion to the size of the body, as 
will be seen by reference to Fig. 135. 

Human spermatozoa are about 
- 5 - 5 -^ of an inch in length. Those of 
reptiles are very much larger. One 
of the remarkable features of these 
minute elements is their peculiar 
movements. While alive, the fila¬ 
mentous tail is in constant action in 
a manner strongly resembling the 
movements of the caudal appendage 
of a tadpole. This wonderful prop¬ 
erty led the earlier observers to be¬ 
lieve that they were true animalcu- 
la. But they are not to be regarded 
as such, though one can scarcely 
make himself believe otherwise while 
watching their lively evolutions, and 
apparent volitionary movements 
from one point to another. 

21 



Fig:. 134. a. Ovary; b. Pistil; 
c c. Stamens and Anthers; d. Cor¬ 
olla; e. Calyx. 





Fig;. 135. a. Human Spermatozoa; b. 
Spermatozoa of the rat; C. Spermatozoa of 
Menobrauchus. (Dalton.) 















322 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


In man the formation of spermatozoa continues with greater or 
less rapidity from puberty to old age, though at the two extremes of 
existence they are imperfectly developed. When not discharged from 
the body, they are said to be absorbed. Some physiologists claim that 
they are composed of a substance identical with nerve tissue, and that 
by absorption they play a very important part in the development 
and maintenance of the nervous system. 

It is asserted by good authorities that the reproductive element in 
man is not so well developed as to be really fit for the reproduction of 
the species before the age of twenty-four or twenty-five. After the 
age of forty-five or fifty, the reproductive elements deteriorate in 
quality, and become again unfitted for vigorous procreation. 

The Ovum. —Fig. 136. The female ele¬ 
ment of generation, the ovum, is produced by 
an organ called the ovary, of which there are 
two in each individual. The human ovum 
varies in size from -giir to of an inch in 
diameter, and consists of a single cell. Ova are 
not formed in such large numbers as zoos¬ 
perms. As a general rule, in the human fe¬ 
male, a single ovum is developed and dis¬ 
charged once in about four weeks, during the 
period of sexual activity. 

Fecundation. —It is often asked, and the question has elicited 
some discussion, Which is the principal reproductive element; the 
zoosperm, or the ovum ? The ancients supposed the male element 
to be the essential element, being simply nourished and developed by 
the female; but modern research in biological science does not sus¬ 
tain this view. Probably neither one enjoys especial preeminence; 
for neither can undergo complete development without the other. In 
very rare cases, the ovum has been observed to undergo a certain 
amount of development of itself; but a perfect individual can be pro¬ 
duced only by the union of the two kinds of elements, which process 
is known as fecundation. The instant this union occurs, the life of a 
new individual begins. All the changes which result between that 
moment and the birth of the individual are those of development 
only. Indeed, the same existence continues from the instant of the 
union of the two elements, not only until birth, but through growth, 
the attainment of maturity, the decline of life, and even until death. 



Fig. 136. Human Ovum, 
magnified one hundred and 
thirty diameters. (Dalton.) 





MODES OF FECUNDATION. 


323 


It is interesting to observe the different methods by which fecun¬ 
dation is effected, botli in plants and animals, for this is a process com¬ 
mon to both. 

Fecundation in Flowers. —The great naturalist, Linnaeus, was 
the first to explain the reproductive process in plants. He tells us 
that “ the flower forms the theater of their amours; the calyx is to be 
considered as the nuptial bed; the corolla constitutes the curtains; 
the anthers are the testes; the pollen, the fecundating fluid; the 
stigma of the pistil, the external genital aperture; the style, the vag¬ 
ina, or the conductor of the prolific seed; the ovary of the plant, the 
womb; the reciprocal action of the stamens on the pistil, the accessory 
process of fecundation.” 

Modes of Fecundation in Animals. —The modes by which fec¬ 
undation is effected in animals are still more various and wonderful 
than in plants. In some of the lower animals, as in most fish and rep¬ 
tiles, both elements are discharged from the bodies of the parents be¬ 
fore coming in contact, there being no contact of the two individuals. 
In this class of animals the process is almost wholly analogous to fec¬ 
undation in those plants in which the male and female flowers are on 
different plants or different parts of the same plant. In the female 
fish, a large number of ova are developed at a certain season of the 
year known as the spawning season. Sometimes the number reaches 
many thousands. At the same time, the testicles of the male fish, 
which are contained within the abdominal cavity, become distended 
with developed zoosperins. When the female seeks a place to deposit 
her eggs, the male closely follows; and as she drops them upon the 
gravelly bottom, he discharges upon them the zoosperms by which 
they are fecundated. The process is analogous to that observed in 
some species of frogs. When the female is about to deposit her eggs, 
the male mounts upon her back and rides about until the eggs are all 
deposited, discharging upon them the fertilizing spermatozoa as they 
are laid by the female. 

Development. —After the union of the two elements, known as 
fecundation or conception , if the conditions are favorable, development 
occurs, and the little germ is in due process of time developed into an 
individual which is an exact counterpart of its parents. During this 
developmental process, the embryonic being is variously treated by 
different classes of animals. 


324 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


Unprotected Development, —Most fishes and reptiles discharge 
their ova before fecundation, or soon after, and pay no further atten¬ 
tion to them. The fish deposits its eggs in a little hollow scooped out 
in the gravelly bed of a stream, or sows them broadcast upon the wa¬ 
ters. The turtle buries its eggs in the sand, and leaves them to be 
hatched by the sun. The ostrich disposes of her eggs in the same 
way. Many other species of animals pay no regard to the protection 
of the germs which are destined, if placed under favorable conditions, 
to become individuals like themselves. 

Development in the Higher Animals and Man.— Higher ani¬ 
mals are less prolific, and their development is a more complicated proc¬ 
ess ; hence, their young need greater protection, and, for this reason, 
the ova, instead of being discharged from the body of the female 
after fecundation, are retained.* As we have seen that a suitable re¬ 
ceptacle is sometimes provided outside of the body, so now a recepta¬ 
cle is needed, and is provided in the interior of the body of the female. 
This receptacle is called— 

The Uterus. —This is a hollow, pear-shaped organ, located in the 
median line, just behind the bladder, between it and the rectum. It 
is supported in place by various ligaments and by the juxtaposition of 
other organs. Its larger end is directed upward, and communicates 
upon each side with a very narrow tube which is prolonged outward 
on either side until it nearly touches the ovary of the same side. 
When an ovum is matured, it escapes from the ovary into the nar¬ 
row tube referred to, called the Fallopian tube , and passes down 
into the cavity of the uterus. If fecundation does not occur, it is 
expelled or absorbed after six to twelve or fourteen days. 

Uterine Gestation. —This is the term applied to the process last 
referred to. We shall not attempt to describe in detail this most won¬ 
derful and intricate of all living processes; but will sketch only the chief 
points, leaving the reader who would obtain a more complete knowledge 

* Curious examples of internal development sometimes occur in animals which usually 
deposit eggs. Snakes have been known to produce both eggs and living young at the 6ame 
time. At the annual meeting of the American Society for the Advancement of Science, at 
Detroit, Mich., in August, 1875, we had the pleasure of examining a specimen, exhibited 
by Prof. Wilder, of a chick which had undergone a considerable degree of development 
within the ovary of the hen. It had a head, a rudimentary brain, and internal viscera, 
but no feathers nor limbs. It was, in fact, an egg hatched before it had been laid. This 
anomaly excited much iuterest at that time and since among biologists. 


THE PRIMITIVE TRACE. 


325 



of the subject to consult any one of the numerous physiological and ob¬ 
stetrical works which deal with it in a very exhaustive manner. 

As soon as the ovum is impregnated by 
the male element, it begins a process of sym¬ 
metrical division. The first division pro¬ 
duces two cells out of the single one which 
first existed. By the next division, four seg¬ 
ments are produced; then eight, sixteen, 
etc. Fig. 137. While this process is go¬ 
ing on, the ovum becomes adherent to the 
internal wall of the uterus, and is soon en¬ 
veloped by its mucous membrane, which 
grows up about and incloses it. 

The Primitive Trace. —When the proc¬ 
ess of segmentation has advanced to a cer¬ 
tain point, the cells are aggregated together 
in a compact layer at the surface. Soon a 
straight line appears upon this layer, which 
is called the primitive trace. Fig. 138. 
This delicate line becomes the basis for the 
spinal column; and upon and about it the 
whole individual is developed by an intricate 
process of folding } dividing, and reduplica- 



Fig - . 137. Diagram illustrating 
the segmentation of the Ovum. 


Fig - . 138. The Human Ovum after 
fecundation, showing primitive trace. 


tion of the layer of cells. One end of the line becomes the head, and 
the other becomes the tail. Even man has a caudal appendage at an 
early stage of his existence. After a further lapse of time, little excres¬ 
cences, buds, or “ pads,” appear in the proper positions to represent the 
arms and legs. After further development the ends split up into fin- 





3*26 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


gers and toes, and by the continued development of the parts, perfect 
arms and legs are formed. 

Curious Relation to Lower Animals.— It is a very remarkable 
fact that in the lower animals we have numerous examples in which the 
permanent condition of the individual is the same as some one of the 
stages through which man passes in the process of development. An 
eminent author makes the following interesting statements:— 

“ The webbed feet of the seal and ornithorhynchus typify the period 
when the hands and feet of the human embryo are as yet only partly 
subdivided into fingers and toes. Indeed, it is not uncommon for the 
* web ’ to persist to some extent between the toes of adults; and occa¬ 
sionally children are born with two or more fingers or toes united to their 
tips. 

“ With the seal and the walrus, the limbs are protruded but little 
beyond the wrist and ankle. With the ordinary quadrupeds, the 
knee and elbow are visible. The cats, the lemurs, and the monkeys 
form a series in which the limbs are successively freed from the 
trunk, and in the highest apes they are capable of nearly the same 
movements as the human arm and leg, which, in their development, 
passed through all these stages.” 

Simplicity of Early Structures. —The first structures formed 
are exceedingly simple in form. It is only by slow degrees that the 
great complexity which characterizes many organs is finally attained. 
For example, the heart is at first only a straight tube. By enlarge¬ 
ment and the formation of longitudinal and transverse partitions, the 
fully developed organ is finally produced. The stomach and intes¬ 
tines are also at first but a simple straight tube. The stomach and 
large intestine are formed by dilatation; and by a growth of the tube 
in length while the ends are confined, the small intestines are formed. 
The other internal organs are successively developed by similar 
processes. 

The Stages of Growth .—At first insignificant in size,—a simple 
cell,—the embryonic human being steadily increases in size, gradually 
approximating more and more closely to the human form, until, at 
the end of about nine calendar months, or ten lunar months, the new 
individual is prepared to enter the world and begin a more independ¬ 
ent course of life. The following condensation of a summary quoted 
by Dr. Austin Flint, Jr., will give an idea of the size of the develop¬ 
ing being at different periods, and the rate of progress:— 


DURATION OF GESTATION. 327 

At the end of the third week, the embryon is a little less than 
one-fourth of an inch in length. 

At the end of the seventh week, it is three-fourths of an inch 
long. The liver, lungs, and other internal organs are partially 
formed. 

At the eighth week, it is about one inch in length. It begins to 
look some like a human being, but it is impossible to determine the 
sex. 

At the third month, the embryon has attained the length of two 
to two and one-half inches. Its weight is about one ounce. 

At the end of the fourth month, the embryon is called a fetus. It 
is from four to five inches long, and weighs five ounces. 

At the fifth month, the fetus is nearly a foot long, and weighs 
about half a pound. 

At the sixth month, the average length of the fetus is about thir¬ 
teen inches, and its weight one and a half to two pounds. If born, 
life continues but a few minutes. 

At the seventh month, the fetus is from fourteen to fifteen inches 
long, and weighs two to three pounds. It is now viable (may live if 
born). 

At the eighth month, the length of the fetus is from fifteen to six¬ 
teen inches, and its weight from three to four pounds. 

At the ninth month, the fetus is about seventeen inches long, and 
weighs from five to six pounds. 

At birth, the infant weighs a little more than seven pounds, the 
usual range being from four to ten pounds, though these limits are 
sometimes exceeded. 

Duration of Gestation. —The length of time required for the de¬ 
velopment of a human being is usually reckoned as about forty 
weeks. A more precise statement places it at about two hundred and 
seventy-eight days. This limit is often varied from. Cases have oc¬ 
curred in which a much longer time has been required, and number¬ 
less cases have occurred in which human beings have been born sev¬ 
eral weeks before the expiration of the usual time, as stated. There 
is some uncertainty respecting the exact length of the period of gesta¬ 
tion, which grows out of the difficulty of determining, in many cases, 
the exact time when conception takes place. 

Uterine Life. —The uterine life of the new individual begins 
with the impregnation of the ovum, which occurs the instant it is 


328 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


brought in contact with the zoosperms of the male. While in the 
uterus, the young life is supported wholly by the mother. She is 
obliged to provide not only for her own sustenance, but for the main¬ 
tenance of her child. And she must not only eat for it, but breathe 
for it as well, since it requires a constant and adequate supply of oxy¬ 
gen before birth as much as afterward. 

How the Unborn Infant Breathes. —Oxygen and nutriment are 
both supplied to it through the medium of an organ called the pla¬ 
centa, which is a spongy growth composed almost entirely of blood¬ 
vessels, and is developed upon the inner wall of the uterus, at the 
point at which the ovum attaches itself after fecundation. The grow¬ 
ing fetus is connected with this vascular organ by means of a sort of 
cable, called the umbilical cord. The cord is almost entirely com¬ 
posed of blood-vessels, which convey the blood of the fetus to the pla¬ 
centa and return it again. The fetal blood does not mix with that 
of the mother, but receives oxygen and nourishment from it by ab¬ 
sorption through the thin walls which alone separate it from the 
mother’s blood. 

The umbilical cord contains no nerves, as there is no nervous con¬ 
nection between the mother and the child. The only way in which 
the child can be influenced by the mother is through the medium of 
the blood, to changes in which it is very susceptible, as we shall see 
more clearly hereafter. 

The cord is attached to the body of the child at the point called 
the navel, being cut off' at birth by the accoucheur. With the pla¬ 
centa, it is expelled soon after the birth of the child, and constitutes 
the shapeless mass familiarly known as the after-birth, by the reten¬ 
tion of which the most serious trouble is occasionally caused. 

Parturition. —At the end of the period of development, the 
young being is forcibly expelled from the laboratory of nature in 
which it has been formed. In other words, it is born; and this proc¬ 
ess is termed parturition. Though, at first thought, such an act 
would seem an utter impossibility, yet it is a very admirable illustra¬ 
tion of nature’s adaptation of means to ends. During the months of 
gestation, while the uterus has been enlarging to accommodate its 
daily increasing contents, the generative passages have also been in¬ 
creasing in size and becoming soft and distensible, so that a seeming 
impossibility is in due time accomplished without physical damage, 


CHANGES IN THE CHILD AT BIRTH. 


329 


though possibly not without intense suffering. However, it is a most 
gratifying fact that modern medical science may do much to mitigate 
the pains of childbirth. It is possible, by a proper course of prepara¬ 
tion for the expected event, to greatly lessen the suffering usually 
undergone; and some ladies assert that they have thus avoided real 
pain altogether. Although the curse pronounced upon the feminine 
part of the race, in consequence of the sin of Eve, implies suffering in 
the parturient act, yet there is no doubt that the greater share of the 
daughters of Eve are, through the perverting and degenerating influ¬ 
ences of wrong habits and especially of modern civilization, compelled 
to suffer many times more than their maternal ancestor. We have 
sufficient evidence of this in the fact that among barbarian women, 
who are generally less perverted physically than civilized women, 
childbirth is regarded with very little apprehension, since it occasions 
little pain or inconvenience. The same is true of many women 
among the lower laboring classes. In short, while it is true that 
more or less suffering must always accompany parturition, yet the 
excessive pain usually attendant upon the process is the result of 
causes which can in many cases be removed by proper management 
beforehand and at the time of confinement. 

After being relieved of its contents, the uterus and other organs 
rapidly return to nearly their original size. 

Changes in the Child at Birth .—In the system of the child a 
wonderful change occurs at the moment of its expulsion into the outer 
world. For the first time, its lungs are filled with air. For the first 
time, they receive the full tide of blood. The whole course of the circu¬ 
lation is changed, and an entirely new process begins. It is surprising 
in how short a space of time changes so marvelous can be wrought. 

Nursing. —The process of development is not fully complete at birth. 
The young life is not yet prepared to support itself; hence, still further 
provision is necessary for it. It requires prepared food suited to its con¬ 
dition. This is provided by the mamma, or breasts, of the female, 
which are glands for secreting milk. The fully developed gland is 
peculiar to the female ; but a few instances have been known in which 
it has been sufficiently developed to become functionally active in men, 
as well as in young girls, though it is usually inactive even in women 
until near the close of gestation. It is a curious fact that the breasts of 
a new-born child occasionally contain milk. 

The first product of the mamnue is not the proper milk secretion, 


330 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


but is a yellowish fluid called colostrum. The true milk secretion le- 
gins two or three days after delivery. 

The lacteal secretion is influenced in a very remarkable manner by 
the mental conditions of the mother. By sudden emotions of grief or 
anger, it has been known to undergo such changes as to produce in the 
child a fit of indigestion, vomiting, diarrhea, and even convulsions and 
death. Any medicine taken by the mother finds its way into the milk, 
and often affects the delicate system of the infant more than herself. 
This fact should be a warning to those nursing mothers who use stimu¬ 
lants. Cases are not uncommon in which delicate infants are kept in a 
state of intoxication for weeks by the use of alcoholic drinks by the 
mother. The popular notion that lager-beer, ale, wine, or alcohol in any 
other form, is in any degree necessary or beneficial to a nursing woman 
is a great error which cannot be too often noticed and condemned. Not 
only is the mother injured, instead of being benefited, by such a practice, 
but great injury, sometimes life-long in its consequences, is inflicted upon 
the babe at her breast that takes the intoxicating poison at second hand, 
and is influenced in a fourfold degree from its feebleness and great 
susceptibility. 

Puberty. —For a certain period after birth, the sexual organs re¬ 
main in a partially developed condition. This period varies in duration 
with different animals; in some cases being very brief, in others, com - 
prising several years. Upon the attainment of a certain age, the indi¬ 
vidual becomes sexually perfect, and is then capable of the generative 
act. This period is called puberty. In man, puberty commonly occurs 
between the ages of ten and fifteen years, varying considerably in differ¬ 
ent climates. In this country, and in other countries of about the same 
latitude, puberty usually occurs at the age of fourteen or fourteen and 
one-half years in females, and a few months later in males. In cooler 
climates, as in Norway and Siberia, the change is delayed to the age of 
eighteen or nineteen years. In tropical climates it is hastened, occurring 
as early as nine or ten years. In warm climates it is no uncommon 
thing for a girl to be a mother at twelve; and it is stated that one of 
the wives of Mahomet was a mother at ten. 

Other causes besides climate tend to hasten the occurrence of this 
change, as habits, temperament, constitutional tendency, education, and 
idiosyncrasy. 

Habits of vigorous physical exercise tend to delay the access of pu¬ 
berty. For this reason, together with others, country boys and girls gen- 


INFLUENCE OF DIET ON PUBERTY. 


331 


erally mature later by several months, and even a year or two, than those 
living in the city. Anything that tends to excite the emotions hastens 
puberty. The excitements of city life, parties, balls, theaters, even the 
competition of students in school, and the various causes of excitement 
to the nervous system which occur in city life, have a tendency to hasten 
the occurrence of the change which awakens the sexual activities of the 
system into life. Hence, these influences cannot but be considered prej¬ 
udicial to the best interests of the individual, mentally, morally, and 
physically, since it is in every way desirable that a change which arouses 
the passions and gives to them greater intensity should be delayed rather 
than hastened. 

Influence of Diet on Puberty. —The dietary has a not unimpor¬ 
tant influence in this respect. Stimulating food, such as pepper, vinegar, 
mustard, spices, and condiments generally, together with tea and coflee, 
and an excess of animal food, have a clearly appreciable influence in in¬ 
ducing the premature occurrence of puberty. On this account, if on no 
other, should these articles be prohibited to children and youth, or used 
very sparingly. Those who advocate the large use of meat by children 
and youth have not studied this matter closely in all its bearings. While 
it is true that children and growing youth require an abundance of the 
nitrogenous elements of food, which are found abundantly in beefsteak, 
mutton, fish, and other varieties of animal food, it is also true that in 
taking those articles of food they take along with the nutrient elements 
properties of a stimulating character, which exert a decidedly detrimental 
influence upon the susceptible systems of children and youth. At the 
same time, it is possible to obtain the same desirable nitrogenous ele¬ 
ments in oatmeal, unbolted wheat flour, peas, beans, and other vegetable 
productions, which are wholly free from injurious properties. We are 
positive from numerous observations on this subject, that a cool, unstim¬ 
ulating, vegetable or farinaceous diet would deter the development of 
the sexual organism for several months, and perhaps for a year or two. 

While it may not be in all cases desirable to do this, it would at least 
be wise to adopt such measures in cases in which the child is unavoida¬ 
bly exposed to influences which have a tendency to hasten the change. 

It is important to add in this connection a word of caution against 
the adoption of a dietary too abstemious in character. It is necessary 
that an abundance of good, wholesome food, rich in the elements of nu¬ 
trition, should be taken regularly. There is no doubt that many young 
ladies have induced conditions of serious disease by actual starvation of 


332 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


the system. A young woman who attempts to live on strong tea or 
coffee, fine-flour bread, and sweet-cake, is as certainly starving herself as 
though she were purposely attempting to commit suicide by means of 
starvation, and with as much certainty of the same result. 

Cases occasionally occur in which puberty makes its appearance at 
the age of three or four years. Indeed, a case has been reported in this 
country in which a female child possessed all the characteristics which 
are usually developed at puberty, from birth. In this case the regular 
periodical changes began at birth. 

Premature Development Occasions Early Decay. —A fact which 
is of too great importance to allow to pass unnoticed, is that whatever 
occasions early or premature sexual development, also occasions prema¬ 
ture decay. Females in whom puberty occurs at the age of ten or 
twelve, by the time this age is doubled, are shriveled and wrinkled 
with age. At the time when they should be in their prime of health and 
beauty, they are prematurely old and broken. Those women who 
mature late retain their beauty and their strength many years after 
their precocious sisters have become old, decrepit, and broken down. 
Thus, the matrons of thirty and forty years in colder climates are much 
more attractive in appearance than the maidens of sixteen; while quite 
the reverse is true in this and other countries where sexual development 
is unduly hastened. 

The unnaturally early appearance of puberty is a just cause for ap¬ 
prehension, since it usually indicates an inherent weakness of the consti¬ 
tution. When there are reasons for fearing its occurrence, active meas¬ 
ures should be taken to occasion delay if possible. We call especial at¬ 
tention to this point, since there are many who erroneously suppose the 
early occurrence of puberty to be a sign of superior vigor. 

Changes which Occur at Puberty. —The changes which occur 
in the two sexes at this period have been thus well described :— 

“ In both sexes, hair grows on the skin covering the symphysis pubis, 
around the sexual organs, and in the axillae (armpits). In man, the 
chest and shoulders broaden, the larynx enlarges, and the voice becomes 
lower in pitch from the elongation of the vocal cords; hair grows upon 
the chin, upper lip, and cheeks, and often exists upon the general sur¬ 
face of the body more abundantly than in woman.” The sexual organs 
undergo enlargement, and are more frequently excited. The testicles 

first begin the secretion of the seminal fluid. 

© 

“ In woman, the pelvis and abdomen enlarge, but the whole frame 


CHANGES WHICH OCCUR AT PUBERTY. 


333 


remains more slender, the muscles and joints less prominent, the limbs 
more rounded and tapering [than in the male]. Locally, both external 
and internal organs undergo a considerable and rapid enlargement. The 
mammse enlarge, the ovarian vesicles become dilated, and there is es¬ 
tablished a periodical discharge of one or more ova, accompanied, in 
most cases, by a sanguineous fluid from the cavity of the uterus.” 

These changes, so varied and extraordinary, often occur within a 
very short space of time; and as they are liable to serious derangement, 
especially in the female, great care should be taken to secure for the in¬ 
dividual the most favorable conditions until they are successfully effected. 
It is, however, a fact deserving of mention, that many of the ills which 
are developed at this particular period are quite as much the result of 
previous indiscretions and mismanagement as of any immediate cause. 
A few suggestions with regard to the proper treatment of individuals 
at this age may be in place. 

1 . Do not allow the boy or girl to be overworked, either mentally or 
physically. Great and important changes are occurring within the body, 
and nature should not be overtaxed. 

2 . Keep the mind occupied. While excessive labor should be avoided, 
idleness should be as carefully shunned. Some light, useful employment 
or harmless amusement—better some kind of work—should keep the 
mind fully occupied with wholesome subjects. 

3. Abundant exercise out-of-doors is essential for both sexes. Sun¬ 
shine and fresh air are as necessary to the development of a human be¬ 
ing as for the expanding of a flower,bud. 

4. Watch carefully the associations of the youth. This should be 
done at all times, but especially just at the critical period in question, 
when the general physical disturbances occurring in the system react 
upon the mind and make it peculiarly susceptible to influences, especially 
those of an evil character. 

5. None too much care can be exercised at this important epoch of 
human life, provided it is properly applied ; but nothing could be more 
disastrous in its consequences than a weak solicitude which panders to 
every whim and gratifies every perverted appetite. Such care is a fatal 
error. 

Menstruation. —The functional changes which occur in the female 
are much more marked than those of the male. As already intimated, 
the periodical development and discharge of an ovum by the female, 
which occurs after puberty, is accompanied by the discharge of a bloody 


334 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


fluid, which is known as the flowers, menses, or catamenia. The ac¬ 
companying symptoms together are termed the process of menstruation, 
or being unwell. This usually occurs, in the human female, once in 
about four weeks. In special cases, the interval may be a week less or 
a week longer; or the variation may be even greater. Dalton describes 
the process as follows:— 

“ When the expected period is about to come on, the female is affected 
by a certain degree of discomfort and lassitude, a sense of weight in the 
pelvis, and more or less disinclination to society. These symptoms are 
in some cases slightly pronounced, in others more troublesome. An un¬ 
usual discharge of vaginal mucus then begins to take place, which soon 
becomes yellowish or rusty brown in color, from the admixture of a 
certain proportion of blood ; and by the second or third day, the dis¬ 
charge has the appearance of nearly pure blood. The unpleasant sensa¬ 
tions which were at first manifest, then usually subside ; and the dis¬ 
charge, after continuing for a certain period, begins to grow more scanty. 
Its color changes from a pure red to a brownish or rusty tinge, until it 
finally disappears altogether, and the female returns to her ordinary 
condition.” 

The menstrual function continues active from puberty to about the 
forty-fifth year, or during the period of fertility. When it finally dis¬ 
appears, the woman is no longer capable of bearing children. The time 
of disappearance is termed the “ change of life,” or menopause. Ex¬ 
ceptional cases occur in which this period is greatly hastened, arriving 
as early as the thirty-fifth year, or even earlier. Instances have also 
been observed in which menstruation continued as late as the sixtieth 
year, and even later; but such cases are very rare; and if procreation 
occurs, the progeny is feeble and senile. 

With rare exceptions, the function Is suspended during pregnancy, 
and usually, also, during the period of nursing. 

Nature of Menstruation. —There has been a great amount of spec¬ 
ulation concerning the cause and nature of the menstrual process. No 
entirely satisfactory conclusions have been reached, however, except 
that it is usually accompanied by the maturation and expulsion from 
the ovary of an ovum, which is termed ovulation. But menstruation 
may occur without ovulation, and vice versa. 

Menstruation is not peculiar to the human female, being represented 
in the higher animals by what is familiarly termed the “ rut.” This is 
not usually a bloody discharge, however, as in the human female, 
though such a discharge has been observed in the monkey. 


IMPORTANT HINTS. 


335 


It has been quite satisfactorily settled that the discharge of the 
ovum from the ovary generally takes place about the time of the cessa¬ 
tion of the flow. Immediately after the discharge, the sexual desires of 
the female are more intense than at other times. This fact is particu¬ 
larly manifest in lower animals. The following remark by Prof. Dalton 
is especially significant to those who care to appreciate its bearing: — 

“ It is a remarkable fact, in this connection, that the female of these 
[domestic] animals will allow the approaches of the male only during 
and immediately after the oestrual period [rut]; that is, just when the 
egg is recently discharged, and ready for impregnation. At other times, 
when sexual intercourse would be necessarily fruitless, the instinct of 
the animal leads her to avoid it; and the concourse of the sexes is ac¬ 
cordingly made to correspond in time with the maturity of the egg and 
its aptitude for fecundation.” 

The amount of fluid lost during the menstrual flow varies greatly 
with different individuals. It is estimated at from three ounces to half 
a pint. In cases of deranged function, it may be much greater than 
this. It is not all blood, however, a considerable portion being mucus. 
It is rather difficult to understand why the discharge of so considerable 
a quantity of blood is required. There is no benefit derived from a very 
copious discharge, as some suppose. Facts seem to indicate that in gen¬ 
eral those enjoy the best health who lose but small quantities of blood 
in this manner. 

As the first occurrence of menstruation is a very critical period in 
the life of a female, and as each recurrence of the function renders her 
especially susceptible to morbid influences, and liable to serious derange¬ 
ments, a few hints respecting the proper care of an individual at these 
periods may be acceptable. 

Important Hints. — 1 . Avoid taking cold. To do this, it is neces¬ 
sary to avoid exposure; not that a person must be constantly confined 
in a warm room, for such a course would be the surest way in which 
to increase the susceptibility to cold. Nothing will disturb the men¬ 
strual process more quickly than a sudden chilling of the body when 
in a state of perspiration, or after confinement in a warm room, by 
exposure, without sufficient protection, to cold air. A daily bath and 
daily exercise in the open air are the best known means of preventing 
colds. 

2 . Intense mental excitement, as well as severe physical labor, is 
to be sedulously avoided during this period. At the time of its first 


336 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


occurrence, special care should be observed in this direction. Intense 
study, a fit of anger, sudden grief, or even great merriment, will some¬ 
times arrest the process prematurely. The feeling of malaise which 
usually accompanies the discharge is by nature intended as a warning 
that rest and quiet are required; and the hint should be followed. 
Every endeavor should be made to keep the individual comfortable, 
calm, and cheerful. Feelings of apprehension arising from a contin¬ 
ual watching of symptoms are very depressing, and should be avoided 
by occupying the mind in some agreeable manner not demanding se¬ 
vere effort, either mental or physical. 

There is no doubt that many young women have permanently in¬ 
jured their constitutions while at school by excessive mental taxation 
during the catamenial period, to which they were prompted by ambi¬ 
tion to excel, or were compelled by the “ cramming ” system too gen¬ 
erally pursued in our schools, and particularly in young ladies’ semi¬ 
naries. It is not to be supposed, however, that the moderate amount 
of sound study required by a correct system of teaching would be in¬ 
jurious to a healthy young woman at any time, and we have no doubt 
that a very large share of the injury which has been attributed to 
over-study during the catamenia has been induced by other causes, 
such as improper dress, exposure to taking cold, keeping late hours, 
and improper diet. 

If there is any class of persons deserving of pity it is that large 
class of girls and young women who are in every large city employed 
as clerks, seamstresses, flower-makers, and in other taxing and confin¬ 
ing occupations. In order to keep their situations they are required 
to be on hand daily, being allowed no opportunity for rest at the men¬ 
strual period. In many cases, too, they are compelled to remain upon 
their feet all day behind a counter, or at a work table, even at periods 
when a recumbent position is actually demanded by nature. There 
should be less delicacy in relation to this subject on the part of young 
women, and more consideration on the part of employers. Here is a 
field for philanthropic labor which is well worthy of the best efforts of 
any person of influence who will engage in it. 

Custom of Indian Women. —The ease with which Indian women 
perform the parturient act is proverbial. They suffer scarcely at all 
from the pains of childbirth ; and without doubt one reason of this is 
the preservation of their sexual health by rest during the menstrual 
period. At those seasons they invariably absent themselves from the 


IMPORTANT HINTS. 


337 


lodge, and enjoy absolute rest. We may readily suppose, from the 
nature of some of the Mosaic laws, that a custom somewhat similar 
prevailed among the ancient Hebrew women. If the hardy women 
of the forest are benefited by rest, certainly our more delicate females 
may be thus benefited. All need a degree of rest; with some it should 
be absolute. 

The reckless manner in which some young women treat themselves 
at the menstrual period, is quite appalling to one who is acquainted 
with the painful and inveterate character of the evils which arise 
from such abuse. It is no uncommon thing for yOung ladies to attend 
balls, visit skating rinks, and otherwise expose themselves to in¬ 
fluences in every way the best calculated to do them the most harm 
at this particular period, observing not the slightest precaution. Such 
recklessness is really criminal; and the sad consequences of physical 
transgression are sure to follow. A young lady who allows herself 
to get wet or chilled, or gets the feet wet, just prior to or during men¬ 
struation, runs the risk of imposing upon herself life-long injury. 
Mothers should look carefully after their daughters at these periods, 
and impress upon them the importance of special care. 

3. A third hint, which is applicable to both sexes and at all times, 
is the necessity of attending promptly to the demands of nature for 
relief of the bowels and bladder. School-girls are often very negli¬ 
gent in this respect; and we have seen the most distressing cases of 
disease which were entirely attributable to this disregard of the 
promptings of nature. Obstinate constipation and chronic irritation 
of the bladder are common effects. When constipation results, purga¬ 
tives in the shape of pills, salts, or “ pleasant purgative pellets,” are 
resorted to with the certain result of producing only temporary relief, 
and permanent damage. 

To escape these evil consequences, do this: 1. Establish a regular 
habit of relieving the bowels daily at a certain hour; 2. Discard laxa¬ 
tive and cathartic drugs of every kind; 3. To aid in securing a regu¬ 
lar movement of the bowels, make a liberal use of oatmeal, wheat- 
meal, fruit, and vegetables, avoiding fine-flour bread, sweetmeats, and 
condiments; 4. Take daily exercise, as much as. possible short of fa¬ 
tigue ; if necessarily confined in-doors, counteract the constipating in¬ 
fluence of sedentary habits by kneading and percussing the bowels 
with the hands several minutes each day; 5. Never resist the calls of 
nature a single moment, if possible to avoid it. In this case, as in 


338 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


numerous others, “ delay is dangerous.” Ladies who desire a sweet 
breath—and what lady does not—should remember that retained 
feces are one of the most frequent causes of foul breath. The foul 
odors which ought to pass out through the bowels find their way into 
the blood and escape at the lungs. 

It is of the greatest importance that careful attention should be 
given to the proper establishment of the menstrual function at the 
outset of a woman’s life of sexual activity. The first two years will 
be quite likely to have a deciding influence respecting her health dur¬ 
ing her whole future life. If a woman can get through the first two 
years after puberty without acquiring any serious uterine or ovarian 
disease, she will stand a good chance of enjoying a good degree of sex¬ 
ual health during the balance of her life. The foundation of a great 
share of the many thousands of cases of uterine disease is laid during 
this period. 

At this early period the daughter is usually too young to appreci¬ 
ate the importance of observing slight deviations from the standard 
of health, even if she were able to recognize them. Hence it is a 
duty which no mother should neglect, to inquire into the exact fre¬ 
quency of the periods, the amount and character of the discharge, and 
other points necessary to ascertain whether or not there is any devia¬ 
tion from the natural condition of health. If there is pain, it is a cer¬ 
tain evidence of something seriously wrong. If there is irregularity 
in any particular, it is a matter well deserving of serious attention. 

Extra-Uterine Pregnancy. —Sometimes the ovum becomes fec¬ 
undated before reaching the uterus, and instead of passing onward 
into that organ as usual, remains in its position in the Fallopian tube 
or even on the surface of the ovary. Occasionally an ovum falls into 
the cavity of the abdomen instead of passing into the tube. Even in 
this situation it may be fecundated. Impregnated ova, thus left in 
abnormal positions, sometimes undergo a greater or lesser degree of de¬ 
velopment. They often result in the death of the mother. 

Twins.—The human female usually matures but one ovum at each 
menstrual period, the two ovaries acting alternately. Occasionally 
two ova are matured at once. If fecundation occurs, the result will 
be a development of two embryos at the same time. In rare cases, 
three or even four ova are matured at once, and by fecundation pro¬ 
duce a corresponding number of embryos. As many as five children 
have been born alive at one birth, but have not usually lived more than 
a few minutes. 


MONSTERS. 


339 


Monsters. —Defects and abnormalities in the development of the 
embryon produce all degrees of deviation from the typical human form. 
Excessive development may result in an extra finger or toe, or in the 
production of some peculiar excrescence. Deficiency of development 
may produce all degrees of abnormality from the simple harelip to the 
most frightful deficiency, as the absence of a limb, or even of a head. 
It is in this manner that those unfortunate individuals known as her¬ 




maphrodites are formed. An excessive development of some parts of 
the female generative organs gives them a great degree of similarity to 
the external organs of the male. A deficient development of the mas¬ 
culine organs renders them similar in appearance to those of the female. 
Excessive development shown in a peculiar manner produces both kinds 
of organs in the same individual in a state more or less complete. 

The uncouth shapes which are sometimes supposed to be the result 
of amalgamation with lower animals are produced in essentially the 
same manner. The stories which are frequently told of women giving 
birth to puppies and other animals have no foundation other than that 
mentioned. 

Such curious cases as the Carolina twins and Chang and Eng were 
formerly supposed to be the result of the union of two separate individr 
uals. It is now believed that they are developed from a single ovum. 












240 ANATOMY, PHYSIOLOGY, AND HYGIENE. 

Hybrids. —It is a well-known law of biology that no progeny re¬ 
sult from union of animals of different species. Different's arieties of 
the same species may in some cases form a fertile union, the result of 
which is a cross between its two parents, possessing some of the qual¬ 
ities of each. The mule is the product of such a union between the 
horse and the ass. A curious fact is that the offspring of such unions 
are themselves sterile almost without exception. The reason of this is 
that they do not produce mature elements of generation. In the mule, 
the zoosperms are either entirely absent or else very imperfectly devel¬ 
oped ; hence the fact that a colt having a mule for its sire is one of the 
rarest of curiosities, though a few instances have been reported. This 
is a wise law of nature to preserve the purity of species. 

Law of Sex.—If there is a law by which the sex of the developing 
embryon is determined, it probably has not yet been discovered. The 
influence of the will, the predominant vitality of one or the other of 
the parents, and the period at which conception occurs, have all been 
supposed to be the determining cause. A German physician some time 
since advanced the theory that the two testicles and ovaries produce 
elements of different sexual character, the right testicle forming zoo¬ 
sperms capable of producing only males, and the right ovary producing 
ova with the same peculiarity. The left testis and the left ovary he 
supposed to form the female elements. He claimed to have proved his 
theory by experiments upon animals. Even if true, this theory will not 
be made of practical importance. It is, in fact, nothing more than a 
revival of an old theory held by physicians who flourished more than 
two thousand years ago. 

More recently, another German physician has advanced the theory 
that the sex may be controlled at will by observing the time of fecunda¬ 
tion. He asserts that when fecundation occurs shortly after menstru¬ 
ation, the result will be a female ; but if impregnation occurs later in 
the month, and prior to the three or four days preceding the next men¬ 
strual period, a male will almost certainly be produced. This theory 
was proposed by Prof. Thury of the academy of Geneva, who claims to 
have thoroughly tested it in a great variety of ways, and always with 
an affirmative result. Dr. Heitzman, of New York, an instructor in 
pathological histology, and an eminent physiologist, informs us that he 
has thoroughly tested this theory, and finds it to be entirely reliable. 
There are numerous facts which seem to corroborate the truth of this 
theory, and future investigations may give to it the dignity of an estab¬ 
lished physiological fact. 


HEREDITY. 


341 


Heredity. —The phenomena of heredity are among the most inter¬ 
esting of biological studies. It is a matter of common observation that 
a child looks like its parents. It even happens that a child resembles 
an uncle or a grandparent more nearly than either parent. The same 
peculiarities are often seen in animals. 

The cause of this resemblance of offspring to parents and ancestors 
has been made a subject of careful study by Scientific men. We shall 
present the most recent theory adopted, which, although it be but a 
theory, presents such an array of facts in its support, and explains the 
phenomena in question so admirably, that it must be regarded as some¬ 
thing more than a plausible hypothesis. It is the conception of one of 
the most distinguished scientists of the age. The theory is known as 
the doctrine of pangenesis, and is essentially as follows :— 

It is a fact well known to physiologists that every part of the liv¬ 
ing body is made up of cellular elements which have the power to 
reproduce themselves in the individual, thus repairing the damage re¬ 
sulting from waste and injury. Each cell produces cells like itself. 
It is further known that there are found in the body numerous cen¬ 
tral points of growth. In every group of cells is found a central cell 
from which the others originated, and which determines the form of 
their growth. Every minute structure possesses such a center. A 
simple proof of this fact is found in the experiment in which the spur 
of a cock was grafted upon the ear of an ox. It lived in this novel 
situation eight years, attaining the length of nine inches, and nearly 
a pound in weight. A tooth has been made to grow upon the comb 
of a cock in a similar manner. The tail of a pig survived the oper¬ 
ation of transplanting from its proper position to the back of the an¬ 
imal, and retained its sensibility. Numerous similar illustrations 
might be given. 

The doctrine of pangenesis supposes that these centers of nutrition 
form and throw off not only cells like themselves, but very minute gran¬ 
ules, called gemmules, each of which is capable, under suitable circum¬ 
stances, of developing into a cell like its parent. 

These minute granules are scattered through the system in great 
numbers. The essential organs of generation, the testicles in the male 
and the ovaries in the female, perform the task of collecting these gem- 
mules and forming them into sets, each of which constitutes a repro¬ 
ductive element, and contains, in rudimentary form, a representative of 
every* part of the individual, including the most minute peculiarities. 


342 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


Even more than this : It is supposed that each ovum and each zoosperm 
contains not only the gemmules necessary to reproduce the individuals 
who produced them, but also a number of gemmules which have been 
transmitted from the individuals’ ancestors. 

If this theory be true,—and we can see no sound objection to it,—it 
is easy to understand all the problems of heredity. The gemmules must 
be very small indeed, but it may be suggested that the molecules of 
matter are smaller still, so this fact is no objection to the theory. 

It will be seen, then, that each spermatozoon, or zoosperm, actually 
contains, in an embryonic condition, every organ and tissue of the indi¬ 
vidual producing it. The same is true of the ovum. In other words, 
the reproductive elements are complete representatives, in miniature, of 
the parents, and contain all the elements for producing an offspring pos¬ 
sessing the same peculiarities as the parents. Various modifying circum¬ 
stances sufficiently explain the dissimilarities between parents and chil¬ 
dren. 

This theory is strikingly confirmed by the fact, previously mentioned, 
that in certain cases the ovum alone, a single reproductive element, may 
undergo a degree of development approaching very near to completion. 
It is supposed that fecundation is chiefly necessary to give to the gem¬ 
mules the requisite amount of nourishment to insure development. 

As we shall see hereafter, this matter has a very important bearing 
upon several practical questions. 

Ante-Natal Influences. —There can be no manner of doubt that 
many circumstances which it is entirely within the power of the parents 
to supply, exert a powerful influence in molding both the mental and 
the physical characteristics of offspring. By carefully availing himself 
of the controlling power given him by a knowledge of this fact, the 
stock-raiser is enabled to produce almost any required quality in his 
young animals. Pigeon fanciers show wonderful skill in thus produ¬ 
cing most curious modifications in birds. The laws of heredity and de¬ 
velopment are carefully studied and applied in the production of supe¬ 
rior horses, cows, dogs, and pigeons; but an application of the same 
principles to the improvement of the human race is rarely thought of. 
Human beings are generated in as haphazard and reckless a manner as 
weeds are sown by the wind. No account is taken of the possible influ¬ 
ence which may be exerted upon the future destiny of the new being 
by the physical or mental condition of parents at the moment when the 
germ of life is planted, or by the mental and physical conditions and 


A NTE-NA TA L IXFL UENGES. 


343 

surroundings of the mother while the young life is developing. Indeed, 
the assertion of a modern writer that the poor of our great cities virtu¬ 
ally “ spawn children,” with as little thought of influences and conse¬ 
quences as the fish that sow their eggs broadcast upon the waders, is not 
so great an exaggeration as it might at first sight appear to be. 

Men and women are constantly prone to forget that the domain of 
law is universal. Nothing comes by chance. The revolutions of the 
planets, studied by the aid of the telescope, and the gyrations of the at¬ 
oms, seen only by the eye of science, are alike examples of the controlling 
influence of law. Notwithstanding this sad ignorance and disregard of 
this vitally important subject, the effects of law are only too clearly 
manifested in the crowds of wretched human beings with which the 
world is thronged. An old writer sagely remarks, “ It is the greatest 
part of our felicity to be well born; ” nevertheless, it is the sad misfor¬ 
tune of by far the greater portion of humanity to be deprived of this 
inestimable “ felicity.” 

It is an established physiological fact that the character of offspring 
is influenced by the mental as well as the physical conditions of the 
parents at the moment of the performance of the generative act. In 
view of this fact, how many parents can regard the precocious—or even 
mature—manifestations of sexual depravity in their children without 
painful smitings of conscience at seeing the legitimate results of their 
own sensuality ? By debasing the reproductive function to an act of 
selfish animal indulgence, they imprinted upon their children an almost 
irresistible tendency to vice. Viewing the matter from this stand-point, 
what wonder that licentiousness is rife ! that true chastity is among the 
rarest of virtues ! 

Prof. O. W. Holmes remarks on this subject: “ There are people who 
think that everything may be done if the doctor, be he educator or phy¬ 
sician, be only called in season. No doubt ; but in season would often 
be a hundred or two years before the child was born, and people never 
send so early as that.” “Each of us is only the footing up of a double 
column of figures that goes back to the first pair. Every unit tells, and 
some of them ar a plus and some minus. If the columns don’t add up 
right, it is commonly because we can’t make out all of the figures.” 

It cannot be doubted that the throngs of deaf, blind, crippled, idiotic 
unfortunates who were “ born so,” together with a still larger class of 
dwarfed, diseased, and constitutionally weak individuals, are the lament¬ 
able results of the violation of some sexual law on the part of their pro¬ 
genitors. 



344 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


If parents would stop a moment to consider the momentous responsi¬ 
bilities involved in the act of bringing into existence a human being; if 
they would reflect that the qualities imparted to the new being will af¬ 
fect its character to all eternity; if they would recall the fact that they 
are about to produce a mirror in which will be reflected their own char¬ 
acters divested of all the flimsy fabrics which deceive their fellow-men, 
revealing even the secret imaginings of their hearts,—there would surely 
be far less of sin, disease, and misery born into the world than at the 
present day; but we dare not hope for such a reform. To effect it, 
would require such a revolution in the customs of society, such a radical 
reform in the habits and characters of individuals, as nothing short of a 
temporal millennium would be able to effect. 

SEXUAL HYGIENE, 

Under this head we will consider some of the more general subjects 
relating to the health of the reproductive organism which have not been 
considered in connection with the special organs and functions described. 

The use of the reproductive function is perhaps the highest physical 
act of which man is capable, its abuse is certainly one of the most 
grievous outrages against nature which it is possible for him to perpe¬ 
trate. No observing person can doubt that the sexual relations of men 
and women determine in a great degree their happiness or misery in life. 
This subject, then, deserves due attention and careful consideration. It 
is of no use to scout it; for it will inevitably obtrude itself upon us, no 
matter how sedulously we attempt to avoid it. It can be rightly con¬ 
sidered only with the most perfect candor, with the mind unbiased by 
passion, and prayerfully anxious to know and do what is right. 

In the following paragraphs of this section are considered some of the 
evils out of which grows much of the sexual suffering of men and 
women:— 

Sexual Precocity. —There are two periods in human life when the 
sexual instincts should be totally dormant; and they are so when nature 
is not perverted. The first is the period reaching from infancy to pu¬ 
berty. The second is the period reached in advanced age. 

If raised strictly in accordance with natural law, children would 
have no sexual notions or feelings before the occurrence of puberty. 
No prurient speculation about sexual matters would enter their heads. 
Until that period, the reproductive system should lie dormant in its 


SEXUAL PRECOCITY. 


345 


undeveloped state. No other feeling should be exhibited between the 

sexes than that brotherly and sisterly affection which is so admirable 

and becoming'. 

© 

Fortunate, indeed, would it be for humanity if this natural state 
always existed; but it is a lamentable fact that it is rarely seen in 
modern homes. Not infrequently, evidences of sexual passion are 
manifested before the child has hardly learned to walk. It has been 
suggested that this precocity is nothing remarkable or unnatural, 
since it is often seen in little lambs and other young animals. To this 
it is only necessary to reply that the development of the sexual in¬ 
stincts perfectly corresponds with the longevity of the animal; if 
short-lived, like the sheep, only a short period intervenes between 
birth and the attainment of the sexual appetite and virility. If the 
animal is intended for long life, as is the case with man, these mani¬ 
festations are delayed, or should be, until a much later period. 

Dr. Acton, a distinguished English surgeon, makes the following 
excellent remarks upon this subject:— 

“ Slight signs are sufficient to indicate when a boy has this un¬ 
fortunate tendency. He shows marked preferences. You will see 
him single out one girl, and evidently derive an unusual pleasure (for 
a boy) in her society. His penchant does not take the ordinary form 
of a boy’s good nature, but little attentions that are generally reserved 
for a later period prove that his feeling is different, and sadly prema¬ 
ture. He may be apparently healthy, and fond of playing with other 
boys; still there are slight, but ominous, indications of propensities 
fraught with danger to himself. His play with the girl is different 
from his play with his brothers. His kindness to her is a little too 
ardent. He follows her, he does not know why. He fondles her 
with a tenderness painfully suggestive of a vague dawning of passion. 
No one can find fault with him. He does nothing wrong. Parents 
and friends are delighted at his gentleness and politeness, and not a 
little amused at the early flirtation. If they were wise, they would 
rather feel profound anxiety; and he would be an unfaithful or un¬ 
wise medical friend who did not, if an opportunity occurred, warn 
them that such a boy, unsuspicious and innocent as he is, ought to be 
carefully watched and removed from every influence calculated to 
foster his abnormal propensities.” 

We have been not more disgusted than shocked to see parents, 
whose intelligence ought to teach them better, not only winking at. 


S46 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


but actually encouraging, these premature manifestations of passion 
in their children. They may yet learn, by bitter experience, the folly 
of their course, unless they make the discovery in time to avert, by 
careful reformatory training, the calamitous results which threaten 
the future of their children. 

Chastity. —In Ex. 20:14 and Matt. 5 : 28 we have a complete defi¬ 
nition of chastity. The seventh commandment, with the Saviour’s 
commentary upon it, places clearly before us the fact that chastity re¬ 
quires purity of thought as well as of outward acts. Impure thoughts 
and unchaste acts are alike violations of the seventh commandment. 
As we shall see, also, unchastity of the mind is a violation of natural 
law as well as of moral law, and is visited with physical punishment 
commensurate to the transgression. 

Mental Unchastity. —It is vain for a man to suppose himself 
chaste who allows his imagination to run riot amid scenes of amorous 
associations. The man whose lips delight in tales of licentiousness, 
whose eyes feast upon obscene pictures, who is ever ready to pervert 
the meaning of a harmless word or act into uncleanness, who finds de¬ 
light in reading vivid portrayals of acts of lewdness,—such a one is 
not a virtuous man. 

Man may not see these mental adulteries, he may not perceive 
these filthy imaginings; but One sees and notes them. They leave 
their hideous scars upon the soul. They soil and mar the mind; and 
as the record of each day of life is photographed upon the books in 
Heaven, they each appear in bold relief, in all their innate hideousness. 

Foul thoughts once allowed to enter the mind, stick like the lep¬ 
rosy. They corrode, contaminate, and infect like the pestilence; 
naught but Almighty power can deliver from the bondage of concu¬ 
piscence a soul once infected by this foul blight, this moral contagium. 

It is a wide-spread and deadly error, that only outward acts are 
harmful; that only physical transgression of the laws of chastity will 
produce disease. We have seen all the effects of beastly abuse result 
from mental sin alone. 

“ I have traced serious affections and very great suffering to this 
cause. The cases may occur at any period of life. We meet with 
them frequently among such as are usually called, or think them¬ 
selves, continent young men. There are large classes of persons who 
seem to think that they may, without moral guilt, excite their own 
feelings or those of others by loose or libidinous conversation in soci- 


EARLY CAUSES. 


347 


ety, provided such impure thoughts or acts are not followed by mas¬ 
turbation or fornication. I have almost daily to tell such persons 
that physically, and in a sanitary point of view, they are ruining 
their constitutions. There are young men who almost pass their lives 
in making carnal acquaintances in the street, but just stop short of 
seducing girls; there are others who haunt the lower classes of places 
of public amusement for the purpose of sexual excitement, and live, in 
fact, a thoroughly immoral life in all respects except actually going 
home with prostitutes. When these men come to me, laboring under 
the various forms of impotence, they are surprised at my suggesting 
to them the possibility of the impairment of their powers being de¬ 
pendent upon these previous vicious habits.”* 

“ Those lascivious day-dreams and amorous reveries, in which 
young people—and especially the idle and the voluptuous, and the 
sedentary and the nervous—are exceedingly apt to indulge, are often 
the sources of general debility, effeminacy, disordered functions, pre¬ 
mature disease and even premature death, without the actual exercise 
of the genital organs; Indeed, this unchastity of thought—this 
adultery of the mind—is the beginning of immeasurable evil to the 
human family.” *f* 

“ Filthy dreamers,” before they are aware, become filthy in action. 
The thoughts mold the brain, as certainly as the brain molds the 
thoughts. Rapidly down the current of sensuality is swept the indi¬ 
vidual who yields his imagination to the contemplation of lascivious 
themes. Before he knows his danger, he finds himself deep in the 
mire of concupiscence. He may preserve a fair exterior; but decep¬ 
tion cannot cleanse the slime from his putrid soul. How many a 
church member carries under a garb of piety a soul filled with abom¬ 
inations, no human scrutiny can tell. How many pulpits are filled by 
“ whited sepulchers,” only the Judgment will disclose. 

Early Causes. —The earliest of all causes is hereditary predispo¬ 
sition. As we have shown, a child conceived in lust can no more be 
chaste by nature than a negro can be a Caucasian. But back of this 
there is a deeper cause, as we shall see, one that affects parents as well 
as offspring. Between infancy and puberty, are in operation all those 
influences mentioned under “ Sexual Precocity.” 

The frequent custom of allowing children of opposite sex to 


* Acton. 


t Graham. 


348 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


sleep together, even until eight or ten years of age, or longer, is a 
dangerous one. We have known of instances in which little boys of 
seven or eight have been allowed to sleep with girls of fourteen or 
sixteen, in some of which most shameful lessons were taught, and by 
persons who would not be suspected of such an impropriety. In one 
instance a little boy of eight, occupying the same bed with three girls 
several years older, was used for illustration by the older girl in in¬ 
structing the younger ones in the 'modus operandi of reproduction. 
The sexes should be carefully separated from each other at least as 
early as four or five years of age, under all circumstances which could 
afford opportunity for observing the physical differences of the sexes, 
or in any way serve to excite those passions which at this tender age 
should be wholly dormant. 

Diet vs. Chastity .—From earliest infancy to impotent old age, 
under the perverting influence of civilization, there is a constant an¬ 
tagonism between diet and purity. When old enough to take food in 
the ordinary way, the infant’s tender organs of digestion are plied 
with highly seasoned viands, stimulating sauces, animal food, sweet¬ 
meats, and dainty tidbits in endless variety. Soon, tea and coffee are 
added to the list. Salt, pepper, ginger, mustard, condiments of every 
sort, deteriorate his daily food. If, perchance, he does not die at once 
of indigestion, or with his weakened forces fall a speedy victim to the 
diseases incident to infancy, he has his digestive organs impaired for 
life at the very outset of his existence. 

Exciting stimulants and condiments weaken and irritate his 
nerves and derange the circulation. Thus, indirectly, they affect the 
sexual system, which suffers through sympathy with the other organs. 
But a more direct injury is done. Flesh, condiments, eggs, tea, coffee, 
chocolate, and all other stimulants, have a powerful influence directly 
upon the reproductive organs. They increase the local supply of blood; 
and through nervous sympathy with the brain, the passions are 
aroused. 

Overeating, eating between meals, hasty eating, eating indigestible 
articles of food, late suppers, react upon the sexual organs with the 
utmost certainty. Any disturbance of the digestive function deteri¬ 
orates the quality of the blood. Poor blood, filled with crude, poorly 
digested food, is irritating to the nervous system, and especially to 
those extremely delicate nerves which govern the reproductive func¬ 
tion. Irritation provokes congestion ; congestion excites sexual de- 


BAD BOOKS. 


349 


sires; excited passions increase the local disturbance; and thus each 
reacts upon the other, ever increasing the injury and the liability to 
future damage. 

Thus, these exciting causes continue their insidious work through 
youth and more mature years. Right under the eyes of fathers and 
mothers they work the ruin of their children, exciting such storms of 
passion as are absolutely uncontrollable. 

Tobacco and Tice. —Few are aware of the influence upon morals 
exerted by that filthy habit, tobacco-using. When acquired early, it 
excites the undeveloped organs, arouses the passions, and in a few 
years converts the once chaste and pure youth into a veritable vol¬ 
cano of lust, belching out from its inner fires of passion torrents of 
obscenity and the sulphurous fumes of lasciviousness. If long-con¬ 
tinued, the final effect of tobacco is emasculation; but this is only the 
necessary consequence of previous super-excitation. 

We are aware that we have made a grave charge against tobacco, 
and we have not hesitated to state the naked truth ; yet we do not 
think we have exaggerated, in the least, the pernicious influence of 
this foul drug. As much might be said against the use of liquor on 
the same grounds. 

Bad Books. —Another potent enemy of virtue is the obscene litera¬ 
ture which has flooded the land for many years. Circulated by secret 
agencies, these books have found their way into the most secluded dis¬ 
tricts. Every large school contains one or more of these emissaries of 
evil men and their Satanic master. 

Largely through the influence of Mr. Anthony Comstock, laws have 
been enacted which promise to do much toward checking this extensive 
evil, or at least causing it to make itself less prominent. Our news¬ 
papers still abound with advertisements of various so-called medical 
works, “ Marriage Guides,” etc., which are fruits of the same “ upas- 
tree” that Mr. Comstock has labored so faithfully to uproot. 

It is a painful fact, however, that the total annihilation of every foul 
book which the law can reach will not effect the cure of this evil, for our 
modern literature is full of the same virus. It is necessarily presented 
in less grossly revolting forms, half concealed by beautiful imagery, or 
embellished by wit ; but yet, there it is, and no law can reach it. The 
works of our standard authors in literature abound in lubricity. Pop¬ 
ular novels have doubtless done more to arouse a prurient curiosity in 
the young, and to excite and foster passion and immorality, than even 


350 


ANATOMY, PHYSIOLOGY , AND HYGIENE. 


the obscene literature for the suppression of which such active measures 
have recently been taken. The more exquisitely painted the scenes of 
vice, the more dangerously enticing. Novel-reading has led thousands 
to lives of dissoluteness. 

Many other causes might be enumerated, as idleness, evil associa¬ 
tions, etc., but we need not dwell longer on this point. 

Untliought-of Excesses. —Sexual wrong exists among the mar¬ 
ried as well as the unmarried, and that within the pale of the mar¬ 
riage rite. Ignorant or regardless of the consequences, many married 
people give loose rein to their passions, supposing that the marriage 
vow removes all duty of restraint. Nature does not, however, forget 
to inflict upon the offenders commensurate punishment for their 
wrong-doing. A long list of diseases, affecting both males and fe¬ 
males, might be presented as the direct consequences of this form of 
sexual transgression. Married people should recollect that the duty 
of restraint is as binding upon them after as before marriage. 

Without stopping to consider the various circumstances under 
which absolute continence is expedient, or desirable, or morally re¬ 
quired, we will pi-oceed at once to examine the question, Is continence 
harmful ? 

Continence not Injurious. —It has been claimed by many, even 
by physicians,—and with considerable show of reason,—that absolute 
continence, after full development of the organs of reproduction, could 
not be maintained without great detriment to health. It is needless 
to enumerate all the different arguments employed to support this po¬ 
sition, since they are, with a few exceptions, too frivolous to deserve 
attention. We shall content ourselves chiefly with quotations from 
acknowledged authorities, by which we shall show that the popular 
notions upon this subject are wholly erroneous. Their general ac¬ 
ceptance has been due, without doubt, to the strong natural bias in 
their favor. It is an easy matter to believe what agrees w'ell with 
one’s predilections. A bare surmise on the side of prejudice, is more 
telling than the most powerful logic on the other side. 

“ We know that this opinion is held by men of the world, and 
that many physicians share it. This belief appears to us to be erro¬ 
neous, without foundation, and easily refuted.”* 

The same writer claims “ that no peculiar disease nor any abridg- 


* Mayer. 


DOES NOT PRODUCE IMPOTENCE. 


351 


ment of the duration of life can be ascribed to such continence.” He 
proves his position by appealing to statistics, and shows the fallacy of 
arguments in support of the contrary view. He further says:— 

“ It is determined, in our opinion, that the commerce of the sexes 
has no necessities that cannot be restrained without peril.” 

“ A part has been assigned to spermatic plethora in the etiology of 
various mental affections. Among others, priapism has been attributed 
to it. In our opinion, this malady originates in a disturbance of the 
cerebral nerve power ; but it is due much less to the retention of sperm 
than to its exaggerated loss; much less to virtuous abstinence than to 
moral depravity.” 

There has evidently been a wide-spread deception upon this subject. 
“ Health does not absolutely require that there should ever be an emis¬ 
sion of semen, from puberty to death, though the individual live a hun¬ 
dred years; and the frequency of involuntary nocturnal emissions is an 
indubitable proof that the parts, at least, are suffering under a debility 
and morbid irritability utterly incompatible with the general welfare of 
the system.” 

Does not Produce Impotence. —It has been declared that strict 
continency would result in impotency. The falsity of this argument is 
clearly shown by the following observations :— 

“ There exists no greater error than this, nor one more opposed to 
physiological truth. In the first place, I may state that I have, after 
many years’ experience, never seen a single instance of atrophy of the 
generative organs from this cause. I have, it is true, met the complaint, 
but in what class of cases does it occur ? It arises, in all instances, from 
the exactly opposite cause, abuse; the organs become worn out, and 
hence arises atrophy. Physiologically considered, it is not a fact that 
the power of secreting semen is annihilated in well-formed adults lead¬ 
ing a healthy life and yet remaining continent. No continent man need 
be deterred by this apocryphal fear of atrophy of the testes, from living 
a chaste life. It is a device of the unchaste,—a lame excuse for their 
own incontinence, unfounded on any physiological law.” * 

The truth of this statement has been amply confirmed by experi¬ 
ments upon animals. 

The complaint is made by those whose lives have been far otherwise 
than continent, that abstinence occasions suffering, from which indul- 


* Acton. 


352 


ANATOMY, PHYSIOLOGY, AND HYGIENE 


gence gives relief. The same writer further says that when such a pa¬ 
tient consults a medical man, “he should be told—and the result would 
soon prove the correctness of the advice—that attention to diet, gym¬ 
nastic exercise, and self-control, will most effectually relieve the 
symptoms.” 

Difficulty of Continence .—Some there are who urge that self-de¬ 
nial is difficult; that the natural promptings are imperious. From this 
they argue that it cannot but be right to gratify so strong a passion. 
“ The admitted fact that continence, even at the very beginning of man¬ 
hood, is frequently productive of distress, is often a struggle hard to be 
borne,—still harder to be completely victorious in,—is not to be at all re¬ 
garded as an argument that it is an evil.” * 

But if rigid continence is maintained from the first, the struggle 
with the passions will not be nearly so severe as after they have once 
been allowed to gain the ascendency. On this point, the following re¬ 
marks are very j ust:— 

“ At the outset, the sexual necessities are not so uncontrolled as is 
generally supposed, and they can be put down by the exercise of a little 
energetic will. There is, therefore, as it appears to us, as much injustice 
in accusing nature of disorders which are dependent upon the genital 
senses, badly directed, as there would be in attributing to it a sprain or 
a fracture accidentally produced.” j- 

Helps to Continence. —As already indicated, and as every individ¬ 
ual with strong passions knows, the warfare with passion is a serious 
one if one determines to lead a continent life. He needs the help of ev¬ 
ery aid that he can gain. Some of these may be named as follows :—• 
The Will. —A firm determination must be formed to lead a life of 
purity ; to quickly quench the first suggestions of impurity; to harbor 
no unchaste desire; to purge the mind of carnal thoughts; in short, to 
cleave fast to mental continence. Each triumph over vicious thoughts 
will strengthen virtue; each victory won will make the next the easier. 
So strong a habit of continence may be formed that this alone will be a 
bulwark against vice. 

Diet. —He who would keep in subjection his animal nature must 
carefully guard the portal to his stomach. The blood is made of what 
is eaten. Irritating food will produce irritating blood. Stimulating 
foods or drinks will surely produce a corresponding quality of blood. 


* Ibid. 


t Mayer. 


HELPS TO CONTINENCE. 


353 


Irritating, stimulating blood will irritate and stimulate the nervous sys¬ 
tem, and especially the delicate nerves of the reproductive system, as pre¬ 
viously explained. Only the most simple and wholesome food should be 
eaten, and that only in such moderate quantities as are required to re¬ 
plenish the tissues. The custom of making the food pungent and stim¬ 
ulating with condiments is the great, almost the sole, cause of gluttony. 
It is one of the greatest hindrances to virtue. Indeed, it may with 
truth be said that the devices of modern cookery are most powerful al¬ 
lies of unchastity and licentiousness. This subject is particularly deserv¬ 
ing of careful, candid, and studious attention, and only needs such in¬ 
vestigation to demonstrate its soundness. 

Exercise .—Next to diet as an aid to continence, perhaps of equal 
importance with it, is exercise, both physical and mental. It is a trite 
proverb, the truth of which every one acknowledges, that “ Satan finds 
some mischief still for idle hands to do,” and it is equally true that he 
always has an evil thought in readiness—speaking figuratively—to in¬ 
still into an unoccupied mind. A person who desires to be pure and 
continent in body and mind must flee idleness as he would the devil 
himself; for the latter is always ready to improve upon the advantages 
afforded by an idle moment, an hour given to reverie. 

Walking, riding, rowing, and gymnastics are among the best modes 
of physical exercise for sedentary persons; but there is no better form of 
exercise than working in the garden. The cultivation of small fruits, 
flowers, and other occupations of like character, really excel all other 
modes of physical exercise for one who can engage in them with real 
pleasure. Dozing is bad at any time ; for it is a condition in which the 
will is nearly dormant, though consciousness still lingers, and the imag¬ 
ination is allowed to run wild, and often enough it will run where it 
ought not. Late study, or late hours spent in any manner, is a sure 
means of producing general nervous irritability and sexual excitement 
through reflex influence. 

Bathing .—A daily bath with cool or tepid water, followed by vigor¬ 
ous rubbing of the skin with a coarse towel and then with the dry hand, 
is a most valuable aid. The hour of first rising is generally the most 
convenient time. General and local cleanliness are indispensable to gen¬ 
eral and local health. 

Religion .—After availing himself of all other aids to continence, if 
he wishes to maintain purity of mind as well as physical chastity,—and 
one cannot exist long without the other,—the individual must seek that 
23 


354 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


most powerful and helpful of all aids, divine grace. If, in the conflict 
with his animal nature, man had only to contend with the degrading in¬ 
fluences of his own propensities, the battle would be a serious one, and 
it is doubtful whether human nature alone—at least in any but rare 
cases—would be able to gain the victory; but, in addition to his own* 
inherent tendencies to evil, man is assailed at every point by unseen 
agencies that seek to drag him down and spoil his soul with lust. These 
fiendish influences are only felt, not seen, from which some argue that 
they do not exist. Such casuists must find enormous depths for human 
depravity. But who has not felt the cruel power of these unseen foes ? 
Against them, there is but one safe, successful weapon, “ the blood of 
Christ which cleanseth from all sin.” 

The struggling soul, beset with evil thoughts, will find in prayer a 
salvation which all his force of will, and dieting and exercising, will 
not, alone, insure him. Yet prayer alone will not avail. Faith and 
works must always be associated. All that one can do to work out his 
own salvation, he must do; then he can safely trust in God to do the 
rest, even though the struggle seems almost a useless one; for when the 
soul has been long in bondage to concupiscence, the mind a hold of foul 
and lustful thoughts, a panorama of unchaste imagery, these hateful 
phantoms will even intrude themselves upon the sanctity of prayer, and 
make their victim mentally unchaste upon his knees. But Christ can 
pity even such; and even these degraded minds may yet be pure if with 
the psalmist they continue to cry, with a true purpose and unwavering- 
trust, “ Create in me a clean heart, O God, and renew a right spirit 
within me.” “ Purge me with hyssop, and I shall be clean; wash me, 
and I shall be whiter than snow.” 

At the first suggestion of an evil thought, send up a mental prayer 
to Him whose ear is always open. Prayer and impurity are as incom¬ 
patible as oil and water. The pure thoughts that sincere prayer will 
bring, displace the evil promptings of excited passion. But the desire 
for aid must be sincere. Prayer will be of no avail while the mind is 
half consenting to the evil thought. The evil must be loathed, spurned, 
detested. 

It would seem almost unnecessary to suggest the impropriety of re¬ 
sorting to prayer alone when sexual excitability has arisen from a cul¬ 
pable neglect to remove the physical conditions of local excitement by 
the means already mentioned. Such physical causes must be well 
looked after, or every attempt to reform will be fruitless. God requires 


SEXUAL CRIMES. 


355 


of every individual to do for himself all that he is capable of doing; to 
employ every available means for alleviating his sufferings. 

Sexual Crimes. — The sexual crimes with which we wish to deal, 
as being those most seldom referred to, are prevention of conception, 
and intentional abortion. The first-mentioned, we are aware, is 
hardly considered a crime by the majority of people; and the same 
might be said respecting the second with large numbers of persons, 
though it is so recognized by the law. All medical authorities agree 
that prevention of conception, no matter by which one of the numerous 
methods commonly employed it may be induced, is always harmful and 
productive of disease. Personal experience in the medical carQ of a 
large number of ladies suffering with all forms of sexual derangements 
has enabled us to confirm this judgment many times. As it cannot be 
told at just what moment fecundation takes place, and as it may occur 
immediately, some of the methods employed for prevention plainly in¬ 
volve moral principles most seriously. It has been previously shown 
that in the ovum of the female, and the spermatozoon of the male, 
are, in rudimentary form, all the elements which go to make up the 
“ human form divine.” Alone, neither of these elements can become 
anything more than it already is; but the instant that the two ele¬ 
ments come in contact fecundation takes place, and the individual life 
begins. From that moment until maturity is reached, years subse¬ 
quently, the whole process is only one of development. Nothing ab¬ 
solutely new is added at any subsequent moment. In view of these 
facts, it is evident that at the very instant of conception the embry¬ 
onic human being possesses all the right to life it ever can possess. It 
is just as much an individual, a distinct human being, possessed of 
soul and body, as it ever is, though in a very immature form. That 
conception may take place during the reproductive act cannot be denied. 
If, then, means are employed with a view to prevent conception im¬ 
mediately after the accomplishment of the act, or at any subsequent 
time, if successful, it would be by destroying the delicate product of the 
conception which had already occurred, and which, as before observed, 
is as truly a distinct individual as it can ever become—certainly as in¬ 
dependent as at any time previous to birth. 

Is it immoral to take human life ? Is it a sin to kill a child ? Is 
it a crime to strangle an infant at birth ? Is it a murderous act to de¬ 
stroy a half-formed human being in its mother’s womb ? Who will 
dare to answer “ No,” to one of these questions ? Then, who can re- 


35 G 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


fuse assent to the plain truth that it is equally a murder to deprive of 
life the most recent product of the generative act ? 

Who can number the myriads of murders that have been perpe¬ 
trated at this early period of existence ? Who can estimate the load 
of guilt that weighs upon some human souls ? and who knows how 
many brilliant light? have been thus early extinguished ? how many 
promising human plantlets thus ruthlessly destroyed in the very act 
of germinating ? It is to be hoped that in the final account the ex¬ 
tenuating influence of ignorance may weigh heavily in the scale of 
justice against the damning testimony of these “ unconsidered murders.” 

Criminal Abortion* —Few but medical men are aware of the 
enormous proportions which have been assumed by this terrible crime 
during the present century. That it is increasing with fearful rapid¬ 
ity and has really reached such a magnitude as to seriously affect the 
growth of civilized nations, and to threaten their very existence, has 
become a patent fact to observing physicians. 

An eminent medical author asserts “ that the frequency of this 
form of destroying human life exceeds all others by at least fifty per 
cent, and that not more than one in a thousand of the guilty parties 
receive any punishment by the hand of civil law. But there is a 
surer mode of punishment for the guilty mother in the self-executing 
laws of nature.” 

The destruction of the child after the mother has felt its move¬ 
ments is termed infanticide; before that time it is commonly known 
as abortion. It is a modern notion that the child possesses no soul or 
individual life until the period of quickening, an error which we have 
already sufficiently exposed. The ancients, with just as much reason, 
contended that no distinct life was present until after birth. Hence 
it was that they could practice without scruple the crime of infanti¬ 
cide to prevent too great increase of population. 

The effects of this crime are not upon the child alone. The mother 
suffers not only imminent peril of life at the time, but the almost cer¬ 
tain penalty of chronic invalidism the remainder of her life. We have 
good authority for the assertion that abortion is fifteen times as dan¬ 
gerous as natural childbirth. With reference to the immorality of 
the act the eminent author of “ The Ten Laws of Health ” says:— 

“ There are those who would fain make light of this crime by at¬ 
tempting to convince themselves and others that a child, while in 
embryo, has only a sort of vegetative life, not yet endowed with 


CRIMINAL ABORTION. 


thought, and the ability to maintain an independent existence. If 
such a monstrous philosophy as this presents any justification for such 
an act, then the killing of a newly-born infant, or of an idiot, may be 
likewise justified. The destruction of the life of an unborn human 
being, for the reason that it is small, feeble, and innocently helpless, 
rather aggravates than palliates the crime. Every act of this kind, 
with its justification, is obviously akin to that savage philosophy 
which accounts it a matter of no moment, or rather a duty, to destroy 
feeble infants, or old, helpless fathers and mothers.” * 

“ From a very large verbal and written correspondence in this and 
other States, I am satisfied that we have become a nation of mur¬ 
derers” f 

Said a distinguished clergyman of Brooklyn in a sermon, “ Why 
send missionaries to India when child-murder is here of daily, almost 
hourly occurrence ; aye, when the hand that puts money into the con¬ 
tribution-box to-day, yesterday or a month ago, or to-morrow, will 
murder her own unborn offspring ? ” 

Whether this gigantic evil can ever be eradicated, is exceedingly 
doubtful. To effect its cure would be to make refined Christians out 
of brutal sensualists; to emancipate woman from the enticing, allur¬ 
ing slavery of fashion; to uproot false ideas of life and its duties,— 
in short, to revolutionize society. The crime is perpetrated in secret. 
Many times no one but the criminal herself is cognizant of the evil 
deed. Only occasionally do cases come near enough to the surface to 
be dimly discernible; hence the evident inefficiency of any civil legis¬ 
lation. But the evil is a desperate one, and is increasing; shall no 
attempt be made to check the tide of crime and save the sufferers 
from both physical and spiritual perdition ? An effort should be made, 
at least. Let every Christian raise the note of warning. From every 
Christian pulpit let the truth be spoken in terms too plain for misap¬ 
prehension. Let those who are known to be guilty of this most re¬ 
volting crime be looked upon as murderers, as they are; and let their 
real moral status be distinctly shown. 

It should be known, too, that wives are not the only ones to be 
blamed in this matter. In many instances husbands are the insti¬ 
gator's as well as the abettors of the crime, and in their hands 
lies the power to stay the sacrifices to this horrible modern Mo¬ 
loch. 


*J. R. Black, M. D. 


t Reamy. 


358 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


Secret Tice. —We most deeply deplore the necessity for mention¬ 
ing one more evil akin to those already dwelt upon; but our knowl¬ 
edge of the great prevalence and terrible consequences of the awful 
sin known as solitary or secret vice, masturbation, etc., presses upon 
us the obligation to let no fit opportunity pass without raising a 
w r arning voice. This pernicious habit, which is so common that we 
need not describe it, we are loth to say, but must in deference to 
truth, is by no means confined to boys; girls also indulge in it, 
though, it is to be hoped, to a less fearful extent than boys, at least in 
this country. A Russian physician, quoted by an eminent medical 
professor in New York, stated in our hearing that the habit is uni¬ 
versal among girls in Russia. It seems impossible that such a state¬ 
ment should be true; and yet we have not seen it contradicted. It 
is more than probable that the practice is far more nearly universal 
everywhere than even medical men are willing to admit. Many 
young men who have been addicted to the vice, have, in their confes¬ 
sions, declared that they found it universal in the schools in which 
they learned the practice. 

Parents who have no suspicion of the evil, who think their chil¬ 
dren the embodiment of purity, will find by careful observation and 
inquiry,—though personal testimony cannot be relied upon,—that in 
numerous instances their supposed virtuous children are old in cor¬ 
ruption. Such a revelation has brought dismay into many a family, 
only too late in some cases. Said a wealthy and intelligent lady in 
whose hands our work entitled “ Plain Facts for Old and Young” was 
placed by an agent, “ Oh, if I had only seen this work ten years ago 
my poor boy might have been saved ! ” She was the mother of a large 
family of sons and daughters, most of whom were remarkably bright 
and intelligent. But one had fallen a victim to this awful vice, and 
was then in an insane asylum, his mind a hopeless wreck, in conse¬ 
quence. 

The causes of this vice are numerous, including all which tend to 

7 O 

produce sexual precocity, and those which have been enumerated as 
leading to unchastity. These we need not recapitulate; we would, 
however, mention one cause which in our opinion is, more than all 
others, the exciting agent in the propagation of the vice; viz.,— 

Evil Associations. —The influence of evil companionship is one 
of the most powerful agents for evil against which those who love 
purity and are seeking to elevate and benefit their fellow-men have 


SECRET VICE. 


339 


to contend. A bad boy can do more harm in a community than can 
be counteracted by all the clergymen, Sabbath-school teachers, tract- 
distributers, and other Christian workers combined. An evil boy is a 
pest, compared with which the cholera, small-pox, and even the 
plague, are nothing. The damage which would be done by a terrific 
hurricane sweeping with destructive force through a thickly settled 
district is insignificant compared with the evil work which may be 
accomplished by one vicious lad. 

No community is free from these vipers, these agents of the arch¬ 
fiend. Every school, no matter how select it may be, contains a 
greater or less number of these young moral lepers. Often they pur¬ 
sue their work unsuspected by the good and pure, who do not dream 
of the vileness pent up in the young brains which have not yet 
learned the multiplication table, and scarcely learned to read. We 
have known instances in which a boy of seven or eight years of age 
has implanted the venom of vice in the hearts and minds of half a 
score of pure-minded lads within a few days of his first association 
with them. This vice spreads like wild-fire. It is more “ catching ” 
than the most contagious disease, and more tenacious, when once im¬ 
planted, than the leprosy. 

Boys are easily influenced either for right or for wrong, but espe¬ 
cially for the wrong; hence it is the duty of parents to select good 
companions for their children, and it is the duty of children to avoid 
bad company as they would avoid carrion or the most loathsome ob¬ 
ject. A boy with a match-box in a powder-magazine would be in no 
greater danger than in the company of most of the lads who attend 
our public schools and play upon the streets. It is astonishing how 
early children, especially boys, will sometimes learn the hideous, 
shameless tricks of vice which yearly lead thousands down to ever¬ 
lasting death. Often children begin their course of sin while yet 
cradled in their mother’s arms, thus early taught by some vile nurse. 

It were better for a boy never to see or associate with a lad of his 
own age than to run any risk of being corrupted before he is old 
enough to appreciate the terrible enormity of sin and the awful con¬ 
sequences of transgression. It should be recollected also that not only 
young boys but vicious youths and young men are frequently the in¬ 
structors in vice. It is unsafe to trust any but those who are known 
to be pure. But the difficulties of knowing who is to be trusted are 
so great that the only real safety is in beginning at a very early age 


SCO 


ANATOMY, PHYSIOLOGY, AND HYGIENE. 


to fortify the minds of the little ones against the danger by admoni¬ 
tions and instruction suited to their age and understanding. 

The Evil Underestimated. —While there have been those who have 
exaggerated the consequences of secret vice for nefarious purposes there 
is another class of physicians who take the opposite extreme, declaring 
that its effects are slight, and often not felt at all. We are at something 
of a loss to decide which class lias done the most harm, the quacks who 
have basely excited fears beyond what the facts would warrant, for their 
own selfish advantage, or the medical gentlemen—most of them quite 
eminent in the profession—who, by declaring the vice to be harmless, 
have encouraged its propagation. We have no part with either class. 
The consequences which we have seen in our own experience, having 
had scores of the victims under our professional care, are sufficiently ter¬ 
rible to warrant us in raising a warning cry which we would gladly 
make loud enough to reach the ears of every child and youth in Amer¬ 
ica. The vice is an exterminating one. It ruins more lives than all 
other sexual vices together, because the most prevalent. 

We have not space here to dwell at length upon its symptoms and 
treatment, and need not do so, as we have discussed the subject at length 
elsewhere. 


FOOD AND DIET. 


A\ e need not dwell upon the importance of this department of 
hygiene, as there can be no doubt that this subject is one of the most 
important of all which relate to the physical welfare of human beings. 
Since the human body is made of what is received into it in the form of 
food, it is evident that the character of a person’s food will determine 
his own character. Experiments have again and again proved this to 
be true of animals, and it can be no less true of human beings. A few 
facts bearing on this point may not be without interest to the general 
reader. 

It has been found that the bones of hogs fed on food which had been 
colored with madder, a peculiar coloring matter, were stained the same 
color. 

When herbivorous animals are fed on animal food their flesh ac¬ 
quires an unpleasant and unpalatable flavor. 

M. Monclar, a French agriculturist, has been experimenting upon 
this subject, and finds that he can flavor the flesh of animals at pleasure 
by feeding them upon various kinds of food and employing a variety of 
strong flavoring substances. He was led to investigate the subject by 
the observation that hares killed in a wormwood field, and eggs laid by 
hens which had eaten diseased silk-worms, had such a nauseous taste that 
no one could eat them. These facts accord well with an account which 
we published some years ago of the poisoning of a family by eating- 
chickens which had fed upon potato bugs. A few years ago, also, a 
case was reported in which a family in Ohio were poisoned, some per¬ 
sons fatally, by eating chickens which had feasted upon the carcass of a 
cow that died of milk sickness. 

Hr. Parkes, the eminent English writer on hygiene, mentions the 
fact that a regiment of soldiers under his care were attacked by diarrhea 
in consequence of eating pork which had been fed on garbage. 

Plenty of instances might be cited to show that thousands of infants 
have lost their lives in consequence of eating the milk of cows fed on 
swill or distillery slops. 


361 



362 


FOOD AND DIET. 


Numerous other evidences might be given on this point, but these 
are sufficient. 

Definition of Food. —The numerous definitions of food which 
have been framed at different times and by different persons, too often, 
we have reason to fear, have been made to fit some pet hobby or pre¬ 
conceived notion. We offer the following as being the most nearly in 
accordance with what is known of the relation of various substances 
called foods to the human system : Foods are those substances which 
when introduced into the system are capable of supplying the loss oc¬ 
casioned by the natural wastes of the body. When considered in its 
broadest sense, the term food includes all liquids and gases as well as 
solids capable of supplying the needs of the body resulting from the 
wear and tear of the system. We shall consider under this head, 
however, only solids and liquids, or what are usually termed food and 
drink. 

Classification of Foods. —For our purpose, food may be simply 
classified as follows :— 

1. Albuminous, or nitrogenous. 

2. Farinaceous and saccharine. 

3. Oleaginous, or fatty. 

4. Inorganic. 

Albuminous Elements. —An example of nearly pure albumen is 
found in the white of egg. This may be considered as a type of the 
whole class of albuminous or nitrogenous food elements, a great va¬ 
riety of which are found in both the animal and the vegetable king¬ 
dom. In wheat, this class is represented by gluten; in oatmeal, by 
vegetable albumen; in peas, beans, and other leguminous seeds, by 
vegetable caseine. In animal foods we have the albumen of eggs, al¬ 
bumen and fibrine of the blood, and more or less in most animal tis¬ 
sues ; the caseine of milk; etc. All elements of this class sustain es¬ 
sentially the same relation to the system and to the organs of digestion, 
so that no discrimination need be made between them here. As a 
class, when digested and formed into blood, they serve to nourish the 
living or most highly vitalized tissues of the body, as the muscles, 
brain, nerves, glands, and other active organs. Associated with the 
albuminous elements are the various salts which nourish the bones 
and also enter into the composition of a few of the other tissues. 

The experiments of Dr. Austin Flint upon the pedestrian Weston, 
as well as the experiments of Prof. Liebig, Subbotin, and many other 


STARCH AND SUGAR. 


303 


distinguished physiologists, show very clearly that the nitrogenous 
elements are the chief supporters of vital activity, muscular and nerv¬ 
ous effort, etc., and that food can only support vital action or give 
rise to force by being assimilated into living tissue. 

Starch and Sugar,—The farinaceous and saccharine class includes 
all varieties of starch and sugar. All vegetables and grains, and most 
fruits, contain starch. In some cases, as in most grains and in such 
vegetables as potatoes, turnips, and most other fleshy roots and tubers, 
starch is the most abundant element, often constituting as large a pro¬ 
portion as two-thirds or three-fourths of the whole bulk or weight of 
the article of food. Each particular vegetable, grain, or fruit has its 
own peculiar variety of starch ; 
but the difference is chiefly in the 
form and size of the separate par¬ 
ticles or granules. The only ex¬ 
ception to this statement is that 
the starch of vegetables is, in gen¬ 
eral, less easy of digestion than 
that of grains. 

In its raw state, each little par¬ 
ticle or granule of starch (Fig. 

140) is inclosed in an envelope, 
which protects it from the action 
of water, rendering it insoluble. 

By the process of cooking, and in fruits by the ripening process, this 
envelope is dissolved or ruptured, and the homogeneous contents of 
the granules are thus rendered soluble, a change which is necessary 
before digestion can take place. 

There are several varieties of sugar, which differ among themselves 
much more than do the several varieties of starch. The most common 
variety is cane-sugar, which is chiefly manufactured from the different 
varieties of sugar-cane, although it is also made from the juice of the 
sugar beet and from the sap of the maple-tree. It is found, also, in 
considerable quantities, in the date and in a few other fruits. Cane- 
sugar is the sweetest of all the sugars. 

Grape-sugar, or glucose , is the name of the variety of sugar which is 
most abundant in nature, being found in grapes and many other fruits. 
It is the most easily digestible of the various sugars, requiring, in fact, 
no digestion, being absorbed, without further change, aloug v\ ith the 

CD ' CD 



FOOD AND DIET. 


304 

glucose produced by digestion, since this is one of the products of the 
digestion of starch, as will be seen presently. The saccharine ingre¬ 
dient of milk is known as milk-sugar, or lactose. It is much less 
sweet than the other varieties of sugar, but possesses the same general 
properties. 

The close relation between starch and sugar is seen by the fact 
that in the plant one element is derived from the other. The starch 
of grains, of the potato, of nearly all seeds, in fact, is in the process of 
germination converted into sugar, when it becomes nourishment for the 
growing plant. The rapid growth of new leaves formed by the ma¬ 
ple and other trees in the spring is through the production of sugar 
from the starch stored up in the roots of the tree in the fall. In the 
spring, the vital processes of the plant convert this insoluble starch 
into soluble sugar, and by its ascent with the sap, the astonishingly 
rapid growth often noted in the spring is effected. By tapping the 
tree at this period, as is done in the case of the maple, a portion of the 
sap may be abstracted, and by its condensation, maple sugar is made. 

It is possible for the chemist to imitate nature in a limited 
degree in this sugar-making process, since, as is well known, starch 
may be converted into glucose, or grape-sugar, by purely chemical 
processes. It is even possible for the chemist to produce sugar out of 
woody fibre, as from paper, straw, cotton cloth, or sawdust, the struct¬ 
ures which are formed in the plant by the assimilation of starch or 
sugar. Being originally formed from sugar, the chemist is able to> 
bring it back to its original condition again, though not in a state in 
which it can be utilized as food by the human system. This close re¬ 
lation of starch and sugar places them in the same class, although they 
are treated somewhat differently by the organs of digestion, and can 
by no means be taken interchangeably as food for reasons which will 
appear when we have considered at length the mode of digestion of 
these two alimentary elements. 

The principal nutritive value of this class of foods, like that of the 
class of fatty elements, is to supply material for the support of ani¬ 
mal heat. Just how the changes necessary to the evolution of heat 
are effected, is not fully understood; but it is well established that 
such changes do occur. 

Fats.—Little need be said on this subject, as every one is familiar 
with the various fats which usually enter into the composition of food. 
Butter, lard, and suet are the principal animal fats. Most of the 


INORGANIC ELEMENTS. 


365 


grains, some vegetables, a few fruits, and especially nuts, contain vari¬ 
ous vegetable oils; but the elements of the different varieties of ani¬ 
mal and vegetable fats are essentially the same, the three fatty ele¬ 
ments, oleine, margarine, and stearine, differing chiefly in consistency 
at ordinary temperatures. The differences in the various fats and 
oils are principally due to the different proportions in which these 
various elements are combined. 

Fats are insoluble in water, but dissolve readily in alcohol, and in 
oils. In mucilaginous and alkaline fluids they are divided into very 
minute particles, forming what is termed an emulsion, in which form 
they exist in milk, which is an alkaline fluid. Being lighter than the 




141. Milk Globules. 

other constituents of milk they naturally rise to the surface, forming 
the cream. By the process of churning, the separate particles are 
made to unite, thus producing butter. In Fig. 141 may be seen the 
appearance of healthy milk when viewed by a microscope of good 
magnifying powers. 

In animal tissues, fats are found in the form of cells, as shown in 
Fig. 142. Each cell has a wall of connective tissue which retains its 
contents until digested by the gastric juice. In vegetable produc¬ 
tions the fatty elements are closely associated with the albuminous 
and inorganic, a fact which furnishes an additional argument in favor 
of the use of oatmeal, and the unbolted meal of other grains. 

Like the farinaceous and saccharine elements of food, the fatty 
elements are chiefly useful for the support of animal heat, although a 
few other uses are assigned to them. 

It should be remarked in this connection that saccharine and 
farinaceous substances are included in what is called the carbonaceous 
class of food elements, this class being so named because the sub- 








3GG 


FOOD AND DIET. 


stances included in it contain a large proportion of carbon and no ni¬ 
trogen, by which they are distinguished from albuminous elements. 

Inorganic Elements. —In addition to the three classes of ele¬ 
ments named above, the chemist finds, upon making a chemical analy¬ 
sis of foods, certain salts, the chief of which are phosphates and car¬ 
bonates of potash, soda, and lime, and chlorides of potash and soda. 
These elements cannot be extracted from foods by a simple mechan¬ 
ical process, as can starch, sugar, gluten, and the other elements- 
named, but are only found upon destruction of the food substance. 
The most careful microscopical examination of the various food sub¬ 
stances does not reveal the presence of any of these elements in an in¬ 
organic state. There is good reason for believing that they are in an 
organic or partly organized state as they exist in food substances. 
Similar investigations show that the so-called inorganic elements exist- 
in this state in the animal tissues, even in the bones, which contain 
the largest proportion of this kind of matter of any of the tissues. 

The principle was established long ago that animals cannot or¬ 
ganize or vitalize matter, but simply possess the power to appropriate 
nourishment in the form of substance which has been already vital¬ 
ized by the vegetable kingdom. 

In addition to the elements already mentioned under this head, all 
vegetable foods contain a certain proportion of innutritions matter 
which constitutes the framework of the tissue, being of a woody char¬ 
acter. Vegetable cells of all sorts contain more or less of this woody 
material, or cellulose, in their composition. Most animal foods also 
contain more or less indigestible elements. 

Although wholly indigestible in character, and so not directly nu¬ 
tritious, these elements of food are really very useful; first, in giving 
the required bulk to the food ; and, second, in producing the mechan¬ 
ical irritation necessary to excite proper secretion and muscular action 
to carry on the digestive process. Thus they become a very impor¬ 
tant accessory to digestion and nutrition. It is partly on this account 
that oatmeal, wheat meal, or graham flour, and other whole-grain 
products, are so much to be preferred above the superfine flour which 
millers take pride in producing of the utmost possible fineness and 
whiteness. 

Superfine flour is distinctly a modern invention. The ancients used 
unbolted meal altogether, the present disease-producing devices known 
as bolting machines being then not in use. Indeed, many nations at the 


STRUCTURE OF WHEAT. 


367 


present day, as the Germans, Scandinavians, and, in fact, most nations, 
with the exception of the French, English, and American nations, still 
adhere, substantially, to the ancient custom in this regard. No doubt 
the hardihood of the native German peasant is in great part justly at¬ 
tributable to the highly nourishing qualities of his “ black bread.” 

The “ New Process ” 
dour now manufactured 
is much superior to that 
of superfine character, 
as it contains a much 
larger proportion of the 
elements especially cal¬ 
culated to nourish the 
brain and nerves and to 
support the vigor and vitality of the body. 

It may be interesting in this connection to give a little attention to 
the structure of a kernel of grain, by studying the accompanying cuts, 
taking the wheat as a type of all the grains. 

Fig. 143 shows a grain of wheat greatly magnified, the rough, 
hairy character of the surface being made very apparent. 

In Fig. 144 is seen half of a grain which has been subjected to a 
process for removing the rough external covering of the grain. 




Fig-. 143. 

nified. 


Grain of Wheat mag 


Fig:. 144. Grain 
of Wheat with Husk 
removed. 



Fig-. 145. Transverse Section of Grain of Wheat. 



Fig. 146. Same as Fig. 143, more 
highly magnified. 


Fig. 145 is a magnified section of the central portion of a grain, 
showing; the internal cellular structure of the grain. 

o o 

Fig. 146 represents a small portion of a similar section more highly 
magnified, showing the various layers of the grain with great distinct- 

























368 


FOOD AND DIET. 



Pig 1 . 147. Same as Fig. 145. Very highly 
magnified. 



Fig. i48. This eut shows the General Struct- 
ure of t ie Grain of Wheat. 


ness. a. Represents the outer, 
woody layer, or bran; b. The 
layer just beneath, which con¬ 
tains more or less woody matter 
and is very rich in nitrogenous 
matter, the “ salts,” and, in some 
grains, with fatty matters; c. 
and d. Other cellular layers cov¬ 
ering the central portion of the 
grain, rich in albuminous ele¬ 
ments ; e. f. g. The central or 
starchy portion of the grain, 
which is the chief constituent of 
superfine flour. 

Fig. 147 show’s all of these 
layers much more greatly mag¬ 
nified. 

Fig. 148. This cut shows the 
several layers of cells 'which 
compose the grain of wheat. All 
but the outermost of these con¬ 
tain in abundance the most im¬ 
portant of all the vegetable food 
products. We are indebted for 
the use of these cuts to the court¬ 
esy of the Franklin Mills Co., of 
Lockport, N. Y., by whom they 
were made, to illustrate the ad¬ 
vantages of their flour made from 
the entire wheat by a process 
which retains all its nutritive 
properties in a form the most 
easy of digestion. 


Food Elements not Food. —By means of numerous experiments 
at the expense of numberless dogs, rabbits, pigeons, cats, and other 
animals, it has been clearly demonstrated that while the various ele¬ 
ments mentioned are food elements, they are not in themselves food, 
either when taken alone or "when artificially mixed. Dogs fed on al¬ 
bumen, fibrine, or gelatine,—the constituents of muscle,—died in about 
























FOOD SUBSTANCES. 


3G9 


a month. The same result followed when they were fed on the con¬ 
stituents of muscle artificially mixed. A goose fed on the white of 
egg died in twenty-six days. A duck fed on butter starved to death 
in three weeks, with the butter exuding from every part of its body, 
its feathers being saturated with fat. Dogs fed on oil, gum, and 
sugar, died in four to five weeks. A goose fed on gum died in sixteen 
days; one fed on sugar, in twenty-one days; two that had only 
starch lived twenty-four and twenty-seven days. Dogs fed on white, 
fine-flour bread lived but fifty days. Dogs fed on brown military 
bread made of the whole grain were maintained in perfect health. 
Dogs fed on the so-called inorganic elements, the salts which are ex¬ 
tracted from flesh, died sooner than those which had nothing at all. 

Food Substances. —The various substances, used for food are 
classified, first, as animal and vegetable. The first class includes the 
flesh of animals of all kinds; for every one of the various classes of 
the animal kingdom, from highest to lowest, has been drawn upon to 
contribute to the sustenance or to gratify the palate of human beings. 
Eltlts and milk are included in this class. The second class also 
includes a great variety of productions, all parts of plants of one 
species or another contributing to the food of man. 

Vegetable food is rather imperfectly classified into fruits, grains, 
?/nd vegetables. This division is quite faulty, as neither of the classes 
properly includes nuts or such seeds as peas and beans. Vegetables 
include all other parts of plants used as food with the exception 
of the seed portions. Pumpkins, squashes, cucumbers, melons, and 
similar foods usually called vegetables, are really fruits. 

The following table shows the proportion of solid matter, chiefly 
nutriment, contained in one hundred parts of some of the more com¬ 
mon substances employed as food; the table is arranged from Leth- 
eby’s and Smith’s works on food, and gives the results of the most 
recent examinations of the several articles named in the list. 


24 


370 


FOOD AND DIET. 


Table of Nutritive Values of Various Articles of Food. 


ARTICLES. 

Water. 

Albumen, 

Etc. 

Starch. 

Sugar. 

Fat. 

Salts. 

Total 

Nutritive 

Elements. 

Bread. 

37 

8.1 

47.4 

3.6 

1.6 

2.3 

63 

Wheat Flour.. 

15 

10.8 

66.3 

4.2 

2 

1.7 

85 

Barley Meal... 

15 

6.3 

69.4 

4.9 

2.4 

2 

83 

Oatmeal. 

15 

12.6 

58.4 

5.4 

5.6 

3 

85 

Bye Meal. 

15 

8 

69.5 

3.7 

2 

1.8 

85 

Indian MtaL .. 

14 

11.1 

64.7 

0.4 

8.1 

1.7 

85 

Bice. 

13 

6.3 

79.1 

0.4 

0.7 

0.5 

87 

Peas. 

15 

23 

55.4 

2 

2.1 

2.5 

85 

Beans. 

15 

23 

55.4 

2 

2.1 

2.5 

85 

Lentils. 

• . 

.... 





77 

Arrowroot.... 

18 

.... 

82 




82 

Potato. 

75 

2.1 

18.8 

3.2 

0.2 

0.7 

25 

Sweet-Potato.. 

68 

1.5 

17.3 

10 

0.3 

2.9 

32 

Carrot. 

83 

1.3 

8.4 

6.1 

0.2 

1 

17 

Beet. 

83.5 

1.5 

0.8 

10.5 


3.7 

16.5 

Parsnip. 

82 

1.1 

9.6 

5.8 

0.5 

1 

18 

Cabbage. 

.... 

. . . . 





5.6 

Turnip. 

91 

1.2 

5.1 

2.1 


0.6 

9 

Sugar. 

5 

.... 


95 



95 

Treacle. 

23 



77 



i ( 

New Milk. 

86 

4.1 


5.2 

3.9 

0.8 

14 

Cream. 

66 

2.7 


2.8 

26.7 

1.8 

34 

Skim-Milk .... 

88 

4 


5.4 

1.8 

0.8 

12 

Buttermilk .... 

88 

4.1 


6.4 

0.7 

0.8 

12 

Lean Beef. 

72 

19.3 



3.6 

5.1 

28 

Lean Mutton.. 

72 

18.3 



4.9 

4.8 

28 

Yeal. 

63 

16.5 



15.8 

4.7 

37 

Poultry. 

74 

21 



3.8 

1.2 

26 

White-Fish.... 

78 

18.1 



2.9 

1 

22 

Salmon. 

77 

16.1 



5.5 

1.4 

23 

Entire Egg. 

74 

14 



10.5 

1.5 

26 

W hite of Egg.. 

78 

20.4 




1.6 

22 

Volk of Egg. .. 

52 

16 



30.7 

1.3 

48 

Bread-Fruit.. . 

80 






20 

Banana . 

73 






27 

Date. 

33 

9 


58 

.... 


67 




ACID. 





Grape. 

79.8 

1.7 

1.1 

13.8 

0.5 

0.5 

17.6 

Apple. 

82 

8 

0.8 

6.5 


0.4 

15.7 

Pear. 

85 

4.6 

• > • • 

7.9 


0.3 

12.8 

Peach. 

85 

0.5 

0.6 

1.6 


0.4 

3.1 

Plum. 

81 

0.5 

1 

3 


0.3 

4.8 

Mul berry. 

84.7 

0.4 

1.8 

9.2 


0.7 

12.1 

Blackberry.... 

86 

0.5 

1.2 

4.4 


0.4 

6.5 

Cherry. 

80.5 

2.7 

1.3 

8.7 


0.6 

13.3 

Apricot. 

82 

0.4 

0.7 

1.5 


0.8 

3.4 

Gooseberry... . 

85 

0.4 

1.6 

8.2 


0.5 

10.7 

Strawberry. ... 

87.5 

0.5 

1.1 

7.5 


0.6 

9.7 

Strawb’y (wild) 

87 

0.6 

1.3 

4.6 


0.6 

7.1 

Baspb’y (wild) 

84 

1.6 

0.2 

3.6 


0.3 

5.7 

Baspberry .... 

86.5 

2.3 

1.3 

4.7 


0.5 

8.8 

Currant. 

85 

0.5 

1.8 

6.4 

.... 

0.6 

9.3 






































































PROPORTION OF FOOD ELEMENTS. 


371 


In the foregoing table only the nutritive elements are given. In a 
few instances the proportions given will not aggregate one hundred 
parts, as the innutritions elements are left out. 

Proper Proportion of the Tarions Elements.— It will be ob¬ 
served by reference to the table of nutritive values that the proportion 
of the various elements varies considerably. Experiments upon both 
animals and human beings show that it is of great importance that 
the proportion of elements should be such as will best meet the demands 
of the system, especially in the case of the albuminous and carbonaceous 
elements (gluten, albumen, fats, starch, and sugar). Many and extended 
experiments and observations have shown that the proper proportion 
is about one part of nitrogenous or albuminous elements to seven 
parts of carbonaceous elements. From this it will at once appear that 
most articles of food are deficient in one or the other of these classes 
of elements, requiring that they be supplemented by other substances 
eaten with them. The following table shows the proportion of car¬ 
bonaceous elements to one of the albuminous in some of the more 
common articles of food, by the use of which any one will be able to 
combine various articles of food in such a manner as to secure just the 
right proportion of nutritive elements :— 


PROPORTION OF NITROGENOUS TO CARBONACEOUS 
ELEMENTS IN VARIOUS FOODS. 


Lean Beef, 

ALBUM.OR CARBONA- 
NITROG. CEOUS. 

1 .5 

ALBUM.OR CARBONA- 

NITROG. CEOUS. 

Wheat Meal or 

Eggs, 

i 

1.0 

Bread, 

1 

7.0 

Peas, 

i 

. 2.7 

Indian Meal, 

1 

7.7 

Beans, 

i 

2.7 

Rye Meal, 

1 

9.8 

Lentils, 

i 

2.4 

Potatoes, 

1 

10.7 

Milk, 

i 

3.6 

Carrots, 

1 

11.5 

Fat Beef, 

i 

5.0 

Barley Meal 

1 

12.7 

Oatmeal, 

i 

6.1 

Rice, 

1 

13.0 

By the above table it 

will be seen that wheat meal 

is the food which 

all single 

substances 

the most 

perfectly meets 

the 

requirements 


of the system, containing exactly seven parts of the carbonaceous ele¬ 
ments to one of the albuminous. 

Beef and eggs are deficient in the carbonaceous elements. Potatoes 
and most other vegetables, and rice, are deficient in albuminous ele¬ 
ments. Oatmeal has an excess of the albuminous elements. By com- 



372 


FOOD AND DIET. 


binina' food substances which are deficient in one class of elements with 
those in which the same class is in superabundant proportion, the two 
classes of elements may be furnished to the system in j ust the right pro¬ 
portion. For instance, lean beef, eggs, peas, beans, milk, or oatmeal, 
may be used with potatoes, rice, or other foods deficient in albuminous 
elements. It is for this reason that the Irish or Scotch laborer by in¬ 
stinct combines with his potatoes oatmeal porridge or buttermilk. 

For the convenience of the reader who may not wish to take the 
trouble to figure out the proper proportions of different foods necessary 
to furnish just the right amount of the albuminous elements, we have 
constructed the following table of combinations, which is sufficiently ac¬ 
curate for practical purposes (we have purposely omitted small fractions), 
and will be perfectly safe to follow, as we have taken care to have the 
albuminous, the most important element, in slight excess:— 


TABLE OF COMBINED FOODS. 





oz. 




LB. 

OZ. 

Combine 



8* 


Lean Beef, . . . 

... With 

4 

8 

66 



n 


66 

66 

1 

8 

66 



H 


66 

66 

1 

8 

66 



12 


Eggs, 

66 

1 

6 

66 



9 


66 

6 6 

5 

2 

66 



3 

pts 

, Milk, 

66 

1 


66 



91 

66 

66 

66 

4 

4 

66 



*71 

i w 

oz. 

Peas, 

6 6 

1 

4 

66 



6 

66 

66 

66 

5 


66 

1 

lb. 

5 

66 

Oatmeal, 

66 


5 

66 

1 

66 

4 

66 

66 

66 

1 

11 

66 

1 

66 

4 

66 

66 

66 


5 

66 



15 

66 

66 

66 


10 


Potatoes. 

Rice. 

Indian Meal. 

Rice. 

Potatoes. 

Rice. 

Potatoes. 

Rice. 

Potatoes. 

Rice. 

Potatoes. 

Rye Meal. 

Indian Meal. 


The quantity of each kind of food given in the above table, when 
added to that of the food substance given on the same line hi the oppo¬ 
site column, makes just the quantity necessary to sustain life well for 
one day. Persons engaged in very active labor of course need more food 
than others, and the amounts may be increased accordingly, the same 
proportion being always preserved. 

It may be observed that it is not necessary to combine flesh with 
vegetable food in order to secure the proper proportion of the nitroge¬ 
nous and carbonaceous elements, since there are several vegetable foods 
which contain the albuminous elements in excess, which is also the case 















COMBINED FOODS. 


373 


with eggs and milk. For example, three pints of milk and one pound 
of rice make as perfect a combination, so far as the proportion of ele¬ 
ments is concerned, as seven and a half ounces of lean beef and a pound 
and a half of rice. Seven and one-half ounces of peas and a pound and 
a quarter of rice is an equally perfect combination of food elements, 
which may also be said of one pound five ounces of oatmeal and five 
ounces of rice ; one and a quarter pounds of oatmeal and one pound and 
eleven ounces of potatoes ; the same quantity of oatmeal and five ounces 
of rye meal; or fifteen ounces of oatmeal and ten ounces of Indian meal. 

Bread is not included in the list of combinations, because it is a per¬ 
fect food by itself, and hence does not need to be combined with other 
foods, except for variety. This remark applies, of course, only to wheat- 
meal or graham bread. White or fine-flour bread is very deficient in 
albuminous elements. 

Another advantage in combining various foods is to be found in 
avoiding too great bulk in the case of vegetable foods, and too great 
concentration in the case of some animal foods. This will be readily ap¬ 
parent when it is observed how great quantities of some single food sub¬ 
stances are necessary to supply the system with the proper quantity of 


nitrogenous elements, 

when eaten 

alone, as shown 

by the follow 

table:— 




AMOUNT OF VARIOUS FOODS 

NECESSARY TO 

FURNISH T1 

PROPER DAILY 

AMOUNT OF NITROGENOUS 

ELEMENTS. 


OUNCES. 


POUNDS 

Lean Meat, 

15. G 

Grapes, 

11.0 

Eggs, 

21.2 

Apples, 

2.5 

Peas, 

11.2 

Peaches, 

oh- - 
0< .0 

Oatmeal, 

23. G 

Plums, 

37.5 

Baker’s Bread, 

3G.7 

Cherries, 

7.0 

Wheat Flour (fine), 

27.5 

Carrots, 

14.2 

Graham Flour, 

25.5 

Turnips, 

15.4 

Indian Meal, 

2G.8 

Cabbage, 

15.4 

Rye Meal, 

37.1 

Parsnips, 

1G.9 


POUNDS. 


PINTS. 

Rice, 

3.0 

Milk, 

4.5 

Potatoes, 

8.8 

Beer, 

185.0 


By reference to the preceding tables any one will be able to so com¬ 
bine various articles of food as to secure the proper amount of nitrog¬ 
enous matter without overloading the digestive organs, and yet give 


I 



374 


FOOD AND DIET. 


to the food the bulk necessary for good digestion. Evidently, it would 
overtax the stomach to digest turnips in sufficient quantities to supply 
the wants of the body, while lean meat would afford an insufficient 
amount of bulk, as well as being deficient in carbonaceous matter. 

Popular Errors Relating to Diet.— Probably there is no sub¬ 
ject of importance relating to individual hygiene concerning which 
there are more erroneous notions entertained than respecting the 
matter of diet. How these errors have arisen, it is not in all cases 
possible to discover; but in many cases it is too evident that the med¬ 
ical profession are responsible in a very great degree. Many times 
physicians do not take sufficient care to post themselves on the sub¬ 
ject of diet so as to be able to advise their patients wisely. The sub¬ 
ject receives far too little attention in our colleges; and what little 
instruction is given in school physiologies and popular magazines is so 
mixed with error as to be practically useless. We will call attention 
to a few of these popular errors in as concise a manner as possible. 

1. It is an error to suppose that the appetite is always a correct 
criterion of the quality and quantity of food. 

This is a widely prevalent error, and some very distinguished phy¬ 
sicians have given it countenance and indorsement by saying to pa¬ 
tients, when asked for a diet prescription, “ Eat whatever and when¬ 
ever you have a mind to.” No advice could be more mischievous. It 
virtually assumes either that there is no relation between diet and 
health, that it makes no difference what a person eats, or that the 
appetite is an infallible guide, both of which suppositions are palpably 
false. If all appetites were natural appetites, if there were no such 
thing as depraved taste, then might the appetite be relied upon; but 
in the present state of things among civilized human beings scarcely 
one person in a hundred has a perfectly normal taste and appetite, if 
the number be not even smaller. The appetite is to some degree a 
guide, but it must be controlled and governed by common sense, by a 
knowledge of the laws of digestion and the relation of alimentary sub¬ 
stances to the stomach and the system. 

Either extreme on this point is bad. The appetite must not be 
ignored, and it must not be blindly followed unless it is known to 
be normal in its inclinations. It would be just as proper to advise a 
person to speak anything that comes into his mind, to do everything 
for which he has an inclination, and to thus follow implicitly all the 
promptings of his various organs, as to tell him to eat everything 
which he feels disposed to. 


POPULAR ERRORS IN DIET. 


375 


2. It is an error to suppose that sick persons whose appetites are 
poor should he tempted to eat by means of tidbits and dainties. 

Nothing is more common than for sick persons to be besieged with 
such unwholesome substances as preserves, rich jellies and sauces, pies, 
cakes, confectionery, etc. About as soon as a person is taken sick, in 
some communities, the neighbors begin to show their sympathy by 
contributions of all sorts of unwholesome and indigestible viands, and 
the invalid, whose stomach may be unable to digest any but the very 
simplest food, becomes a victim to the kindness of friends. Many 
times have the best efforts of the intelligent physician been baffled in 
this manner. “ Killed by kindness ” of this sort might be written on 
many a tombstone. The general belief that these things are essential 
for the sick when confessedly bad for the well is forcibly illustrated 
by the story concerning the old gentleman who arrived home late at 
night and not finding any pie in the cupboard awoke his wife with 
the exclamation, “ Why, what would you do if some one should be 
sick in the night! ” Every physician ought to look carefully after 
this matter whenever he has a patient in charge, and the absurdity of 
the custom should be thoroughly exposed. The want of appetite in 
sick people, especially fever patients, is usually an indication that the 
stomach is not in a condition to digest food, if it is received, and only 
the most digestible should be given, and that in small quantities. 

3. It is an error to suppose that children especially need large 
quantities of fat and sugar. 

The opinion has been gaining ground, of late, that fat and sugar are 
preventives of consumption when fed to children so as to increase their 
fat. From some considerable observation on the subject we are decid¬ 
edly of the opinion that the practice is a bad one and the theory upon 
which it is based wholly erroneous. These substances are themselves 
difficult of digestion (this is especially true of fat), and hinder the diges¬ 
tion of food, thus producing dyspepsia, which causes decay of the teeth 
and doubtless an equally marked deterioration hi other parts of the sys¬ 
tem. The notion that the appetite for sugar is a natural one is shown 
to be false by the fact stated by Dr. Anthony Carlisle, the Arctic trav¬ 
eler. According to Mr. Carlisle, the little folks in the vicinity of the 
North Pole are not fond of sweets. He says that when sugar was 
placed in their mouths they made wry faces and sputtered it out with 
disgust. There is no evidence whatever that it “preserves the teeth, 

“ aids digestion,” “ promotes growth,” or “ prevents consumption, as 
many persons believe. 


376 


FOOD AND DIET. 


4. It is an error to suppose that many varieties of food are essen¬ 
tial to good digestion or nutrition. 

The common sense of most people who suffer with weak digestion 
has tauo-ht them that one or two kinds of food at a meal are much more 

O 

easily digested than a larger variety, notwithstanding the erroneous 
teaching of some popular authors on this subject. It is true that the ap¬ 
petite sometimes refuses food when its use is long continued without 
change; but the variety should be obtained by employing different 
foods or dishes at different meals rather than at the same meal. There is 
no doubt that dyspepsia is not infrequently the result of the indiscrim¬ 
inate gormandizing in which people indulge whose chief aim in eating 
is to gratifj' the palate. 

5. It is a very great error to suppose that brain-workers, students, 
clergymen, lawyers, and other persons whose vocation is largely sed¬ 
entary, require but little food. 

The very opposite is true. A brain-worker uses up as much blood 
in three hours of intense labor as the muscle-worker in ten hours of or¬ 
dinary toil. Brain-workers should be well fed, but they must not be 
overfed. Many of the cases of apoplexy in professional men, set down 
to overwork, are really attributable to overeating. A brain-worker 
needs as much food and as nutritious food as a muscle-worker, but he is 
compelled to be more careful in its selection, and cannot exceed with im¬ 
punity the limits of his actual needs. This point is often neglected with 
reference to school-children, especially girls, who are not infrequently al¬ 
lowed to make the attempt to live and study hard on a slice or two of 
white bread and a cup of coffee for breakfast, bread and butter and pickles 
for dinner, and a morsel chiefly made up of “ dessert ” at night, when din¬ 
ner is taken at six, as in many of the large cities. In many female board¬ 
ing-schools the dietary is neglected, an insufficient amount of nourishing 
elements being furnished to support the vigorous mental effort required 
of students. Under such a regimen it is no wonder that many young 
women break down just when they ought to be enjoying the highest de¬ 
gree of health and strength. We are thoroughly convinced that a much 
larger share of the breakdowns among students, male as well as female, 
is due to poor feeding than to overstudy. 

6. It is an error to suppose that fish or any other single article of 
diet is brain food, muscle food, or food for any particular part of the 
system. 

A few years ago a celebrated scientist made the casual suggestion 


POPULAR ERRORS IN DIET. 


377 


that perhaps fish food might be especially nourishing to the brain, as 
there was considerable phosphorus in the brain and also in the fish. The 
notion spread like a heresy, and soon fish of all sorts, big and little, scaly 
fish, shell-fish, and fish with neither scales nor shells, were devoured in 
unprecedented quantities by microcephalous people, and people whose 
brains were not obviously too small, for the purpose of obtaining the 
supposed specific effects of a fish diet. A gentleman eager to cultivate 
his brain and induce an increased growth, addressed a letter to a noted 
wag, asking for advice respecting the quantity of fish which he must eat 
per day. The answer he received was a fitting criticism on the theory, 
and undoubtedly discouraged the aspirations of the young man, being to 
the effect that a small whale would probably be about the right quan¬ 
tity for a meal. 

The falsity of the theory has been repeatedly shown by the citation 
of the fact that the lowest of all human races are those that live almost 
exclusively upon fish. In civilized countries, also, as in the vicinity of 
large fisheries, whole communities often make fish their almost exclusive 
diet; and yet there is no evidence that their mental capacity is increased 
thereby. In fact, the low mental and moral status of these people 
would furnish an argument on the opposite side of the question if it 
were necessarv to offer such argument. 

7. It is cm error to suppose that people suffering with nervous de¬ 
bility, neurasthenia, or other forms of nervous weakness, need large 
quantities of flesh food. 

It is a very common custom when it is decided that a person has 
any form of nervous disorder accompanied by weakness or impaired nu¬ 
trition of the nervous system, to place him at once on a diet consisting 
largely of flesh, as beefsteak, mutton-chop, etc. Sometimes the drinking 
of blood is recommended. That this indiscriminate practice is a bad one 
we have often had occasion to notice. It not infrequently happens that 
the excessive use of flesh food is a cause of nervousness, as has been re¬ 
peatedly pointed out, and we believe that whether its use is advised or 
not, should depend on the condition of the stomach rather than on the 
nerves. A person whose stomach is very feeble may be unable to di¬ 
gest sufficient vegetable food to replenish his blood and fully nourish 
the tissues; for such persons a flesh diet or a mixed diet will be found 
to be very advantageous. 

8. It is a most erroneous notion that “ rich food ” is strengthening 

The strengthening quality of food depends first upon its digestibility, 


378 


FOOD AND DIET. 


and second upon the proportion of albuminous elements which it con¬ 
tains. Sugar, fat, spices, and the other ingredients which are added to 
food in making it “ rich,” are of only secondary importance as nutritive 
elements, and in the case of condiments, of exceedingly doubtful value, 
if not wholly worthless. In the manner in which these substances are 
combined in “ rich food,” they are worse than worthless. Really rich 
food is that which contains a large proportion of the essential elements 
of food in a condition in which they may be easily assimilated. Graham 
bread, oatmeal mush, pea soup, baked beans, and kindred foods, are re¬ 
ally rich, and in the highest degree strengthening. 

9. It is an error to suppose that persons engaged in laborious oc¬ 
cupations require a large amount of flesh food. 

Persons who labor hard, either physically or mentally, need a liberal 
supply of food rich in albuminous elements. These elements are fur¬ 
nished by such food as peas and beans in even larger quantities than in 
the best beefsteak. A pound of peas contains four ounces of albumi¬ 
nous elements, while a pound of beefsteak contains but about three 
ounces. Oatmeal and wheat meal are also very rich in albuminous ele¬ 
ments. The Scotch laborers who subsist very largely upon oatmeal por¬ 
ridge are said to be among the finest developed and hardiest men in the 
world. Numerous similar evidences in favor of a liberal supply of 
Vegetable food might be given. 

10. It is an error to suppose that the system is better supported by 
meals at very frequent intervals than by food taken in accordance 
with the known time required for digestion. 

It has long been the custom to supply laborers undergoing severe 
exertion, as during harvest time among farmers, with two or three ex¬ 
tra meals during the day, thus often bringing meals within two or three 
hours of each other. We believe that the practice is a bad one, and that 
three meals at most are much better than more. The custom of eating 
five meals a day, common in some foreign countries, is certainly most 
unphysiological, and must be injurious. Children are often injured by 
too frequent feeding ; not only while infants, but after having grown 
up so as to be large enough to attend school, being very often supplied, 
by fond mothers, with luncheon for recess, and apples to eat at all hours. • 
It is a most unwise thing to allow children to form the habit of nibbling 
at food between meals. The fact that they are growing, and need a 
large supply of nourishment, is no apology for the practice, but rather 
makes it the more necessary that they should be regular in their habits 


POPULAR ERRORS IN DIET. 


379 


in order to secure good digestion. The stomach needs rest as well as 
the arms and limbs and other organs of the body. More food will be 
well digested with three meals than with a larger number, and hence a 
larger amount of good blood will be produced, and more healthy tissue 
formed. 

11. It is an error to suppose that the best preparation and sup¬ 
port for extraordinary exertion is increasing the amount of food 
eaten proportionately. 

It is generally supposed that if a man has an unusually large day’s 
work to perform he must eat an unusually large breakfast and a pro¬ 
portionately large dinner. This is certainly an error. Large demands 
upon either the muscular or the nervous S 3 7 stem for the time being de¬ 
tract from the power to digest. The stomach requires nervous energy 
to enable it to perform its function. If the nervous forces are other¬ 
wise engaged or used, they cannot be utilized in digestion. Hence it 
follows, theoretically, at least, that instead of giving the digestive organs 
an extra task in preparation for an extra effort, they should be required 
to perform less than the ordinary amount of labor. Experience as well 
as theory supports this view. Sir Isaac Newton, when employed in his 
most arduous labors, lived upon bread and water, and fasted for long 
intervals. General Elliot, the famous defender of Gibraltar, is said to 
have subsisted for a number of days on a little boiled rice. The won¬ 
derful “ L’homme Serpente ” of Paris, always fasted for twelve hours 
before attempting to perform his marvelous feats of agility. This plan 
not only secures a higher degree of efficiency in the effort made, but pre¬ 
vents, in great degree, the injury liable to result from excessive exertion. 
When required to overwork for a succession of days, we have found that 
we were not only able to perform much more work, but to do it with 
less effort at the time, and less exhaustion afterward, when taking a 
greatly reduced quantity of food than when attempting to do the same 
work and still taking the usual quantity of food. We have no doubt 
that a neglect of this precaution is a not infrequent cause of many of 
the sudden deaths of which we so often receive accounts, especially 
among politicians and public men. Overloading the stomach and over¬ 
working the brain at the same time is exceedingly dangerous. The 
man who overworks mentally must be temperate ; he must exercise the 
greatest moderation in his eating, and must to bill 3 " discard all stimulants 
and narcotics. A great share of the cases of apoplexy which occur 
happen when the stomach is full. The increased clearness of intellect 
which results from abstemiousness well repays one for all the self-denial 
practiced. 


380 


FOOD AND DIET. 


VEGETABLE AND ANIMAL FOOD, 

There has been at various times, during the last century particu¬ 
larly, much and animated discussion of the question of vegetarianism. 
In England there exists at the present time an organization known as 
the Vegetarian Society, which was organized in 1847, since which time 
it has been actively engaged in gaining adherents to its rules, which re- 



Fig - . 149. Teeth of Carnivorous Animal. Fig. 150. Skull of Baboon. (Frugivorous.) 

quire entire abstinence from flesh-meats of all kinds. The society num¬ 
bers now nearly two thousand members, among whom are quite a num¬ 
ber of men of considerable distinction. In Philadelphia, there is a sect 
known as the “ Bible Christians ” who are vegetarians, and have been 
such for several generations. It is stated also that John Wesley, the 
founder of Methodism, was a vegetarian. Scattered through nearly all 
civilized countries there are persons who make no use of flesh food; 



Fig. 151. Skull of Wild Boar. (Omnivorous.) Fig-. 152 . Skull of a Rodent. 

and it is well known that the Brahmins and most of the natives of 
India abstain entirely from the use of flesh, from religious scruples. 
Several other nations, as the Chinese, Circassians, Swedes, Nor¬ 
wegians, Swiss, Italians, and even the Scotch and Irish, eat but little 
animal food. The question is an interesting one on account of its 







VEGETARIANISM. 


381 


moral, economic, and physiological bearings, and is well worth consid¬ 
ering. The arguments urged in favor of the preference for vegetable 
food are substantially as follows :— 




Figr. 153. Skull of the Chimpanzee. 
(Frugivorous.) 


1 . Man’s anatomical structure, 
especially the formation of his di¬ 
gestive apparatus, clearly associates 
him with the frugivorous class of 
animals, represented by the gorilla 
and chimpanzee, the lower orders 
which approach most nearly to the 
human form. This is clearly seen 
by an examination and comparison 
of man’s anatomical structure with 
that of animals belonging to the 
class referred to and those of the 
herbivorous, carnivorous, and omnivorous classes. This is admitted 
by the best comparative anatomists, and those who assert the con¬ 
trary give palpable evidence that they have not carefully studied the 
subject. The similarity relates particularly to the teeth, the move¬ 
ments of mastication or mode 
of chewing, the size of the 
salivary glands, and the pro¬ 
portionate length of the ali¬ 
mentary canal. The follow¬ 
ing quotations will suffice for 
authority on the subject:— 

Said the great naturalist, 

Linnaeus, in speaking of the 
dietetic character of man, 

“ His organization, when com¬ 
pared with that of other an¬ 
imals, shows that fruits and 
esculent vegetables constitute 
his most suitable food.” 

Baron Cuvier, an eminent 
authority on comparative 
anatomy, regarded as one of 
the most learned men that ever lived, states that “ The natural food 
of man, then, judging from his structure, appears to consist of fruits, 
roots, and esculent parts of vegetables.” 


Fig:. 154. The Human Skull. 


382 


FOOD AND DIET. 


Says Sir Everard Home, “ While mankind remained in a state of 
innocence there is every reason to believe that their only food was the 
produce of the vegetable kingdom.” 

Mr. Thomas Bell, lecturer on anatomy and the diseases of the teeth 
at Guy’s Hospital Medical College, London, Eng., says, “ The opinion 
which I venture to give has not been hastily formed, nor without 
what appeared to me sufficient grounds. It is not, I think, going too 
far to say that every fact connected with human organization goes to 
prove that man was formed a frugivorous animal.” 

2. It is shown by numerous established historical facts that 
large portions of the human family have in ages past subsisted almost 
wholly, or entirely, upon vegetable food. It is well known that the 
early Grecians and Romans, as well as the still earlier Egyptians, were 
substantially vegetarian in their habits, while it is generally conceded 
that they enjoyed a degree of physical vigor far surpassing that pos¬ 
sessed by men of the present day; and that they were not lacking in 
mental vigor is shown by the fact that among them were found men 
who devised philosophical systems which the world has been following 
ever since, and who laid the foundation for some of the most ab¬ 
struse and recondite of the sciences. 

3. It is also shown that a large share of the present inhabitants of 
the globe subsist upon a dietary containing but a very small propor¬ 
tion of animal food, some of these same persons being the finest speci¬ 
mens of physical development to be found. 

4. It is argued that experience proves that persons who subsist 
upon vegetable food are less liable to disease, longer-lived, capable of 
enduring more, and superior in development to those who employ flesh 
food. 

5. It is shown by cases which are daily becoming more numerous, 
that animal food is exceedingly likely to communicate disease, through 
disease of the animals used for food, and through changes which meat 
often and rapidly undergoes after death. It is also shown that all 
flesh food is stimulating and in some degree clogging in character, on 
account of its containing the excrementitious principles, or waste prod¬ 
ucts, of the body, which are retained with the venous blood. 

6 . It is argued that as the Creator has supplied the human race 
with an abundance of nourishing vegetable foods, which are capable of 
maintaining life in its highest degree of perfection, the killing of ani¬ 
mals for food is unnecessary, and hence immoral. The moral argu- 


PYTHAGORAS OX FLESH-EATING. 333 

ment is admirably presented by Ovid in his account of the teaching of 
Pythagoras, who was a vegetarian from religious scruples, together 
with his followers, believing hi the doctrine of metempsychosis, or the 
transmigration of souls. We quote the following passage from Ovid, 
respecting Pythagoras and his views:— 


He first the taste of flesh from tables drove, 

And argued well, if arguments could move : 

O mortals, from your fellows’ blood abstain, 

Nor taint your bodies with a food profane, 

While com and pulse by nature are bestowed, 

And planted orchards bend their willing load ; 

While labored gardens wholesome herbs produce, 
And teeming vines afford their generous juice ; 

Nor tardier fruits of cruder kind are lost, 

But tamed with fire, or mellowed by the frost; 
********* 

While earth not only can your needs supply, 

But, lavish of her store, provides for luxury ; 

A guiltless feast administers with ease, 

And without blood is prodigal to please. 

Wild beasts their maws with their slain brethren fill ; 
And yet not all, for some refuse to kill; 

Sheep, goats, and oxen, and the nobler steed, 

On browse, and corn, and flowery meadows feed. 
Bears, tigers, wolves, the lion’s angry brood, 

Whom Heaven indued with principles of blood, 

He wisely sundered from the rest, to yell 
In forest, and in lonely caves to dwell; 

Where stronger beasts oppress the weak by night, 
And all in prey and purple feasts delight. 

Oh, impious use ! to nature’s laws opposed, 

Where bowels are in other bowels closed ; 

Where, fattened by their fellows’ fat, they thrive ; 
Maintained by murder and by death, they live. 

’Tis then for naught that mother earth provides 
The stores of all she shows, and all she hides, 

If men with fleshy morsels must be fed, 

And chaw with bloody teeth the breathing bread ; 
What else is this but to devour our guests, 

And barb’rously renew Cyclopean feasts ? 

We, by destroying life, our life sustain, 

And gorge the ungodly maw with meats obscene. 

Not so the golden age, who fed on fruit, 

Nor durst with bloody meals their mouths pollute. 


384 


FOOD AND DIET. 


Then birds in airy space might safely move, 

And timorous hares on heaths securely rove ; 

Nor needed fish the guileful hooks to fear, 

For all was peaceful; and that peace sincere. 

Whoever was the wretch (and cursed he he) 

That envied first our food’s simplicity, 

The essay of bloody feasts on brutes began, 

And after forged the sword to murder man— 

Had he the sharpened steel alone employed 
On beasts of prey that other beasts destroyed, 

Or man invaded with their fangs and paws, 

This had been justified by nature’s laws 
And self-defense : but who did feasts begin 
Of flesh, he stretched necessity to sin. 

To kill man-killers, man has lawful power, 

But not the extended license to devour. 

Ill habits gather by unseen degrees ; 

As brooks make rivers, rivers run to seas. 

The sow, with her broad snout, for rooting up 
The intrusted seed, was judged to spoil the crop, 

And intercept the sweating farmer’s hope : 

The covetous churl, of unforgiving kind, 

The offender to the bloody priest resigned : 

Her hunger was no plea ; for that she died. 

The goat came next in order to be tried : 

The goat had cropp’d the tendrils of the vine : 

In vengeance laity and clergy join, 

Where one has lost his profit, one his wine. 

Here was at least some shadow of offense ; 

The sheep was sacrificed on no pretense 
But meek, and unresisting innocence. 

A patient, useful creature, bom to bear 

The warm and woolly fleece that clothed her murderer ; 

And daily to give down the milk she bred, 

A tribute for the grass on which she fed. 

Living, both food and raiment she supplies, 

And is of least advantage when she dies. 

How did the toiling ox his death deserve, 

A downright simple drudge, and born to serve ? 

O tyrant ! with what justice canst thou hope 
The promise of the year, a generous crop, 

When thou destroy’st thy laboring steer, who tilled 
And ploughed with pains thy else ungrateful field ? 
From his yet reeking neck to draw the yoke, 

That neck with which the surly clods he broke ; 


PYTHAGORAS OX FLESH-EATING. 


38 


And to the hatchet yield thy husbandman, 

Who finished autumn, and the spring began. 

Nor this alone ! but Heaven itself to bribe, 

We to the gods our impious acts ascribe : ' 

First recompense with death their creatures’ toil ; 

Then call the blest above to share the spoil : 

The fairest victim must the powers appease, 

(So fatal ’tis sometimes, too much to please !) 

A purple fillet his bx-oad brows adorns, 

With flowery garlands crowned, and gilded horns : 

He hears the murderous prayer the priest prefers, 

But understands not ’tis his doom he hears : 

Beholds the meal betwixt his temples cast 
(The fruit and product of his labors past); 

And in the water views perhaps the knife, 

Uplifted to deprive him of his life ; 

Then broken up alive, his entrails sees 

Torn out, for priests to inspect the gods’ decrees. 

From whence, O mortal man, this gush of blood 
Have you dei’ived, and interdicted food ? 

Be taught by nie this dire delight to shun, 

Warned by my pi’ecepts, by my practice woxx : 

And when you eat the well-deserving beast, 

Think on the laborer of your field you feast! 
********* 

Ill customs by degrees to habits rise ; 

Ill habits soon become exalted vice. 

What more advance can mortals make in sin, 

So near perfection who with blood begin ? 

Deaf to the calf that lies beneath the knife, 

Looks up, and from her butcher begs her life ; 

Deaf to the harmless kid, that ere he dies, 

All methods to procure thy mercy tries, 

And imitates in vain thy children’s cries ? 

Where will he stop who feeds with household bread, 
Then eats the poultry which before he fed l 
Let plough thy steers, that when they lose their breath, 
To nature, not to thee, they may impute their death. 
Let goats for food their loaded udders lend, 

And sheep from winter cold thy sides defend ; 

But neither spi’ings, nor nets, nor snares employ, 

And be no more ingenious to destroy. 

Free as in air let birds on earth remain, 

Nor let insidious glue their wings constrain ; 

Nor opening hounds the trembling stag affright, 

Nor purple feathers intercept his flight ; 

25 


386 


FOOD AND DIET. 


Nor hooks concealed in baits for fish prepare, 

Nor lines to heave them twinkling up in air. 

Take not away the life you cannot give ; 

For all things have an equal right to live : 

Kill noxious creatures, where ’tis sin to save ; 

’Tis only just prerogative we have : 

But nourish life with vegetable food, 

And shun the sacrilegious taste of blood. 

In answer to these arguments, those who entertain opposite views 
urge the following among less important considerations:— 

1 . Though originally vegetarian in his habits, man has so long been 
accustomed to the use of animal food that it has come to be a necessity. 

2 . Those nations that use the most flesh, as for example the English, 
are the strongest and dominant nations. 

3. The use of animal food is necessary to sustain life in the cold 
regions of the North, both on account of the absence of sufficient vege¬ 
table food and on account of the low temperature. 

4. Confinement to the use of vegetable food would render man im¬ 
potent, and thus exterminate the race. 

5. Animals were made to be eaten. 

6 . The doctrine of evolution proves that as man has developed from 
lower orders to his present condition he has found it necessary to employ 
a more concentrated diet. 

These arguments are met by counter-arguments, as follows:— 

1 . Long-continued violation of a principle cannot destroy it. The 
•dirt-eaters of the Orinoco River in South America have for ages been 
addicted to the habit of eating clay, but this in no way alters the fact 
that clay is not good for them, although they have become so accus¬ 
tomed to its use as to seem to be little inconvenienced by it. If flesh 
was not the best food for Adam, for the primitive Romans, Grecians, 
Persians, and Egyptians, it cannot be for modern man, whose organiza¬ 
tion is essentially the same. Examination of the remains of persons who 
died many thousands of years ago shows that there has been no radical 
change in the human organization within the knowledge of man. And 
again, experience shows that flesh food is not a necessity, since thousands 
have renounced its use, and, though suffering slight inconvenience at 
first, have improved under the change. 

2 . While it is true that the English nation makes large use of ani¬ 
mal food, and is at the same time one of the most powerful on the globe, 


AIKJ UMENTS ANSWERED. 


387 


it is also true that the lowest, most miserable classes of human beings, as 
the natives of Australia, and the inhabitants of Terra del Fuesro, subsist 
almost wholly upon flesh. It should also be borne in mind that it is 
only within a single generation that the common people of England 
have become large consumers of flesh. In former times, and when Eno- 
land was laying the foundation of her greatness, her sturdy yeomen ate 
less meat in a week or a month than the average Englishman of the 
present consumes in a single day. It is still true of the average Irish¬ 
man that he eats less flesh food in a week than the average Englishman 

o o 

eats in a day. Even more might be said of the stalwart Scotchman, 
whose chief article of diet is oatmeal. The Persians, the Grecians, and 
the Romans became ruling nations while vegetarians. Other influ¬ 
ences than diet are the chief factors in determining national supremacy. 

3. That flesh food is not absolutely essential to sustain life in the 
Arctic regions is proven by the fact that the musk-ox, the reindeer, and 
other vegetable-eating animals flourish in those regions, although then- 
food is of the most scanty kind. Again, it should be remembered that the 
albuminous elements, which are most abundant in flesh food, are not 
those which supply the largest amount of heat to the body. The heat- 
producing elements are the carbonaceous, of which vegetable foods con¬ 
tain a large proportion in the form of starch, sugar, and fat. In the 
narrative of the expedition of the Polaris in the Arctic regions, a quota¬ 
tion from the journal of Captain Hall mentions that when traveling on 
foot among the ice and snow, within a few degrees of the North Pole, 
in the month of October, when the long, dark, cold winter night had al¬ 
ready begun, in company with his companions he lunched on graham 
crackers. Accounts are given of the enormous quantities of food eaten 
by the inhabitants of that cold country, which are supposed to be neces¬ 
sary to sustain animal heat, but that this is not so is proved by the fact 
that the crew of the Polaris maintained good health on a diet such as 
would not be considered extravagant for a laboring man in a mild cli¬ 
mate, and on two meals a day. 

It has been suggested, and evidently with much force, that the in¬ 
habitants of the Arctic regions are living in a very unnatural condition 
at the best, and that that region is manifestly not fitted for habitation 
by human beings. A cordial invitation is extended to them to move 
south. 

4. The objection that the exclusive use of vegetable food would 
put an end to propagation is not sustained by evidence. It is cer- 


388 


FOOD AND DIET. 


tainly true that vegetable-eating nations are as prolific as others; and 
it is also true that some of the most prolific of animals are vegetable- 
eaters. If the use of vegetable food should have a tendency to lessen 
the intensity of the reproductive or sexual instinct in man, it would 
probably be no detriment to the race; and that it does have this ef¬ 
fect, experience seems to demonstrate. 

5. The assertion that animals were made to be eaten, is an assump¬ 
tion for which the only evidence is the fact that man does eat animals. 
The idea so prevalent that everything created was for man’s special 
benefit is a most erroneous and pernicious one, as it leads human be¬ 
ings to overlook the fact that lower animals, although far below man 
in the scale of being, yet have rights which are as deserving of respect 
as his own, and which he is under obligations to regard. Each ani¬ 
mal as well as each plant has its particular use in the economy of nat¬ 
ure. There is no more reason to wonder what a sheep was made for, 
if not to eat, than to raise the same query concerning a mosquito or 
an earth-worm. 

6 . The doctrine of evolution can prove nothing respecting man’s 
diet; for, as acknowledged by its most ardent supporters, it is but an 
hypothesis. It has not yet been proven, and it is not likely to be proven, 
that man was once a beast that kept company with gibbons and 
monkeys in the tree-tops of primeval forests. It is not necessary to 
consider any supposed argument founded on this basis until the doc¬ 
trine of evolution has itself been established by scientific and logical 
evidence. 

Testimony of Eminent Men. —The testimony of eminent men 
respecting the comparative merits of animal and vegetable food varies 
considerably, some asserting that a vegetable diet will not sustain life 
well, and others admitting that it is equal to flesh food in this 
particular. 

Says Dr. Carpenter, an eminent English physician and scientist, 
“ A well-selected vegetable diet is capable of producing the highest 
physical development.” 

Dr. Parkes, probably the most eminent of modern writers on hy¬ 
giene, says, “ The well-fed vegetable-eater will show, when in train¬ 
ing, no inferiority to the meat-eater.” 

Says Dr. Tyson, in an able article on “ Food and Drink ” in P>uck’s 
Hygiene, “ A diet too exclusively composed of animal flesh produces 
congestions and enlargements of the liver, and the so-called arthritic 


LEHMAN’S EXPERIMENTS. 


380 


or gouty diathesis.An excess of oleaginous food [always 

due to excess in use of animal fats] tends to produce the so-called 
bilious diathesis, characterized by excessive bile production and con¬ 
gestion of the liver.” 

The fact that animal food has a tendency to produce the gouty 
diathesis, urinary calculi, etc., is shown by the acidity of the urine in 
flesh-eaters. In the case of vegetable-eaters it is almost invariably 
alkaline. 

Says Dr. Edward Smith, one of the most eminent English writers 
on Food and Dietetics, “ Every element, whether mineral or organic, 
which is required for nutrition is found in the vegetable kingdom.” 

Lehman’s Experiments. —The well-known experiments of Leh¬ 
man show beyond question that the use of flesh food requires mere 
work of the kidneys than a vegetable diet. When living on an ex¬ 
clusively animal diet he found that the amount of urea eliminated by 
the kidneys was two and one-half times as much as when the diet was 
exclusively vegetable, and one and a half times as much when he par¬ 
took of both animal and vegetable food. This shows beyond ques¬ 
tion that when the diet is exclusively animal, the kidneys have more 
than double the amount of work to do than when it is vegetable in 
character, and that when partly animal and partly vegetable, they are 
required to do one-half additional and extra work. This excessive 
work must inevitably tend to the production of kidney disease, which 
is becoming a very common affection among the English and Amer¬ 
icans, who, as is well known, eat more animal food than any other 
civilized nations. 

Dietetic Importance of Meat Overestimated. —Dr. Pavy, one 
of the most eminent living writers on food, says:— 

“ The prevailing tendency, certainly in the English of the present 
day, is to give an undue weight to the value of animal food.” 
“ Against those who think that a large consumption of animal food is 
a sine qua non for the maintenance of health and strength, the ex¬ 
perience of vegetarians may be adduced.” 

In the effects of the Scotch prison dietaries, corroborative testi¬ 
mony is afforded. Dr. J. B. Thompson, resident surgeon to the Gen¬ 
eral Prison for Scotland, writing in the Medical Times and Gazette , 
1808, after ten years’ experience with the same, speaks in high praise 
of a diet into which meat entered very sparingly, consisting chiefly of 
bread, oatmeal, barley, and milk, only one ounce of meat a day being 


390 


FOOD AJS T D DIET. 


allowed. Under this diet 88 per cent maintained their original 
weight or gained, notwithstanding the rigor of prison discipline. 

Dr. Edward Smith reports that it is not uncommon to find 
that among the agricultural laborers of Scotland [who are celebrated 
for their strength and endurance] no meat is consumed. Oatmeal is 
the principal diet of the sturdy Highlanders. 

Dr. Guy, who made extensive investigations of the dietaries in 
English prisons, in his report states, as one of the deductions from his 
observations, “ that we possess conclusive evidence of the sufficiency 
of a diet from which meat is wholly excluded, and even of a diet con¬ 
sisting wholly of vegetable matter.” 

A committee of the English House of Peers recently appointed to 
consider the question of diet in prisons, strongly advocated “ not only 
the great economical advantages, but also the superior nutritive value 
of a farinaceous diet over one of flesh.” The opinion seems to be 
gaining ground that animal food in large quantities is not good, and 
that human life can be well supported without it. If the English au¬ 
thorities try the experiment in their prisons, as it would seem prob¬ 
able that they may do, judging from the report referred to, we shall 
soon have a good opportunity of seeing vegetarianism tested on a 
large scale, and in such a manner as to secure conclusive results, or 
results which may be considered conclusive by those who are not con¬ 
vinced by the evidence already offered on the subject. 

Meat a Stimulant. —That meat is stimulating in its effects is de- 
duced from three admitted facts: 1. Flesh is known to contain ele¬ 

ments of an excrementitious character which cannot be used by the 
system, and when taken in must be expelled; 2. A stimulant in the 
form of beef extract can be obtained from meat; 3. Observation 
shows that its effects are stimulating in character. The pulse of a 
person who uses flesh food freely is well known to be more rapid 
than that of one whose diet is vegetable in character. 

Dr. Dundas Thompson, in a paper entitled, “Experimental Re¬ 
searches on the Food of Animals,” quotes the following account of the 
effects of eating meat upon a party of native Indians whose diet had 
previously been of a vegetable character:— 

“ They dined most luxuriously, stuffing themselves as if they were 
never to eat again. After an hour or two, to his [the traveler’s] great 
surprise and amusement, the expression of their countenances, their 
jabbering and gesticulations, showed clearly that the feast had pro- 


DIET OF THE ICEL AN.DEE. 


391 


duced the same effect as any intoxicating spirit or drug. The second 
treat was attended with the same result.” 

Dr. Druit, in describing before the London Obstetrical Society trie 
properties of beef essence, attributed to it rapid and remarkable stim¬ 
ulating effects upon the brain, and recommended it as a substitute for 
brandy in cases of great exhaustion and weakness. 

Dr. Edward Smith says of beef extract, “ It should be classed with 
such nervous stimulants as tea and coffee.” 

Liebig, the eminent German chemist, in an article in the London 
Lancet in 1869, wrote as follows :— 

“ It is essentially their food which makes carnivorous animals 
.... more combative than the herbivora which are their prey. 
A bear kept at the Anatomical Museum of Giessen showed a quiet, 
gentle nature, as long as he was fed exclusively on bread, but a few 
days’ feeding on meat made him vicious and even quite dangerous. 
That swine grow irascible by having flesh food given them is well 
known—so much so, indeed, that they will then attack men.” 

It is also known that blood-hounds will become dangerous by 
being fed on flesh. 

The following quotations from eminent authors respecting the diet 
of different nations and its effects, are interesting in this connection:— 
Animal Diet of Icelanders, and its Effects. —We quote the 
following from “ Mackenzie’s Travels in Iceland :”— 

“ The diet of the Icelanders consists almost solely of animal food, 
of which fish, either fresh or dried, form by far the largest proportion. 
During the summer they have milk and butter in considerable abun¬ 
dance ; but of bread and every other vegetable food there is the ut¬ 
most scarcity, and among the lower classes an almost entire privation. 

.As an effect of these circumstances in the mode of life of 

the Icelanders, cutaneous diseases, arising from a cachectic state of the 
body, are exceedingly frequent among them, and appear under some 
of their worst forms. Scurvy and leprosy are common in the island, 
occurring especially on the western coast, where the inhabitants de¬ 
pend chiefly upon fishing, and where the pastures are inferior in ex¬ 
tent and produce.Scurvy is observed to occur with greatest 

frequency at those periods when there has been a deficiency of food 
among the inhabitants, or when the snow and frost of the winter suc¬ 
ceed immediately to a wet autumnal season. For its cure, a vegetable 
diet is employed, in as far as the circumstances of the Icelanders will 


392 


FOOD AND DIET. 


allow of such means. „ . . . Inflammatory affections of the abdom¬ 
inal viscera are likewise very common among the Icelanders, chiefly, 
perhaps, in consequence of the peculiar diet to which they are accus¬ 
tomed. 

“ The diet of the Icelanders likewise gives much disposition to 
worms, and the ascarides are observed to be particularly frequent.” 

Raw-Meat Diet of the Ahyssinians, —The Abyssinians are very 
fond of raw meat which they cut from the living animal and eat while 
warm. Johnston, in his “ Travels in Southern Abyssinia,” says, “ Trav¬ 
elers who have witnessed their ‘ brunde ’ feasts can attest to the intox¬ 
icating effects of this kind of food, and they must have been aston¬ 
ished at th« immense quantities that can be eaten in the raw state 
compared to that when the meat is cooked, and at the insensibility 
which it sometimes produces.” 

Vegetable Diet of the Mexicans. —“Accustomed to uniform 
nourishment of an almost entirely vegetable nature, that of their maize 
and cereal gramina, the Indians would undoubtedly attain very great 
longevity if their constitutions were not weakened by drunkenness.” 
—Taylors Selections from Humboldt's Works relating to Mexico. 

Cannibalism. —Prof. Pavy remarks that “There is reason to believe 
that the practice of eating human flesh has not at all times been con¬ 
fined to the lowest savages, but it is difficult to obtain much satisfactory 
information respecting it. 

“There is little doubt that our ancestors, the ancient inhabitants of 
Britain, were guilty of eating human flesh, and St. Jerome specially 
charges the Attacotti, a people of ancient Scotland, with preferring the 
shepherd to his flock. 

“ There have been numerous instances of cannibalism among people 
suffering from starvation in sieges and from shipwreck, and the evidence 
is tolerably strong that some men belonging to civilized races, living in 
wild places, have occasionally decoyed persons to their dens and eaten 
them. Andrew Wyntoun, in his rhyming chronicle, charges a man who 
lived early in the fourteenth century with this crime. 

“ Lindsay, of Pitscottie, also relates that a man and his wife and fam¬ 
ily were all burnt on the east coast of Scotland for the crime of eating- 
children that they had stolen away. During the horrors of the great 
French Revolution the heart of the Princess Lamballe was plucked out 
of her body by one of the mob, taken by him to a restaurant, and there 
cooked and eaten.” 


DISEASED FOODS. 


393 


DISEASED FOODS, 

So many instances of poisoning, often fatal, from the use of food 
rendered unwholesome by disease are constantly occurring, that it is 
evidently important to give this subject due consideration. Prof. Gam- 
gee, of London, quoted by Dr. Letheby, health officer of the city of 
London, states that fully one-fifth of all the flesh sold in that great 
city is diseased. The amount of diseased food offered for sale in the 
city may be judged from the fact that more than four hundred tons 
of meat are sold daily in four of the principal markets. The means 
of inspection employed are so inadequate and inefficient that but a 
small fraction of the amount really unfit for food is discovered and 
seized. To this fact is attributed the remarkable increase in England 

O 

within the last few years of deaths from boils, carbuncle, and phleg¬ 
mon, the latter having increased to more than thirty-two times its 
former frequency. 

Experience abundantly shows that animals which die of disease 
are unfit for food, being liable to produce in those who eat their flesh 
symptoms of poisoning of all grades, from a mere trifling febrile dis¬ 
turbance to the most rapidly fatal effects. This danger has for ages 
been recognized by the Jews, whose laws require of them the most 
careful examination of all animals, both before and after killing, to in¬ 
sure soundness. The written laws given in the Bible do not include 
the more definite instructions on this point which are said by the 
Jews to have been given by Moses to the people orally, since which 
time they have been carefully observed. A Jew will not eat flesh 
which has not been inspected in the most careful manner by an officer 
called a searcher or bodek, appointed for the purpose, who is required 
to declare under the obligations of a solemn oath whether or not the 
animal which he examines is fit for food. A Jewish rabbi once in¬ 
formed us that in many of the large cities nineteen out of twenty 
animals thus examined were rejected as unfit for food. The rejected 
animals are sold to Christians, who are less scrupulous about the char¬ 
acter of their food, and in consequence are more subject to disease and 
are shorter lived than Jews. 

It is a common custom with farmers as soon as an animal shows 
symptoms of decline in health to send it to the butcher at once, or 
kill it and sell the meat themselves. When an epidemic among cattle is 
prevalent, the markets in the large cities are flooded with the flesh of 


394 


FOOD AND DIET . 


diseased animals. Thousands of animals are consumed every year 
as food, whose death was only a very little hastened by the 
butcher. There can be no doubt that a very large proportion of all 
the animal food sold in the markets is more or less contaminated by 
disease. Domestic animals suffer with diseases essentially the same 
as those from which man suffers; and there is good evidence for be¬ 
lieving that in not a small number of instances the disease is commu- 
© 

nicated from animals to man. 

A trustworthy butcher informed us that not one in a hundred of 
the livers of hogs is found in a healthy condition. Often they 
are the seat of foul abscesses. The investigations and experiments 
of Dr. A. N. Bell, of New York City, as well as of eminent French 
experimenters, show that consumption is a very common disease 
among cattle, and that it is communicable from them to human be¬ 
ings. The president of the Board of Health of one of our large East¬ 
ern cities, and a professor of agriculture in one of the leading colleges 
- of the country, stated in our hearing that consumption is a great deal 
more common among cows than is generally known, and especially 
among blooded stock, which are generally more closely kept than 
common breeds. 

Very recently a case has been reported in which five hundred per¬ 
sons were stricken down with typhoid fever in consequence of eating 
the flesh of a calf, which, as was afterward ascertained, had died of 
typhoid fever. Every person who ate of the flesh of the calf was sick 
with the fever, the symptoms of which were characteristic, and quite 
a number died. 

Origin of Tape-Worm.—This troublesome and quite too common 
affection originates in the use of meat containing the young creatures 
inclosed in little cysts, or sacs. There are several varieties of the 
worm. One of the two most common, known as the tcenia solium , 
coming from the use of pork, the other from the use of beef. When 
taken into the system, the tiny embryos attach themselves to the mu¬ 
cous membrane of the intestine, and live and grow by absorbing the 
digested foods with which they are surrounded. They sometimes at¬ 
tain an enormous length, and give rise to many grave but often ob¬ 
scure symptoms. The only positive evidence of the presence of the 
worm, however, is the finding of portions of the parasite in the dis¬ 
charges from the bowels. 

The embryos of tcenia solium may be seen with the naked eye, 


TAPE-WORM. 


395 


looking like small bladders in the lean meat of pork, as shown in Fig. 
155. In beef the cysts are too small to be readily seen with the un¬ 
aided eye. Flesh containing these creatures is said to be measly. This 
disease is very common in Ireland, where, according to good authorities, 
as large a proportion as three per cent of the hogs are affected. The 
disease is communicated to man by eating measly flesh without sufficient 
cooking to kill the embiyos ; hence it is 
most common among those who eat raw 
meat. Pork-packers and cooks are said 
to be most frequently affected with tape¬ 
worm, which is probably due to the habit 
of eating raw meat when about their 
work. Among the Abyssinians, whose 
regular diet is raw flesh, almost every per¬ 
son has a tape-worm. 

It was formerly supposed that the 
danger of acquiring this disagreeable ten¬ 
ant was wholly connected with the use 
of pork; but the researches of Dr. Leidy, 
of Philadelphia, during the last fifteen 
years, recently made public, have shown 
that the variety of the worm which is ing Young Tape-Worms, 
most common is that caused by the use of raw beef. Of the many 
specimens examined by him he had never yet found one of the pork 
species. 

It need scarcely be suggested that in the light of these developments 
the use of raw flesh of any kind is dangerous and to be scrupulously 
avoided. No kind of flesh food should be used without exposure to a 
degree of heat at least as great as that of boiling water, and for a suf¬ 
ficient length of time to insure entire destruction to any living germ 
which may be lurking in it. Even then there is the constant liability of 
consuming cooked parasites along with the food, which will scarcely be 
considered appetizing. A very careful inspection should be made of all 
flesh food before it is eaten. This is required, as before stated, by the 
Jewish laws, and by municipal laws in some large cities ; but on the 
whole, the modern world is behind the ancient in this particular. In 
Rome, many centuries ago, public inspectors made a careful examination 
of all flesh foods before they were allowed to be sold. 

Dr. Leidy has also recently discovered that the cucumber, as 



Fig 1 , 155. Measly Pork contain- 






S9G 


FOOD AND DIET. 


well as pork and beef, is affected with tape-worm. He found in a 
cucumber a well-developed worm which had evidently grown there. 
The disease known as hydatids is caused by taking into the system 
the eggs of tape-worms instead of the young worms in flesh containing 
the cysts of hydatids. It is exactly the same disease in man known as 
measles in pork. Sometimes a person suffering with tape-worm be¬ 
comes infected. While the worm is in the intestines it is constantly 
giving off thousands of eggs, which are carried away with the bowel 
discharges, not being received into the system. Sometimes, however, 
through violent retching, some of the eggs are thrown up into the 
stomach, and then the person may become self-infected. The cysts 
may be formed in any part of the body. The liver is the most com¬ 
mon seat of hydatids in man. Occasionally the eye and the brain are 
invaded by them. In sheep the brain is the chief seat, producing the 
disease known as staggers. 

The Trichina. —See Plate IX. This parasite has been so often 
described that we hardly need enter upon a lengthy description here. 
For a long time after it was discovered, the general public received 
reports concerning the new parasite with incredulity; but so many 
cases of fatal poisoning from this source have now occurred that 
no one longer doubts. 

The trichina is found usually in pork, though it may infest the 
flesh of numerous other animals as well. Cases have been reported 
in England in which it was found in calves. It has also been recently 
discovered in the hippopotamus. It exists only in the lean flesh of 
animals, and is found among the muscular fibres, or inclosed in little 
sacs or capsules. It is almost always found in the latter condition. 
Ao found in these conditions -the parasite is a minute, thread-like 
worm, about -%j of an inch in length, and about of an inch in 
diameter. This is the embryonic or undeveloped form of the worm. 
When taken into the stomach by the eating of flesh containing it, the 
worm is soon liberated from its capsular prison, and in the course of a 
week undergoes complete development, reaching a size much greater 
than that described, so that it even becomes visible. During this time 
it is buried in the mucus of the stomach and intestines. When de¬ 
velopment is complete it speedily brings forth young in immense num¬ 
bers, a single worm producing, it is stated, one thousand or more 
young. The young worms very quickly begin to penetrate the 
.system, either by boring their way through the intestinal walls and 




Fig . 1. 


Fig-. 2. 


Fig:. 3. 


Figr. 4. 




Plate IX.—// UMA X PA PA SITES. 

Fig. 1. Trichina- lying loose among the muscular fibres as seen in a piece of ham newly infected. 
Fig. 2. Single Trichina in its capsule, some weeks after infection. Fig. 3. Head of a Tape-worm 
greatly magnified Fig 4 ThreadWorm. 




























































































THE TRICHINA. 


397 


thence to the muscles, their final destination, or by getting into the 
blood-vessels and being swept along with the blood current. Which 
is the exact method, has not yet been determined. 

After reaching the muscles it penetrates the sheaths of the fibres, 
and finally becoming quiet, coils itself up and after a time becomes 
encapsulated, in which condition it is shown in the engraving, Fig. 15G. 
This was drawn by the aid of the 
camera lucicla, from a specimen found 
in a piece of pork sent to us by a gen¬ 
tleman in Wisconsin, who was led to 
suspect that a neighbor had been poi¬ 
soned with the parasite by the pecul¬ 
iarity of his symptoms, which puzzled 
the physicians in attendance. There 
were several deaths, but the cause was 
unsuspected, except by the gentleman 
referred to, until the pork was sent us 
for examination. The astonishing apa¬ 
thy of the people to the subject a few 
years ago was well illustrated by the 
fact that neither the poisoned family 
nor the attending physician would be¬ 
lieve the true nature of the case, even 
after we published an account of the 
examination, with a cut of some of the 
worms found, but persisted in calling 
the disease cholera morbus, though it 
occurred in mid-winter. 

After some months the walls of the 
capsules become impregnated with car¬ 
bonate of lime, when they appear like 
small, white specks, as seen in Figs. 157 and 158, which are readily 
seen by the naked eye. We frequently found these evidences of the 
presence of the worm in human muscles when dissecting as a med¬ 
ical student at Bellevue Hospital, New York. Prof. Jane way, then 
Demonstrator of Anatomy, informed us that he had observed the 
proportion of trichinatous bodies for a number of years, and believed 
that about one in twenty was thus affected. The worms were found 
still alive in cases in which they must have been encapsulated for 



Fig. 156. Trichinae—Two in a single 
Capsule. Highly Magnified. 





















308 


FOOD AND DIET. 



flplg 

tm ,v ' v - 

'Fig. 157. Meat con¬ 
taining Trichinae in 
Calcareous Cysts. 



Fig. 158. Same as Fig. 
157. Enlarged. 


more than twenty years, so great is the vitality of these creatures. 
After they have once entered the tissues nothing can dislodge them; 
they will remain as long as the individual lives. However, they do 
not, as some erroneously suppose, multiply after entering the muscles. 
They generate hut once, and in the intestinal canal. 

The entrance of this 
'Iwti, parasite into the system, 

except when it is received 
in very small numbers, oc¬ 
casions a most serious dis¬ 
turbance of the vital func¬ 
tions. At first the symp¬ 
toms resemble those of 
cholera morbus, dysentery, 
or some other serious 
bowel disturbance. When 
the young worms begin to 
penetrate the system, the symptoms become more general, and 
simulate rheumatism, cerebro-spinal meningitis, typhoid fever, and 
other diseases. This is the reason why the malady is often over¬ 
looked. Indeed, there is reason for believing that the largest share 
of the cases of this disease are not detected. Whether or not death 
results, depends upon the number of parasites received into the 
system and the vitality of the patient. Heath usually occurs from 
exhaustion, but may be caused by paralysis of some of the mus¬ 
cles involved in respiration. That the disease is rapidly on the 
increase is shown by the fact that examinations of pork, made in 
Chicago, the greatest pork mart of the world, a number of years ago, 
showed the average number affected to be about one in forty. Re¬ 
cent examinations, made under the direction of the health officer of 
that city, show that at the present time one out of every twelve hogs 
packed in that city is infected with the disease. In some parts of 
the country a still higher percentage of infection is found. As there 
is no means of arresting the disease after a person or an animal has 
once been infected, it appears very probable that at no very distant 
date the hog race will be universally infected with this pest. Already 
it has been found necessary in most foreign countries open to the im¬ 
portation of American products to prohibit the reception of American 
pork. If a law were enacted in this country requiring that the rais- 





THE LIVER FLUKE. 


399 

ing of the beast and consumption of its carcass should be totally dis¬ 
continued, we doubt not that the result would be in the highest de¬ 
gree beneficial, and in no material degree damaging to the interests of 
the country. 

The special symptoms of trichinae poisoning, or trichiniasis, are fur¬ 
ther described in connection with the description of other diseases. 
The incurable character of the malady and the extreme liability of 
contracting it, seem to us to be ample grounds for discarding the use 
of pork altogether. The hog is well qualified to act the part of a 
scavenger, for which he was evidently by nature designed; but there 
is plenty of food for human beings far superior in quality to swine’s 
flesh. 

The Liver Fluke. —This is a small parasite which, like the dreaded 
trichina, is common both in man and in animals which he frequently 
uses as food. It has been found in the squirrel, rabbit, dog, horse, and 
elephant, as well as in the sheep, the deer, and the ox. It is especially 
destructive to sheep, which seem to be more liable to it than most 
other animals, being frequently infested to such an extent that whole 
flocks are carried off by the disease to which it gives rise. It is stated 
that two million sheep die in England from this cause in a single 
year. Thousands of sheep annually die in this country from the same 
cause, without the real origin of the disease being suspected. 

The “ fluke ” is a very small creature, being flat and oval in shape, 
very much like a leaf. At one end is a thickened conical portion, in 
which are situated the head and mouth. When taken into the stom¬ 
ach, these parasites soon find their way into the gall duct, where they 
subsist and flourish with the bile for their food. In a short time, their 
increased numbers cause obstruction of the duct, which occasions 
absorption of the bile into the system, indicated by yellowness of the 
skin and, various other symptoms. The disease is known as the “rot,” 
or the “ liver rot." When first afl’ected with the disease, the sheep ap¬ 
pears very much like a person suffering with the jaundice. “In a short 
time the sheep fails, the skin and eyes become white and bloodless, 
a watery tumor appears beneath the jaws, the abdomen swells from 
dropsy, the wool becomes harsh and easily parts from the skin, and 
after lingering some time, the sheep dies, completely rotten, with ev¬ 
ery organ diseased.” 

This disease is very common among human beings in Iceland. It 
also occurs in this country. The natural history of the parasite is 


400 


FOOD AND DIET. 


very curious. The eggs, being discharged from the body through the 
bowels, are hatched in the water. After a time they develop into 
minute hydatids and attach themselves to small snails. Some of them 
also become attached to blades of grass, water-cress, etc. Sheep be¬ 
come affected by eating the snails or the hydatids with grass; and 
there is good reason to believe that man becomes affected through 
eating water-cress and other aquatic plants. 

The Lung Parasite. —A curious worm is sometimes found in the 
luno-s of animals, known as the strongylus ftlaria. It gives rise to a 
disease resembling consumption in man, and hence must be a cause of 
serious deterioration to animals affected by it, rendering them wholly 
unfit for food. 

Bilious Beasts. —That animals are subject to conditions familiarly 
known among human beings as biliousness, jaundice, etc., is made evi¬ 
dent by indisputable facts. In examination of the carcasses of animals 
in the markets, very frequently one will be found in which the flesh 
has a golden tinge or distinct yellow hue. This is known to be the re¬ 
sult of some derangement of the liver, and it is a condition which is by 
no means uncommon. 

In France a regular business is made of producing diseased liver-:, 
geese being selected as the victims. This business is chiefly carried cn 
in Strasbourg, which has become world-famous for its goose-liver pies, 
known as pate de foie gras. The geese are shut up in a dark room, 
their feet nailed down to a plank, and often their eyes put out, so that 
they cannot exercise too much, and then they are regularly stuffed 
with corn and dough once in two hours, the food being crowded down 
the throat of the poor fowl with a stick. Antimony, a mineral poison 
closely allied to arsenic, is also fed to them for the purpose of increasing 
the diseased condition of the liver, by which means it is hoped to make it 
more tempting to French, English, and American gourmands. It re¬ 
quires about thirty quarts of corn to complete the stuffing process, by 
the end of which the poor geese are so nearly dead that it is certainly 
an act of mercy to kill them, their diseased livers having become so 
enlarged as to occupy almost the entire abdominal cavity. It would 
seem, however, much more appropriate that such creatures should be 
carried away by the public scavenger instead of being eaten as a deli¬ 
cacy by human beings. 

Parasites in Wild Game. —The idea is entertained by many per¬ 
sons that even if domestic animals are subject to such diseases as trl- 


PARASITES IN WILD GAME. 


401 


chiniasis, measles, etc., which render them unfit for food, wild animals, 
fowls, and game of all sorts, are free from this objection. That this is 
not the case is strongly suggested by the following paragraph, which 
recently (1880) appeared in the Forest and Stream, from the pen of a 
correspondent of that journal:— 

“ Through the kindness of a professional colleague I had the op¬ 
portunity of examining a wild duck (mallard) a few days ago, which 
w r as, I think, of sufficient interest to warrant the begging of a few 
lines of your valuable space. The duck was infested with a large 
number of encysted parasites of the same general nature as the trichi¬ 
nae found in the muscles of pigs; i. e., an encysted form of en- 
tozoa. It had been bought in the market by a gentleman, but when 
his cook came to prepare it for the spit, she noticed an unusual ap¬ 
pearance of the flesh of the breast, the skin being torn in one place, 
and called the master’s attention to it, and it was by him submitted 
to my friend, who, after sending out a piece cut from the heart to the 
Zoological Museum, at Cambridge, was kind enough to send the bird 
to me, knowing that I was interested in everything pertaining to field 
sports. 

“ The muscles of the duck were crowded with the encysted parasites, 
more especially the pectorals, and they seemed to be more numerous 
at the surface; i. e., just under the skin. The cysts were from ^ to 
of an inch long by about - 3 V in width, being all very nearly of the 
same dimensions. They may be described as cylindrical, with rather 
bluntly rounded off ends, about the color of fat, or rather light-colored 
butter, and were imbedded in the muscles, between the fibres, with 
the long diameter parallel with the muscular fibres. I cannot think 
of any better well-known object to which to compare them than small 
pieces of that form of Italian paste which we call vermicelli. Their 
number may be appreciated when I say that in the space of a square 
inch on the breast, the skin of which had been stripped off, fifteen 
were seen on the surface. I have it at second hand, that Prof. Hagen, 
of the Museum at Cambridge, states that they are cysts of Psoms- 
permia, the immature, encysted stage of the Gregarinioe, and that he 
has never before known of these entozoa being found in the muscles 
of birds. 

“ If these parasites are capable of development in the intestinal 
tract of men, it ought to be known, as from the semi-cooked state in 
which we eat our ducks, the cysts would be very apt to be ingested 
2G 


402 


FOOD AND DIET. 


without having their vitality destroyed. On the other hand, if as 
large and as numerous as in the specimen I saw, nobody, with eyes 
open, could fail to notice the presence of unusual bodies. 

“My object in making this communication is twofold: First, to 
get any scientific knowledge that your many scientific readers may be 
able to give on the subject; and second, to find out from the sports¬ 
men whether the presence of these parasites has been previously no¬ 
ticed in ducks. So far I have not been able to hear of any similar 
case.” 

A note from Dr. Hagen, of Harvard University, addressed to the 
editor of the same paper, confirms the observation above described, 
and states that the Psorospermia is also very common in hams, about 
ten per cent of which are affected. In the ham the parasites are much 
smaller, and hence are not so easily discovered as in the duck. Dr. 
Hagen also mentions the discovery of disgusting parasites in bear- 
fiesh. He says, “ I received yesterday bear-flesh from the market. 
It contained in the cellular tissue next to the veins, cysts containing 
thin white worms, four inches long and less than one-twelfth thick. 
This is a very interesting parasite, described in 1G72 by Fr. Redi, It¬ 
aly, and since seen by nobody. Rudolphi quotes it as Strongylus 
ursi, and Diering as Nematoidium, but both only after Redi’s de¬ 
scription, which was made after the parasites of the European brown 
bear, which is the same species with our bear.” 

Effects on Animals of Abuse and Violent Exertion before 
Slaughtering. —The exhaustion and suffering incident to a long ride 
on the cars, often without sufficient food and water for days, or long 
drives in the hot sun, over dusty roads, producing a feverish condition 
of the system, is seriously damaging to the flesh as food. The same 
may be said of animals which become much excited while being 
slaughtered. Prof. Liebig gives an account of a family of five who 
were violently poisoned by eating the flesh of a deer which had been 
-caught in a trap and struggled violently before it was killed. The 
flesh of such animals is very tender, because decomposition really be¬ 
gins before the animal dies, so greatly are the tissues disintegrated. 
It is observed that the flesh of such animals decomposes very quickly, 
becoming putrescent much sooner than usual. It was once a custom 
in England to “ bait the bull,” that is, tease him with dogs, before 
slaughtering, so as to make the meat tender. The New Zealanders 
have a practice of hanging animals up by their hind legs and whip- 


DISEASED MILK. 


403 


ping them to death. This is said to make the tlesli very tender. 
Such practices are most inhuman; and the use of such flesh must be 
in the highest degree injurious. 

Diseased and Poisoned 3Iilk. —Numerous experiments and ob¬ 
servations in this country and England show that milk may become 
a means of spreading disease far and wide in two ways: 1. By com¬ 
municating disease from diseased animals; and, 2. By being the car¬ 
rier of contagions, infections, or other forms of germs by disease which 
is produced in those who make use of it. 

1. It is now well 
established that 
the milk of ani¬ 
mals suffering with 
pulmonary ' disease 
or consumption will 
communicate the 
disease t o human 
beings as well as 
to other animals. 
The most serious consequences have resulted from the use of milk 
from animals affected with “ milk sickness,” “ foot-and-mouth disease,” 
the “trembles,” and various other maladies. In Figs. 159 and 160 
may be seen a specimen of healthy milk compared with that which 
is diseased. 

2. Many well-authenticated instances are recorded in which typhoid 
fever, diphtheria, scarlet fever, and possibly other diseases, have been 
spread over whole communities through the medium of milk. This has 
most often happened through the adulteration of milk with water con¬ 
taminated with the diseases mentioned, but cases have occurred when 
the only possible means of contamination was through the washing of 
the cans with impure or contaminated water. We are acquainted 
with the circumstances of an epidemic of typhoid fever in which we 
were able to trace the origin of a large proportion of the sixty cases 
which occurred to the use of milk from cows watered from a well in 
the barn-yard. 

Cases of mysterious poisoning occur not infrequently from the use 
of milk and cheese, the cause of which is still somewhat obscure. In 
response to a question respecting cases of this kind occurring in Wis¬ 
consin, Prof. Arnold remarked as follows in 1876 in the New York 
Tribune :— 



Healthy Milk. Diseased Milk. 


404 


FOOD AND DIET. 


“ Cases of poisoning similar to that described have been the occasion 
of much solicitude among dairymen and others, as they are every now 
and then breaking out in different parts of the country. Cases of a 
milder type are not infrequent, the symptoms running no further than 
nausea and pain in the stomach and bowels, without either vomiting or 
purging. I have satisfactorily traced the cause to organic poison in the 
milk, derived from the use of bad food and water taken by the cow. 
When water which is foul is permitted to stand where it is warm, or 
at a temperature at which organic changes can take place, organisms of 
one kind or another, poisonous to the human body, it is well known be¬ 
come developed, as is proved by the use of the water. Cows making 
use of such water are liable to take the poison germs into their circulat¬ 
ing system and excrete them in their milk. As in the processes of 
cheese-making the milk receives no treatment which will destroy them, 
they carry their vitality into the cheese, which, when eaten and dissolved 
in the stomach, sets them free to produce their legitimate results. When 
milk thus affected is used for butter, the poison is liable to and does ap¬ 
pear in the butter, producing the same symptoms as in the case of 
cheese. Or if the milk is used directly, exactly the same results follow 
as when made into butter or cheese. Dr. Inglehart, of Syracuse, N. Y., 
is now investigating a case of this kind. It is a case of poisoning in 
which a number of persons were affected precisely as in cases of poison 
cheese, and has been traced to the use of milk, and the milk traced to a 
herd of cows which had access to a cesspool in the yard and had their 
brewer’s grains moistened with water from a well affected by the drain¬ 
age in the yard. The writer has had personal experience in the use 
both of poison milk and poison cheese, and can identify their connection. 
This origin of the cause of the poison is supposed by some to be impossi¬ 
ble, because it is supposed impossible that organic germs could pass 
through the walls of the gland cells. But it has been rigidly demon¬ 
strated that germs which are taken in at the mouth come out in the 
milk alive, and afterward develop and multiply. (See “ Poison Cheese,” 
Seventh Annual Report of American Dairymen’s Association.) Cases of 
this kind are all the time occurring in dairy experience. Three cases 
have come to my knowledge within the past year where poisonous fer¬ 
ments taken in with the food of the cows have been developed in their 
milk and appeared in cheese and in butter and buttermilk. 

“It is useless to appeal to chemical analyses for the cause; for the 
analysis kills the germs on which the poison depends, and of course it 


EFFECT OF DIET UPON ANIMAL FOODS. 


405 

eludes the chemist’s most careful work. Cases of mineral poison now 
and then occur from lead derived from the paint in the vessels used 
about the dairy, or from some other accidental circumstance. These the 
analyst can trace out with great exactness, but in cases of organic poi¬ 
sons his labors have been futile, and these cover the great majority of 
the cases of poison cheese, in which, I have no doubt, the poisoning hi 
Wisconsin is included. The cause of this kind of poisoning is a ferment, 
and has the nature of yeast. A little leavens all it is mixed with. The 
milk of a single cow will poison the largest vatful. The remedy is to 
keep all bad food and water out of the way, to remove the cause.” 

No doubt many of the cases of diarrhea and dysentery which are 
attributed to other causes, and frequently to harmless articles of food, 
might, by proper research, be traced to the cause pointed out above. 
The remedy indicated by Prof. Arnold is a good one, so far as it goes, 
but it is certain to be totally disregarded, in all but a very few cases, at 
least. A better remedy is to discard so questionable an article as cheese 
altogether, and to be very cautious about .the use of milk during the sum¬ 
mer months, or never to use it without first scalding- it. 

Effect of Diet upon Meat, Milk, and other Animal Foods.— 

The effect of food upon the flesh of animals in rendering it unwholesome 
has already been referred to in another connection. We wish only to 
call attention here to a few of the more common dangers. In certain 
parts of the country and at certain times of the year, the flesh and milk 
of cows is rendered unwholesome by their eating plants poisonous to hu¬ 
man beings. There is reason to believe that both the flesh and the 
eggs of fowls are affected in a similar manner, by the use of bad 
food. Both fowls and hogs are very apt to eat carrion and other foul 
substances which come in their way, which cannot be otherwise than 
detrimental to their flesh and to the eggs of fowls. This subject has re¬ 
ceived little or no attention, but we believe it to be important. It is 
well known that in certain parts of the country some varieties of birds, 
especially pheasants, are likely to be poisonous. This is said to be the 
case in Pennsylvania, where it is supposed to be due to their eating laurel 
buds. Fish of some kinds are sometimes poisonous at certain seasons of 
the year, and some varieties of fish are always poisonous, producing 
death when eaten, almost as quickly as prussic acid. Persons have been 
known to expire with a morsel of the fish in their mouths yet unswal¬ 
lowed. Danger of this kind is chiefly confined to the tropics. 

Another similar danger, but recently recognized, exists nearer home. 


406 


FOOD AND DIET. 


in the case of oysters, mussels, and various shell-fish. As is well known, 
these mollusks are the scavengers of the sea. They subsist upon the de¬ 
composing organic matters which they find in solution in the water in 
which they live. For greater convenience in marketing, extensive beds of 
oysters and clams are planted near large cities; and it not infrequently 
happens that they feed and fatten on the filth from sewers which empty 
into the sea in the vicinity of the beds, or which is brought to them by 
the tide. Not long since, the London Lancet called attention to this 
danger, stating that many cases of illness are undoubtedly attributable 
to the use of this unwholesome food. Shell-fish of all sorts are very 
poor food at the best, and are not worth the risk necessarily taken in 
eating them. 

In France and Belgium, oysters are made, if possible, still more un¬ 
wholesome by keeping them for several months in stagnant water 
until they become bloated and green, when they are served up to tickle 
the depraved palates of French gourmands. Such food cannot but be 
productive of injury to those who consume it, although the real cause of 
the maladies from which they suffer is sure to be overlooked. Violent 
poisoning from the eating of clams, oysters, snails, and lobsters, is not an 
uncommon occurrence. 

At a Sanitary Convention held in Detroit, Jan. 7 and 8,1880, under 
the auspices of the State Board of Health, of Michigan, the first conven¬ 
tion of the kind in America, a physician of that city read a valuable pa¬ 
per on the supply of milk in cities, in which he called attention to the 
injury likely to result from the use of milk from cows fed on unwhole¬ 
some food. He remarked as follows on this point :— 

“ There is no doubt that much of the mortality of children can be set 
down as resulting from the use of adulterated milk, or what is j ust as 
bad, milk made from unwholesome food. The milk that a cow gives is 
largely determined by the food she eats, and in order to get good whole¬ 
some milk you must feed good wholesome food. If you feed swill, you 
must expect swill-milk.” 

Dr. Bell and others have shown that much of the infant mortality in 
New York City in past years has been due to the use of milk from cows 
fed on distillery slops, and known as swill-milk. We are convinced, by 
observation, that the evil is not confined to cities. We have often 
known farmers to feed their cows on the swill and slops from the house, 
and it is a very common thing to keep cows shut up in the summer time 
for weeks in inclosures where their only opportunity to quench their 


DISEASED VEGETABLE FOODS. 


407 


thirst is afforded by a stagnant, slime-covered mud-pool. Milk from 
cows kept under such conditions cannot but produce disease. 

It may also be mentioned here, perhaps, as well as 
elsewhere, that the treatment of cows must affect 
the character of milk in a marked degree. The ef- 
feet of anger in a mother upon a nursing child 
through changes in the milk are well known. It is 
then evident that ill treatment which may excite an 
animal to rage before or during milking may cause 
such changes in the milk as will affect the consumer 
cleleteriously. Children, whose power of resistance to 
morbid influences is much less than that of grown 
people, would be especially liable to injury from this 
source. 

Attention has also been recently called to the im¬ 
portance of securing healthy persons to milk cows 
and care for milk in connection with dairies, since 
it has been suggested, on very probable grounds, that 
one of the vilest and most ineradicable of all diseases 
may be communicated through the medium of milk 
by persons affected by the disease, especially when 
employed as milkers. 

Diseased Vegetable Foods. —Although more 
rarely affected by disease, some forms of vegetable 
food are subject to unnatural conditions which some¬ 
times become a serious cause of disease. Perhaps 
the most common and serious malady induced in 
this way is that known as ergotism, which results 
from the use of flour from what is termed spurred 
rye or wheat. Barley, rice, and other grains are also 
affected. Ergot is a fungus botanic-ally known as 
Claviceps purpurea, which in wet seasons grows 
upon the grains mentioned. Previous to the eight¬ 
eenth century the disease was much more common 
than it is now, since its cause is known and avoided. 

Extensive epidemics have occurred, which have 
sometimes been very fatal, the persons poisoned dying of exhaustion 
after suffering untold agonies from tetanic convulsions 



Fig-. 160. Spurred 

Eye or Ergot. 



Fig. 


161- Ergot Grains 
Enlarged. 


Gangrene 


occurs in one form of the disease. l H igs. 1(51 and 162 are idustiations. 




408 


FOOD AND DIET. 


of this poisonous fungus. The presence of ergot in flour may be 
detected by the violet color, peculiar odor and flavor of the bread made 
from it, and by the following chemical test: Make a paste of the flour, 
and add a little dilute nitric acid. The appearance of a reel color is evi¬ 
dence of the presence of ergot. The addition of caustic potash should 

change the red to vio- 
let. Another method is 
to add caustic potash 
and heat the mixture. 
If ergot is present, it 
will be shown by a 
characteristic odor re¬ 
sembling that of her- 

O 

rings. 

© 

Dr. B. W. Richard¬ 
son of England holds 
that cerebrospinal 
'meningitis, a most fa¬ 
tal malady, is due to 
ergot poisoning and to 
the use of bread made 
from grain affected with 
smut. A report of an 

made in 1875 by Dr. H. B. Baker, Secretary of the State Board of 
Health of Michigan, affords evidence in support of this view. Grain 
of this description should, of course, never be used for food. 

Pellagra, a disease which occurs particularly in Lombardy, is sup¬ 
posed to be due to the use of corn affected by a fungus. The skin be¬ 
comes dry and wrinkled, the mind and nervous system are powerfully 
affected, and convulsions occur similar to those observed in ergotism. 

Rust, Red-Rag, or Red-Gum, —A fungus growth which often 
affects wheat is known by each of the above names in various parts of 
this and other countries. There are grounds for suspicion that flour 
infested with this fungus is a cause of serious disease. Fig. 163 shows 
wheat flour which is infested by the spores of the rust fungus. Fig. 164 
shows the mature plant. 

Smut Rolls, or Pepper Brand. —The spores seen in Fig. 165 rep¬ 
resent very fairly those produced by the fungus of that name, which 
is a later form of the rust fungus. 


epidemic of this disease, 



Fig'. 162 . Flour Infested with Rust, as seen under the 
Microscope. (Hassall.) 





ANIMAL PARASITES. 


409 


Animal Parasites. 

—The iveevil and 
midge are the most 
common parasitic in¬ 
sects destructive to 
grain. In the case 
of the weevil, the 
center of the grain is 
eaten by the insect, 
leaving merely a shell. 
The midge is injurious 
through the voracity 
of the yellow maggots 
or caterpillars that 
develop from eggs de¬ 
posited in the blossoms 
of the wheat, which 
is thus rendered worth¬ 
less, through the fail¬ 
ure to develop grains. 

Another very curi¬ 
ous parasite is ear- 
cockle , or pepper-corn, 
which is thus described 
by Hassall: u The 
grains affected turn 
green at first, and ul¬ 
timately black; they 
become rounded, re¬ 
sembling a small pep¬ 
per-corn ; the husks 
are spread out and the 
awns twisted, by 
which means the in¬ 
fected ears are read¬ 
ily observable amongst 
the ' standing corn. 
The blighted grains 
are filled with a moist, 



Fig. 103. The Rust Fungus (Hassall). 



Fig. 164. Spores of Smut Bolls (Hassall). 






410 


FOOD AND DIET. 


cotton-like substance, and contain no flour. This substance is composed 
of myriads of eel-shaped animalcules, which, as soon as moistened with 
water, exhibit the most active movements. A most extraordinary cir¬ 
cumstance connected with these animalcules is that they may be so per¬ 
fectly dried that on the slightest touch they break up into powder, and 
yet, when moistened, they will revive and become as active as at first. 
This operation may even be repeated several times before the vitality 
of the animalcules is fully destroyed.” 

The Meal-Mite. —Damaged flour is often infested by mites very 
closely resembling the sugar-mite and its near relative, the itch-mite. 
One variety of this species of acarus is to be seen on Plate X, together 
with the sugar-mite. 

The Sugar-Mite. —Brown sugar is very liable to be infested with 
a parasitic insect closely resembling the itch-mite, of which it is a near 
relative, as well as of the acarus folliculorum, of the sebaceous follicles. 
It is known as the acarus sacchari. The disease known as grocers’ itch 
is produced by this insect, which burrows into the hands of those who 
handle the cheap grades of brown sugar, especially those known as raw 
sugars. The bisects cannot be seen without a microscope. A very good 
representation of the sugar-mite is shown in Plate X. 

Decayed Food. —It has been clearly shown by numerous cases, that 
the use of decayed or moldy food is dangerous to health and life. Prob¬ 
ably decayed flesh is the most dangerous. More than four hundred 
cases of poisoning from the use of moldy sausage have occurred in Wiir- 
temburg, Germany, within the last fifty years, one hundred and fifty of 
which have been fatal, from which it will be seen that the use of such 
food is in the highest decree dangerous. 

Cases of most severe poisoning have occurred from eating moldy 
bread, decayed cheese, milk which had been kept in cans not well 
cleaned, and canned meat which had undergone a species of decomposi¬ 
tion which cannot be detected by the smell or appearance, but which 
renders the meat extremely poisonous. Fish is much more apt to un¬ 
dergo this peculiar change than other kinds of food. 

As is well known, meat is much more tender and has a higher 
flavor after being kept sufficiently long after killing the animal to al¬ 
low decomposition to begin. When decay has progressed so far as to 
give to the flesh a distinctly putrescent odor, it is said to be “ high” 
Game of all sorts is usually eaten in this condition. In Europe it is 
generally customary to allow all meat to get very “ high ” before it is 



Platk X 












DECAYED FOOD. 


411 


considered fit for the table. In France the degree of putrescence de¬ 
sired is generally greater than in England. Many wild tribes much 
prefer their food in a state of decay. Decomposed fish, under the 
name of gnappee, is said to be considered by Burmese epicures as one 
of the choicest of dainties. The loathsome stuff is thus described by 
a correspondent of the London Times :—- 

“ This horrible mass of putrefaction is one of the choicest dainties 
of the Burmans. A quantity of fish, caught in the sea, is pickled, and 
then buried in the earth, and left there to attain the desired pitch of 
rottenness, for a time varying from one to four years, according to 
the taste of the particular market for which it is destined. Just as 
the wine manufacturers of Epernay and Rheims give to their cham¬ 
pagnes particular flavors to meet the various tastes of their clients, so 
the dealers in gnappee are said to prepare their delicate commodity. 
Whether kept for one or four years, it is absolutely putrid, and 
swarming with loathsome animal life. Not only do the Burmans 
love the horrible viand itself, but they actually revel in its effluvium, 
and the native passengers on the flats which carried it nestled and 
snuggled up to the vicinity of the nastiness, inhaling its stench with 
as much gusto as a hungry London gamin sniffs the odors of a cook- 
shop. Can human beings consume this loathsome putridity without 
suffering evil consequences ? I remember on the eve of my departure 
for a previous visit to India, that Mr. Jonathan Hutchinson, the emi¬ 
nent surgeon, asked me to observe, if I had the opportunity, whether 
the salt fish on which a large proportion of the population of the In¬ 
dian sea-board subsisted, appeared productive of any specific disorder. 
The opportunity for such an inquiry did not then offer itself; but 
in Burmah there are two facts which may have some relation one 
with the other: that this putrid, pickled fish is an extensive article of 
consumption as human food, and that leprosy is so prevalent in the 
jail of Rangoon that it is found necessary to have a special ward for 
lepers.” 

The same writer also suggests that the destructive outbreak of 
plague which occurred in Astrachan was probably largely due to the 
use of this kind of food. 

While food which is far advanced in decomposition many times 
seems to be eaten with impunity, there is good reason, as intimated 
above, for believing that food of this character may be an active cause 
of loathsome and very fatal diseases. Not infrequently, too, acute 
and fatal poisoning occurs. 


412 


FOOD AND DIET. 


Serious sickness frequently arises from the use of stale eggs, espe¬ 
cially in the summer time, when it is often difficult to obtain eggs 
that are fresh.. 

During warm weather, eggs speedily undergo changes akin to 
putrefaction. The shell but partially protects its contents from the 

destructive action of 
germs, unless it is 
rendered impervious 
by the application of 
some substance capa¬ 
ble of filling the pores 
so that the air cannot 
pass through. 

An English' gen¬ 
tleman who has in¬ 
vestigated the subject 
quite thoroughly, 
finds, upon a careful 
microscopical exami¬ 
nation, that stale eggs 
often contain certain 

peculiar cells of a fun- 
Fi^. 165. Spores of Yeast Magnified. (Hassall.) gold character. These 

seem to be developed from the yolk of the egg, that portion which 
should furnish the material to form the flesh and bones of the chick 
which the egg would have produced by development under favorable 
conditions. Eggs containing these cells produced a poisonous effect 
upon dogs to which they were fed. We knew a case in which a 
whole family were seized with violent purging in consequence of the 
use of stale eggs; at least the difficulty could be assigned to no other 
cause. 

Eggs grow lighter as they grow older, by the evaporation of their 
fluid contents, causing the internal portion to shrink. This leaves a 
small air space at one end, which becomes larger as the egg is older, 
and if it is very stale it will float when placed in water. Such eggs 
should be discarded as unfit for food. 

Rotten Clieese. —When fresh made, cheese is not an unwhole¬ 
some food, though rather difficult of digestion; but when it has 
passed through the process of curing, or maturing, which is really a 





YEAST A XT) MOLD. 


413 


process of decay, it is wholly unfit for food, being difficult of diges¬ 
tion, and likely to interfere with the digestion of other food. Some 
kinds of cheese, especially those of foreign make, as the limburger, is 
utterly loathsome to all unperverted tastes, and should on no account 
be eaten. Cheese often contains a peculiar grub, the larvm of a spe¬ 
cies of fly, commonly 
known as skippers or 
jumpers, from their 
jumping powers. If 
a man could leap as 
high in proportion to 
his length as a skip¬ 
per, he could easily 
spring over a steeple 
one ‘hundred feet high. 

Another parasite 
which infests cheese 
is known as the 
cheese-mite, which so 
closely resembles the 
itch-mite, or acarus 
scabiei, that it is not 
necessary to represent 
it. 

Yeast and Mold. 

—One of the most 
active agents in the 
production of decom¬ 
position is the yeast fungus, the spores of which are well shown in 
Fig. 16G, and the fully developed fungus in Fig. 1(>7. This is the 
effective agent in the fermentation of beer and wine, the raising of 
fermented bread, the “working” of cider, etc. It is the presence of 
many of the spores unaffected by the heat which renders the use of fer¬ 
mented bread objectionable in some cases of dyspepsia. Compressed 
yeast consists of the spores of the plant dried and compressed. With 
the aid of warmth and moisture, fermentation will take place sponta¬ 
neously, as the air constantly contains many of the yeast germs, or spores, 
which find ready access to fermentable substances and induce their pe¬ 
culiar process. 



Fig. 166. Yeast Fungus Magnified. (Hassall.) 









414 


FOOD AND DIET. 



Fig. 1G8 is a representation of the green mold so often seen on old 
cheese, stale bread, and other articles of food, as seen under a good micro¬ 
scope. It is by no means a harmless fungus, as the most serious illness 
has frequently resulted from the use of food affected with mold. In one 

case a whole family were 
poisoned by eating a 
pudding which con¬ 
tained a few pieces of 
stale and moldy bread. 

Stale Vegetables.— 

The use of stale vegeta¬ 
bles is often a cause of 
serious disturbance of 
the bowels, especially 
early in the season, 
when many kinds of 
vegetables are taken to 
market in an unripe 
and immature state. 
Vegetables and fruit 
keep fresh much longer 
than animal foods ; but 
when kept in the vi¬ 
cinity of strong and of¬ 
fensive odors they ab¬ 
sorb bad gases and may 
thus become unwholesome. Fruits and vegetables which have begun 
to decay are unfit for food. Potatoes and other vegetables which 
have begun to sprout much are not fit to be eaten. Potato sprouts 
contain a poison which may produce serious results, as it is of about 
the same nature as belladonna and other poisons of that class. 

Vegetables can be best kept in a wholesome condition by storing 
in a cool, dry place. The damp, dark vegetable cellars, usually located 
under a house or barn, are anything but wholesome. The vegetables 
rapidly deteriorate in quality, and the poisonous gases generated by 
decay ascend into the house to poison and sicken its inmates, as is 
well shown in Plate XV. 


Figr. 167. 


Green Mold of Old Cheese and Stale Bread. 
(Hassall.) 








MODES OF ADULTERATION. 


415 


ADULTERATIONS OF FOODS AND DRINKS. 

The present seems to be an age of fraud and deception, and in no 
direction is the prevailing tendency more manifest than in the adulter¬ 
ation of food. It would seem that of all forms of adulteration this 
would be the last to be thought of or perpetrated; but so great is the 
cupidity of men in search of wealth that they do not hesitate to seize 
upon every opportunity for sophistication of food or drink of any de¬ 
scription, utterly regardless of the consequences to the consumers of 
the vile compounds. In many countries this evil has grown to such 
magnitude that it has by law been recognized as a criminal offense, 
to be visited with punishment when detected. Notwithstanding all 
laws, however, the nefarious business flourishes, and especially in a 
country like this, where there is as yet not adequate legislation to con¬ 
trol it. The punishment usually inflicted, when the crime is recog¬ 
nized and the offender tried and convicted, is so slight that there is 
no hesitancy in repeating the attempt to defraud the consumer, by 
sophisticating any article of food or drink he may purchase. We 
would suggest that an excellent means of punishment in many cases 
would be to compel the person found guilty of adulteration to con¬ 
sume the adulterated articles himself, and thus feel the actual effects 
of his crime. Such a mode of punishment would soon put a stop to 
the worst forms of adulteration, at least. 

Modes of Adulteration. —The different forms of adulteration may 
be classified as injurious, fraudulent, and accidental. In one or the 
other of these ways a large share of the articles employed as food or 
drink have been adulterated to the serious detriment of either the 
health or the pocket of consumers. Some of the more serious of these 
adulterations we will now notice, also describing, so far as may be 
practically useful, the best modes of detection. 

Hassall, in his very excellent work on the adulterations of food, 
enumerates the following formidable list of injurious substances act¬ 
ually found in different articles of food:— 

Cocculus Indicus, arsenite of copper, emerald green or Scheele’s 
green, sulphate of copper, or blue vitrol, acetate of copper, or verdigris, 
carbonate of copper, verditer, chromate of lead, red oxide of lead, 
Venetian red, bole Armenian, red and yellow ochres, umber, carbonate 
of lead, plumbago, or black-lead, bi-sulphuret of mercury, or cinnabar, 
sulphate of iron, cayenne, gamboge, chromate of potash, Brunswick 


410 


FOOD AND DIET. 


green, indigo, Prussian blue, Antwerp blue, ultramarine, alum, sul¬ 
phuric acid, and bronze powders, besides chalk, plaster of Paris, terra 
alba, and other substances in some degree injurious, though not act¬ 
ively poisonous. 

Let us now consider in detail some of the substances contaminated, 
and the modes of detecting the adulterants. 

Bread. —In this country, where good flour is usually moderate in 
price, adulteration of bread is not as common as in England and some 
other foreign countries; there is no doubt, however, that adultera¬ 
tion is not uncommon even in this country, especially in the large 
cities, and particularly in the bread supplied to the poorer classes. 
The objects of the adulteration of bread are the production of a loaf 
of good appearance from inferior flour, and the retention of a large 
proportion of water so as to increase the weight, as in many cities the 
weight of loaves of a certain price is regulated by law. For this 
purpose alum is more frequently used than any other substance, as it 
produces the desired effect. Sulphate of copper has also been used, 
but seldom. Alum is very deleterious to the digestive organs, produc¬ 
ing bad dyspepsia when long used. Hence, its detection is important. 
The following is a simple method which any one can employ:— 

Detection of Alum in Bread. —The simplest method is to dip a 
slice of the suspected bread in a solution of logwood in water (either 
the extract or fresh chips may be employed). If alum is present, the 
bread will become a claret color. A more precise method is the fol¬ 
lowing. Macerate in three or four tablespoonfuls of water a half slice 
of .bread; strain off the water, and add to it twenty drops of a strong 
solution of logwood. Then add a large teaspoonful of a strong solu¬ 
tion of carbonate of ammonium. If alum is present, the mixture 
wall be changed from pink to a lavender-blue. This test will discover 
a grain of alum in a pound of bread. 

To Detect Blue Yitriol in Bread. —Dissolve some of the bread 
in warm water. Add a strong solution of prussiate of potash. If 
copper is present, a chocolate color will appear. 

Flour. —Wheat flour is sometimes adulterated with alum, ground 
rice, grit, and sand. Potato starch was formerly used, when flour was 
very high in price, but is now seldom or never employed for this pur¬ 
pose. Flour is sometimes contaminated with lead, which comes, to¬ 
gether with the grit and sand, from the wheat being ground with 
newly cut stones, and with stones the grinding faces of which have 


ADULTERATION OF BUTTER. 


417 


been repaired with lead. A number of cases of lead poisoning from 
this cause have been reported. Flour is also adulterated by admixt¬ 
ure with inferior grades, and with flour made from musty or grown 
wheat. Such flour should not be eaten. 

Alum may be detected in flour by the same method described for 
bread. The adulteration with rice and potato starch, with sand and 
metallic lead, may be detected by means of the microscope. 

Butter. —Formerly the only adulterants employed in butter were 
excess of salt, starch, and annatto, a peculiar coloring matter, which 



is itself often adulterated with gypsum, red lead, and blue vitriol. 
Within the last few years, however, an immense business has sprung 
up in the manufacture not only of adulterated butter, but of an arti¬ 
cle which is wholly counterfeit. This fraudulent article is known to 
the trade as oleomargarine butter; but the article is retailed to con¬ 
sumers as genuine. Immense quantities of lard and tallow are manu¬ 
factured into bogus butter in the larger cities of this country, as well 
as abroad. This artificial butter is often found to contain portions of 
flesh, membranes, and muscular tissue; and undoubtedly much of it is 
made from diseased hogs and cattle. It is highly probable that both 
tape-worm and trichinae may be communicated by this article. Fig. 
1G8 shows the contrast between genuine and artificial butter as seen 
under the microscope, the only means of detection. 

The presence of annatto is shown by the unnaturally deep color 
of the butter. Other adulterants are easily detected by melting the 
butter with a gentle heat which causes them to separate. 

27 










418 


FOOD AND DIET. 


Milk. —No article of food of general consumption is so frequently 
adulterated as this. The most common adulterant is water. It is 
said that chalk, annatto, burnt sugar, infusion of sheeps brains, and 
salt are also added in some cases. A fraud is also practiced in skim¬ 
ming the milk, or a part of it, before taking to market. The sub¬ 
stances commonly added are not often actually poisonous in them¬ 
selves, although numerous cases of typhoid fever have occurred, in 
which the disease was traced to the use of milk which had been 
adulterated with foul water. It is probable that diphtheria, and per¬ 
haps other diseases, are occasionally communicated in the same manner. 
Milk may also be contaminated with lead from the use of water con¬ 
taining this poison, and from standing in lead or zinc vessels. 

It is not always easy to detect adulterations in milk without a 
careful analysis; but any unnatural appearance or unpleasant odor 
should cause it to be rejected at once. Milk should be purchased only 
of reliable parties, and careful inquiry should be made respecting the 
care of the animals from which it is produced, as one of the most 
dangerous means of adulterating milk is feeding cows upon unwhole¬ 
some food, and keeping them in close, foul, unventilated stalls. Under 
these circumstances, especially when the secretion is greatly prolonged 
beyond the natural period, as in cows known as “ farrow,” the milk 
secretion really becomes an excretory product, and contains quite a 
large proportion of the waste matters of the system. Such milk is 
totally unfit for human food, and when fed to children, especially, 
will be certain to produce very marked and disastrous results. 

Sugar.—The different varieties of sugar, sirup, and honey, are 
the subject of frequent and extensive adulteration. It has long been 
known that sugar could be manufactured from starch by boiling it 
for some time with dilute sulphuric acid. By a slight variation of 
the process, sugar can also be made from woody fibre of all sorts, as 
cotton, sawdust, shavings, etc. The sugar thus made is called glucose, 
as it closely resembles the sugar of grapes. It is much inferior to 
cane-sugar in sweetening properties, and does not crystallize, as does 
cane-sugar. It possesses chemical properties in several respects dif¬ 
ferent, by means of which it is readily distinguished. In the man¬ 
ufacture of glucose the sulphuric acid is neutralized by chalk, but as 
it is not always wholly removed, a portion may be retained in the 
sugar in a free state, as well as combined with iron in consequence of 
the contact of the acid with iron during the process of manufacture. 


ADULTERATION OF SIRUP. 


419 


On account of the non-crystallizable character of glucose it cannot 
be readily mixed with the coarse granular sugars, but it is used in large 
quanities in the fine granulated and pulverized sugars. 

The cheap grades of sugar have often been adulterated with 
plaster of Paris, sand, clay, bone-dust, and numerous similar sub¬ 
stances used to increase weight. Recently the astonishing discov¬ 
ery has been made that chloride of tin, an exceedingly poisonous 
salt, is used very extensively for the purpose of bleaching colored 
sugars, and is not wholly removed by the refining process. 

The presence of glucose in sugar can be easily detected by the fol¬ 
lowing method : Dissolve in a test-tube half a teaspoonful of the sus¬ 
pected sugar, in two teaspoonfuls of warm water. Add six or eight 
drops of a strong solution of blue vitriol. This will give to the solu¬ 
tion a faint blue tinge. Now add a solution of caustic potash. 
This will deepen the blue color greatly, and produce a curdy appear¬ 
ance. Continue to add the potash until the solution becomes clear, 
shaking the test-tube frequently so as to mix the contents well, and 
then heat to boiling in the flame of a spirit-lamp. If grape-sugar is 
present, as the liquid approaches the boiling point a yellowish color 
will appear, which will soon deepen to orange, then orange red, and 
deep red. The changes in color are due to the precipitation of red 
oxide of copper, which is the chemical test for grape-sugar. 

The inorganic adulterants of sugar mentioned can be readily de¬ 
tected by dissolving the sugar, when they will appear as a sediment. 

Sirup. —Sirups are still more extensively adulterated than sugars, 
as the fraud is much more easily covered in them. Seven years ago 
(1873), we examined a large number of specimens of sirup of every 
grade, varying in price from eighty cents to two dollars per gallon, 
and found ninety-five per cent of them grossly adulterated with 
sugar made from the refuse of corn-starch factories. Much of this 
kind of sirup is also made from potato starch. In the West there are 
several large firms exclusively engaged in the manufacture of artificial 
sugar from corn. Probably the most serious injury from the use of 
these sirups arises from the sulphuric acid which they contain, some¬ 
times in considerable quantity, besides quite large quantities of iron 
in some cases. We have known of instances in which serious injury 
has been done by this fraudulent stuff. A case is reported in which the 
cork of a jug of sirup was said to have been considerably corroded 
while on the way to a lumberman’s camp. In a case which came 


420 


FOOD AND DIET. 


under our observation a party of young persons had what was termed 
a “ candy pull,” making candy of sirup which had been purchased as 
“ golden drip.” The next morning every one who had eaten of the 
candy found his tongue and teeth as black as ink, from the action of 
the chemicals contained in the sirup. Such compounds must cer¬ 
tainly be wholly unfit to be put into the stomach of any human 
being. 

This fraud is not always easy to detect, but it may generally be dis¬ 
covered through the action of well-known chemical re-agents upon the 
sulphuric acid and iron which it is almost certain to contain. These 
substances may be detected by the following means:— 

Test for Iron .—It is well known that iron forms with tannic acid a 
black compound. It is by this means that ink is made from oak-bark 
or logwood and salts of iron. Hence by adding a little of the sirup to a 
solution of tannin, it will become black. Common tea contains tannin 
in sufficient quantity to make a good test. Into half a cup of moder¬ 
ately strong, clear tea put a teaspoonful of the sirup. If the tea be¬ 
comes black, iron is present in the sirup. It is true that the iron itself 
in very small quantities may not be productive of great injury, though 
hi the quantities in which we have found it we think it might do harm; 
but a knowledge of its presence is of value as indicating the probable 
presence of sulphuric acid and of glucose. Sirup or sugar which will 
blacken tea may well be suspected and avoided. 

Test for Sulphuric Acid. —Procure at a drug-store a dram of 
nitrate or chloride of barium. Dissolve in a few spoonfuls of water. 
Dissolve some of the sirup in warm water in a test-tube or clear, clean 
vial. Add some of the barium solution and shake. Set aside for half 
an hour. If a white powder appear at the bottom of the vial as a sedi¬ 
ment, the sirup undoubtedly contains sulphuric acid, and should be 
rejected. 

The adulteration of sirups is so common that it is entirely unsafe to 
purchase or use the article, no matter how alluring its name or fine its 
appearance, without ascertaining its purity by careful testing. 

Adulterated and Artificial Honey.—A large share of the 
strained honey in market is adulterated with glucose, as well as are 
sirups. In some cases, so-called honey contains not a particle of the 
genuine article, being simply a flavored sirup of glucose. We have 
examined specimens in which considerable quantities of sulphuric acid 
were present. 


ARTIFICIAL HONEY—CANDY. 


421 


Unscrupulous men are in different parts of the country engaged 
in the manufacture of artificial honey from cane-sugar and various 
flavoring ingredients. We were informed by a gentleman not long 
since that in a Western State he had encountered a man who was 
traveling through the country selling a recipe for making artificial 
honey. W hen solicited to purchase, he very properly responded that 
he had nothing whatever to do with frauds of any kind. 

It is stated that another very ingenious form of adulteration of 
honey has been quite extensively practiced. What is termed the 
foundation of the comb is made of paraffine, a wax-like substance 
made from petroleum. This saves the bees much labor, as they have 
but to build up the cells on the foundation furnished them. Then, to 
still further economize their time and labor, they are abundantly 
supplied with glucose in solution, which they have but to transfer to 
the comb, thus avoiding the trouble of gathering sweets from distant 
fields. Of course no transformation takes place in the artificial sugar, 
it being simply transferred from the feeding vessel to the comb. 
Thus we have honey which is wholly artificial with the exception of 
a portion of the wax. This certainly caps the climax of adulterations. 

The tests for artificial and adulterated honey are the same as those 
for glucose in sirups. 

Candy. —Of all mixtures put into the stomach, probably candy is 
nearly, if not quite, the most thoroughly adulterated. With the ex¬ 
ception of rock candy, which is pure crystallized cane-sugar, there is 
probably no variety of candy which is not adulterated more or less. 
Very little cane-sugar is employed in its manufacture, it being chiefly 
composed of glucose. Considerable quantities of gypsum and terra 
alba are also used, especially in the cheaper grades. The flavoring 
substances employed are all artificial and unwholesome, often poison¬ 
ous. But the most deleterious adulterant used is found in the colors 
with which candies are made attractive to unsophisticated eyes. No 
less than twenty-four different coloring substances, mostly mineral, 
are employed, all of which are rank poisons. Numerous cases have 
occurred in which poisoning has been traced directly to colored can¬ 
dies, and in some instances death has occurred. 

We need not give directions for the detection of adulteration in 
candies, for all are bad, and should never be allowed to enter a human 
stomach. Children especially, should of all persons be forbidden these 
poisonous dainties. They would be harmful enough to warrant their 


422 


FOOD AND DIET. 


disuse if they were wholly pure; but as it is, they are absolutely dan¬ 
gerous ; and the manufacturers should be dealt with as foes to the 
public health. 

Adulteration of Baking-Powders. —The competition in trade 
and the cupidity of manufacturers, as might reasonably be expected 
in these days of wholesale and almost universal sophistication, has led 
to the wholesale adulteration of this widely used commodity. Some 
time since, Henry A. Mott, Ph. D., government chemist, made an ex¬ 
tensive series of analyses of baking-powders and published the re¬ 
sults, which showed that many of the most popular brands were 
largely adulterated with alum, the deleterious effects of which were 
well known. There was a great disturbance at once among the man¬ 
ufacturers of baking-powders, and it was not long before the attempt 
was made to convince the public that alum when used in this manner 
is in no way detrimental to health, it being claimed that the chem¬ 
ical reactions which take place when it is used in raising bread are 
such as to convert it into a different and wholly harmless substance. 
In order to answer these specious arguments conclusively and satis¬ 
factorily, Dr. Mott undertook an extended series of experiments with 
alum baking-powders upon animals. He selected healthy dogs and 
fed them upon biscuit made with the baking-powder. In every case 
the dogs became sick, some within a few hours, and others after a day 
or two. As a general rule they would scarcely touch the biscuit after 
the first day, preferring starvation to poisoned food. The principal 
symptoms arising from the use of the alum baking-powder were sick¬ 
ness, violent vomiting, loss of energy, and weakness of the limbs. 
The effects upon human beings have been shown to be, “headache, in¬ 
digestion, flatulence, constipation, diarrhea, dysentery, palpitation, and 
urinary calculi." Its effects upon young children are especially disas¬ 
trous, causing a great increase of mortality through the production of 
diarrhea. Among the numerous names of distinguished physicians 
who protest against the adulteration in cjuestion may be mentioned 
Dr. Willard Parker, Dr. Alonzo Clark, and Dr. Wm. A. Hammond. 

Dr. Mott’s experiments showed that alum interferes with digestion 
by rendering the gastric juice incapable of digesting food, and also 
causes congestion and inflammation of the mucous membrane of the 
stomach and bowels. By making an analysis of the internal organs 
of several dogs killed after being fed on biscuit made with alum 
powders for several days, he was able to detect it in considerable 


CANS ED FRUITS AND VEGETABLES. 


423 


quantities in the stomach, spleen, liver, heart, and other viscera, and 
also in the blood. 

Baking-powders are preferable to soda, saleratus, cream of tartar, 
and sour milk, in the way these substances are commonly used, and 
yet they can be avoided, and with benefit to the health. The alum 
powders are the worst of all compounds use for raising bread. They 
should never be employed. The presence of alum in baking-powders 
may.be detected by testing for alum the bread made from it, as al¬ 
ready directed. 

Cheese. —Like butter, cheese is now much adulterated by the oleo¬ 
margarine process. Much of it is made of skim-milk to which tallow 
has been added to replace the cream removed. There is no means by 
which the fraud can be detected. Cheese is often colored with an- 
natto, by which it is frequently rendered poisonous from adulteration 
of the coloring matter with red lead and salts of copper. Persons 
have been seriously poisoned by eating cheese rendered unwholesome 
in this way. The rind of cheese is often extremely poisonous, in con¬ 
sequence of having been washed with a solution of corrosive sublimate 
to prevent the attacks of insects. Mercury has frequently been found 
in the rind of cheese. 

Canned Fruits and Yegetables. —Canned fruits and vegetables 
are often adulterated with coloring and flavoring substances of an un¬ 
wholesome character. The most common are red coloring matters in 
tomatoes (not very common in this country), fuchsine and aniline in 
fruits, and salts of copper in peas and other green vegetables. It occa¬ 
sionally happens, also, that the solder with which the cans are closed 
causes contamination of fruits with lead. Sometimes the cans them¬ 
selves are a still greater source of danger, being made of lead-tin. 

Within the last few years a recipe for preserving fruits has been 
widely sold which consisted in exposing the fruit to the fumes of burn¬ 
ing sulphur, or immersing it in water which had become impregnated 
with sulphurous acid by such exposure. The deleterious influence of 
such a preservative is well shown by the fact that it destroys the color 
of fruit exposed to its action, and deprives it of its finest aromatic flavors. 
It should never be employed. The plan is not a new one, though pre¬ 
sented as such. It has been well known for many years, perhaps cent¬ 
uries. Salicylic acid has been suggested as a preservative ; but the 
quantities in which it would need to be used would render articles pre¬ 
served with it unwholesome as food. 


424 


FOOD AND DIET. 


When the coloring matter is of an earthy character, some portions 
may he found in the bottom of the can as sediment. When fuchsine 
or aniline is present, it may be detected by placing in the juice of the 
fruit, as found in the can, a few threads of white woolen yarn or 
worsted. After half an hour remove the threads, and if the coloring 
matters mentioned are present they will be colored red, as will not be 
the case if only the fruit j uices are present. 

Adulteration with copper may be strongly suspected if such vegetables 
as peas have a bright green appearance. The presence of copper will 
be proven if a bright strip of iron or a sewing-needle placed in the can 
over night, after adding a few drops of sulphuric acid, is found to be 
coated with a coppery-colored film in the morning. A very small pro¬ 
portion of copper may be detected in this way. 

Preserves, Marmalade, etc. —A large share of the preserves man¬ 
ufactured for the retail trade are adulterated more or less in one way or 
another. It is customary to make into preserves inferior fruit, or that 
which has spoiled by too long keeping, or is otherwise unfit for sale. 
In many cases, preserves are colored with fuchsine and aniline, as are 
some canned fruits. Marmalade often consists chiefly of apples flavored 
with orange essence. Copper is also sometimes found, as in canned 
fruits. It is usually accidental, however, its presence being due to the 
fact that preserves are generally made in copper kettles, some of the 
-copper being dissolved by the juices of the fruits, the solution of the 
-copper being facilitated by the heat and the stirring. On this account, 
preserves should never be made in copper kettles. “ Marbleized iron¬ 
ware” should also be avoided, as it is dangerous on account of the 
presence of lead in the enamel. 

Jellies. —It is rare to find in the market such a thing as pure 
fruit jelly. If found, it will be held at a high price. The ordinary 
jellies sold are largely made up of gelatine, colored with aniline and 
other dye-stuffs, and flavored with various essences. Many of them 
contain not a particle of the fruit after which they are named. A 
less harmful but no less fraudulent form of adulteration is the use of 
apple jelly, flavored to suit the different varieties for which it is sold. 
The coloring matters may be detected by the method already' de- 
scribed ; but as so few are pure, it is best to avoid them altogether. 

Fruit Extracts. —The science of chemistry has lent its aid to the 
.art of adulteration so effectually that almost, if not quite, every one of 


CANNED AND POTTED MEATS. 


425 


the principal fruit flavors is imitated by chemical compounds so 
closely that the difference cannot be detected by the taste, though, 
undoubtedly, the difference is readily noticed by the stomach. The 
following description of the composition of some of the principal fla¬ 
voring extracts we condense from a report on the subject in the An¬ 
nual Report of the Massachusetts Board of Health for 1873:— 

Pine-apple essence is a solution in alcohol of butyric ether, which 
is made by distilling butyric acid with alcohol and oil of vitriol. The 
butyric acid is made from decayed cheese. 

Quince essence is a solution in alcohol of an ether obtained by 
treating .oil of rue with aqua fortis, and digesting with alcohol the 
acid thus obtained. 

Pear essence is made by distilling a mixture composed of fusel-oil, 
acetate of potash, and strong sulphuric acid, or oil of vitriol, and mix¬ 
ing the product with alcohol. 

Apple essence is made from sulphuric acid, fusel-oil, and valerianic 
acid. 

The flavor of currants, bananas, raspberries, strawberries, etc., is 
imitated by mixing the various ethers known to chemistry, and com¬ 
bining with them camphor, acetic acid, vanilla, and the various essen¬ 
tial oils. 

Not only are these essences sold at retail for domestic use, but 
they are largely, in fact almost exclusively, used by bakers and con¬ 
fectioners. Pastry, jellies, and ices are made still more atrocious by 
the addition of these abominable mixtures. Serious illness and even 
death has frequently been caused by the use of articles containing 
the poisonous substances above mentioned. 

A perusal of the above will be sufficient to satisfy any one that 
the so-called fruit essences are not suitable substances to be mingled 
with food. Sirups flavored with, these essences are usually employed 
in the preparation of soda-water, a fact which certainly makes the 
use of this popular summer beverage exceedingly questionable. Can¬ 
dies also are flavored with the same vile compounds, together with 
jellies, as before mentioned. 

Canned and Potted Meats.— Canned fish and other meats are 
often in a condition unfit for food when put up, and are further de¬ 
teriorated by a peculiar kind of decomposition which it is scarcely 
possible to discover by examination, but which often produces most 
serious consequences when the meat is eaten. This condition of the 


426 


FOOD AND DIET. 


contents of a can may be best determined before the can is opened, 
by observing whether the end bulges outward or is drawn in. If 
there is bulging, the meat is bad. Potted meats are often colored for 
the purpose of hiding dirt, or to give the cooked meat a more lively 
appearance. All such meats are particularly unwholesome. 

It has been discovered through the testimony of a manufacturer 
that large quantities of horses’ tongues and Hanks are worked up into 
potted meats as beef. 

It has been known for a long time that sausages are often adulter¬ 
ated with horse-flesh, as well as that of dogs and other animals. A 
year or two ago the discovery was made in San Franciscp that a 
prominent sausage-maker of that city was in the habit of working 
into his sausages large quantities of cat-flesh. This fact was discov¬ 
ered by the lai'ge number of cats which he was known to receive 
daily, and was acknowledged by him in court. We can hardly re¬ 
gard these additions as making the article any worse than it is orig¬ 
inally, since we can imagine no animal whose flesh would be likely to 
be more unwholesome than that of the swine. 

Vinegar and Pickles. —Vinegar is very often adulterated with 
mineral acids, sulphuric acid being the most commonly used. Many 
specimens of vinegar offered for sale as cider vinegar have not a drop 
of apple juice in them. Vinegar is itself an unwholesome article; but 
it becomes tenfold more injurious when adulterated with strong acids, 
injuring not only the stomach but the teeth. The presence of sul¬ 
phuric acid, or oil of vitriol, may be detected by the test given for this 
acid in sirups. It is said that it may also be detected in the follow¬ 
ing manner: Add to the vinegar a small quantity of sugar. Then 
put a drop or two on a clean plate and evaporate at a low heat. If 
the acid is present, the spot will become black, through its action on 
the sugar. 

The following is a recently devised, and probably the best, test for 
mineral acids in vinegar: Pour into a test-tube or small vial two to 
four teaspoonfuls of the vinegar to be tested. Add twenty or thirty 
drops of a strong solution of salicylate of soda. If mineral acids 
are present, the salicylic acid will be separated from the soda and 
will appear in the form of curds. The salicylate of soda may be ob¬ 
tained at any drug-store. A dram will be sufficient to test several 
samples of vinegar. The chloride-of-barium test may also be used. 


TEA AND COFFEE. 


427 


Pickles are of course liable to contamination with the same acid 
to be found in vinegar, and in addition are subject to a very danger¬ 
ous form of adulteration, the addition of some salt of copper to 
deepen the color. Very green pickles are sure to have more or less 
copper in their composition. The copper is sometimes added, perhaps 
more often derived from the copper kettle in which the pickles are 
made, through the action of the acid of the vinegar upon the copper. 
It is customary to make pickles in brass kettles for the purpose of 
giving them a green color. Some cook-books even recommend that a 
few copper pennies be boiled in the kettle with the pickles for the pur¬ 
pose of “ greening ” them. The practice is not only a most absurd one, 
since it in no way adds to the flavor of the pickles, but is very dan¬ 
gerous. Pickles are unwholesome and indigestible at the best; and 
when poisoned in this manner they become about the worst articles 
which can be put into the stomach. Copper and brass kettles should 
never be used in any way in connection with cookery. 

The presence of copper in pickles may be easily detected by put¬ 
ting a clean bright iron wire for a few hours into the bottle contain- 
ing them. If copper is present, it will appear as a thin film upon the 
wire. 

Lemon and Lime Juice. —These valuable acids, sometimes pre¬ 
served in the form of the juices of the fruits from which they are ob¬ 
tained, are not infrequently adulterated with sulphuric acid, which is 
intensely sour, and is also an active chemical poison. Sulphuric acid 
is not infrequently used by those who sell cheap lemonade at stands 
in the cities, as it is a much cheaper acid than lemon. We have 
known of instances in which serious poisoning has occurred from 
drinking this kind of lemonade which had been made in a zinc water- 
cooler, the poisoning being occasioned by the zinc. Test with chloride 
of barium. “ Salts of lemon” sold in the market is a dangerous poison 

consisting of oxalic acid. 

© 

Tea and Coffee. —These substances, used as beverages in infusion, 
are largely adulterated, though in the case of coflee the adulterants em¬ 
ployed are not worse than the original substance. Tea is, however, 
rendered even more unwholesome than it naturally is, by the addition 
to it of Prussian blue, and various other harmful substances. It is a 
fact worth remarking, that Chinamen in this country will not drink 
the tea which is imported from their country for American consumers. 


428 


FOOD AND DIET. 


alleging, when questioned, that it is impure, they being evidently 
aware of the general practice of adulteration for foreign exportation. 

The chief adulterants of tea are the leaves of other plants—as of the 
sycamore, horse-chestnut, plum, beech, plane, elm, poplar, willow, oak, 
hawthorn—exhausted tea leaves, lie tea, sand, quartz, oxide of iron, 
iron filings, starch, black-lead, gum, indigo, Prussian blue, turmeric, 
Chinese yellow, China clay, soapstone, French chalk, mica, gypsum, 
rose pink, Dutch pink, chrome yellow, Venetian red, carbonate of cop¬ 
per, arsenite of copper (Paris green), bichromate of potash, carbonates 
of lime and magnesia, copperas, catechu, etc. 

The detection of the leaves of other plants is comparatively easy. 
The tea should be soaked in warm water for an hour or two, when 
they can be unrolled and spread out upon a pane of glass and com¬ 
pared with the genuine leaves shown on Plate XI, on which, and on 
Plate XII, are also shown some of the more common leaves employed 
in the adulteration of tea. Leaves that have been once used, and 
treated with gum to give them the appearance of the genuine, may 
be detected by their unnaturally glossy appearance. The roll is also 
less regular than that of unused tea. 

Lie tea is composed of fragments of tea leaves, exhausted leaves, 
dirt, coloring matter, etc., held together by boiled starch. The fraud 
may be easily detected by soaking the sample a few minutes in boil¬ 
ing water. The small masses, instead of unrolling, as in genuine tea, 
dissolve into small, dirty particles. 

Iron oxide and iron filings may be easily detected by means of a 
magnet. When a magnet is plunged into the tea, small particles 
adhere to it. By repeating the process, removing the adhering parti¬ 
cles each time, all the iron may be removed from the tea. 

Prussian blue, indigo, black-lead, gypsum, turmeric, and various 
other substances used as facing, may be easily detected by either one 
of the following methods:— 

Place two or three ounces of the tea in a piece of thin muslin and 
shake well over a piece of white paper. Examine the dust thus col¬ 
lected with a magnifying glass, capable of enlarging ten or fifteen 
diameters. An ordinary botanizing glass answers the purpose admira¬ 
bly. Prussian blue appears as brilliantly blue, transparent, angular 
particles. Indigo particles are greenish blue and opaque. 

Another method is to wash a few ounces of tea with cold water, 
placing the washings in a glass to settle. Examine the sediment in 
the manner directed. 




D 

A. Wild Plum; B. Elder; C. Elm; D. Tea leaf; E. Young leaf; F. Leaf partly grown; G. Tea- 
leaf of green variety. 

Plate XI. GENUINE LEAVES OF TEA AND LEAVES 
USED IN ITS ADULTERATION. 




















A. Hawthorn; B; Beech; C. Oak; D. Plane; E. Willow; F. Poplar. 


Plate XII. LEAVES USED IN ADULTERATION OF TEA. 



























ADULTER A TION OF COFFEE. 


429 


Black-lead, turmeric, mica, sand, and most other adulterants, may 
also be detected by examining the dust or sediment with a magnify¬ 
ing glass. The presence of gypsum is shown as follows: Add to some 
of the sediment, in a test-tube, a few drops of muriatic acid; add a 
little water, and then a few drops of a solution of chloride of barium. 
If a white precipitate appears, it is evidence that the tea has been 
adulterated with sulphate of lime. 

Adulteration of Coffee, and Modes of Detection.— The most 
extensively used adulterant of coffee is chicory, a fleshy root. This 
is found not only in ground coffee, but in coffee berries, the chicory 
being molded into the form of coffee berries by means of machinery 
for the purpose. Chicory is not a poisonous substance, and is wholly 
devoid of narcotic or stimulating properties. Ground coffee is univer¬ 
sally adulterated, not one specimen in ten, according to most reliable 
authorities, containing a particle of genuine coffee. Peas, beans, 
acorns, wheat, rye, barley, bran, carrots, parsnips, chefus-nut, almond 
shells, sawdust, oak bark, exhausted tan bark, and many similar sub¬ 
stances, are used in adulterating coffee, being roasted and ground, and 
sold in packages. Burnt sugar and molasses are used to flavor and 
color these various substances. Venetian red is also used for coloring;. 
Essence of coffee consists almost wholly of burnt molasses. 

Bate stones have recently been employed in the adulteration of 
coffee in large quantities, and, according to Hassall, this beverage, so 
much prized by millions of the human race, is in some parts of 
England and the East adulterated with the livers of horses and cattle, 
which are roasted and ground for the purpose. 

Nearly all the substances used in the adulteration of coffee may 
be detected by means of the microscope. The following simple means 
are also usually sufficient to determine the character of any specimen 
of coffee:— 

1. Notice if the ground coffee cakes in the paper or package con¬ 
taining it or when pressed between the fingers. If it does, it is spu¬ 
rious. 

2. Place a few pinches upon water in a goblet. If part floats 
while another portion sinks, it is adulterated. Pure coffee absorbs 
water slowly and so floats for some time, while the substances used to 
adulterate it absorb water quickly and sink. The amount of adulter¬ 
ation can be readily estimated by observing what proportion sinks 
readily. 


430 


FOOD AND DIET. 


3. Moisten a few grains of the coffee spread out on a piece of glass. 
If small particles can be picked out which are so soft that they can be 
easily mashed between the fingers, the coffee is adulterated. 

4. If water into which ground coffee is placed quickly becomes 
deeply colored, the sample is adulterated, since pure coffee colors 
water slowly. 

Cayenne Pepper. —Though not an article of food, and an un¬ 
wholesome condiment, cayenne is the subject of a dangerous form of 
adulteration. In order to add weight, ground rice, and other sub¬ 
stances, are employed; and then to produce the required intensity of 
color, red lead and vermilion or bi-sulphuret of mercury, both very 
poisonous substances, are used. We mention this fact as an addi¬ 
tional inducement for abstaining from the use of cayenne as well as 
other condiments. 

Artificial Cider .—In the West, large quantities of a mixture called 
cider are made by compounding sugar, tartaric acid, and yeast, and 
allowing fermentation to take place. It is a harmful beverage. 

Adulteration of Till. —On account of the increased cheapness and 
convenience of manufacture, a large share of the tin plate made at the 
present time contains in it a large proportion of lead. As tin vessels 
are much used in cooking and other processes connected with food, 
this is a matter of very serious importance. Numerous examinations 
by eminent chemists have shown that milk pans, basins, dippers, cook¬ 
ing utensils, etc., are nearly all rendered dangerous by this means. 
The lead of tin-lined milk pans will not be affected to a sufficient ex¬ 
tent to do any harm until the milk sours, when the lead is rapidly 
taken up by the acids formed. Acid fruits of any kind, and even 
sweet fruits, sirups, and preserves, when cooked or allowed to stand 
for any length of time, may become contaminated with lead, and pro¬ 
duce lead poisoning. Tomatoes, vegetables, and various fruits put up 
in tin cans, may become contaminated in this way. This kind of tin 
may be detected by a simple test which any one can apply. Place 
upon the metal a drop of nitric acid, spreading it to the size of a dime. 
Dry over a gentle heat, apply a drop of water, and then add a small 
crystal of iodide of potash. If lead is present, a yellow color will make 
its appearance very quickly after the addition of the crystal of iodide 
of potash. 

The cheaper grades of tin are, almost without exception, adul¬ 
terated in this way. On this account, we should by all means dis- 


POISONING FROM FRUIT-JARS. 


431 


courage tlie use of tin cans for canning either fruit or vegetables, the 
danger of contamination being so great. For those who put up their 
own fruit, glass cans are fully as cheap, as they can be used many 
times instead of but once. 

Poisoning from Fruit-Jars. —Another danger to which atten¬ 
tion has been called very recently is from the use of glass fruit-cans 
with zinc covers. Only those having glass or porcelain-lined tops 
should be employed. The danger of using those with zinc covers is 
shown by the following account of a case of poisoning which w r e 
quote from a prominent sanitary journal of recent date (1880) :— 

“Four persons were poisoned recently in Brooklyn from eating 
canned cherries. Fortunately they all recovered by prompt treat¬ 
ment. Prof. Geo. W. Plympton made an analysis of the fruit left, and 
found the poison to be a salt of zinc formed by the action of the acid 
in the cherries on the zinc cover of the jar. The preserving had been 
done with scrupulous care, the jars were of a kind in common use, 
and the contents of several had been eaten without any unpleasant 
effects. On examining some which had not been before opened, one 
having a zinc top with a porcelain lining was selected, and in it there 
was no indication of zinc. But on pouring a portion of the sirup of 
this jar into the zinc cover of the first, and warming it over a water- 
bath for three-quarters of an hour, the solution promptly yielded to 
the test for zinc. . . . The case is not without parallel, and the 

public should learn that the use of zinc or galvanized iron in the 
preservation of fruit or vegetables is not free from danger.” 

Lead Glazing. —Within the last few years there has appeared a 
kind of glazed ironware which is in the highest degree unsafe on ac¬ 
count of the amount of lead and even arsenic contained in the glazing. 
The quantity is so great that acid fruits would readily become af¬ 
fected. Crockery is also sometimes glazed with lead, making it dan¬ 
gerous to use except for dry substances. This ware may be tested in 
a manner similar to that suggested for lead-adulterated tin. Only the 
“ marbleized ironware ” is adulterated. “ Granite-ware” is safe. 

Accidental Poisoning of Water with Zinc and Lead. —By 

means of lead and zinc employed as water-pipes, tanks, eave-troughs, 
roofs, cistern covers, etc., water may be so charged with these mineral 
poisons as to become highly dangerous to health. Many cases of lead 
paralysis have been caused by taking lead in some unsuspected man¬ 
ner, such as mentioned. Hence it is very important that the public 


432 


FOOD AND DIET. 


should be told to be on the lookout for danger from this source. Nei¬ 
ther lead nor zinc is a suitable material for the conveyance or storage 
of water, and should never be employed. Galvanized iron is no bet¬ 
ter than zinc. When obliged to drink water which runs through lead 
or zinc pipes, it should be allowed to run some little time before being 
used, in order that that which has been long in the pipe may be ex¬ 
changed for that which is pure. Only pure tin should be used for 
roofing, eave-troughs, leaders, etc., when the water collected is to be 
used for drinking or cooking purposes. Wood and iron are much to 
be preferred to lead or lead-tin as a material to be used for such pur¬ 
poses. In cases in which tin containing lead has been used for roof¬ 
ing purposes, the difficulty may be remedied by covering the roof with 
a mixture of coal-tar and water-lime cement, in the proportion of one 
part of lime-water to three of coal-tar. Roofing tin is so rarely pure 
that it may be considered as being always contaminated with lead. 
Hence the importance of attending to the last suggestion made. 


W A TER: 


ITS HYGIENIC USES, AND DANGERS PROM ITS USE WHEN IMPURE. 


The Hygienic Value of Water. —If we except pure air, it may 
safely be said that no other element in nature sustains so important 
relations to the living system as does pure water. An individual will 
live much longer on water alone than if deprived of drink. Water 
constitutes a large proportion of all our food, varying, in grains and 
vegetables, from fifteen to more than ninety per cent. If the water 
thus contained in solid food were wholly removed, an individual 
would doubtless be enabled to subsist longer on water only than on 
solid food so treated. Though water undergoes no change in the 
body, and hence takes no part in the development of force, it is abso¬ 
lutely essential to the performance of the vital functions, being nec¬ 
essary to enable the various organs to perform their offices in the 
maintenance of the vital activities. 

The circulatory system is especially dependent upon this element. 
Water is the menstruum which floats the blood corpuscles and the 
varied nutritive and excrementitious elements which form the blood. 
By its aid, the nutrient particles destined to enter into the structure 
of the body are conveyed to the most minute and remote fibre of the 
intricate human mechanism where repair or growth is demanded. No 
other element in nature is so well suited to this exact purpose as 
water. It is so limpid and mobile that it can circulate through the 
most delicate capillaries, and can even find its way, by osmosis, into parts 
inaccessible by openings. 

Thirst. —Water is continually passing away from the body. The 
dry air entering the lungs by respiration absorbs it from the moist 
surface of the pulmonary membranes. A large portion is lost by 
evaporation from the skin, upon which it is poured out by millions 
of little sewers, the perspiratory ducts, for the purpose of washing 
away impurities from the system. The kidneys remove a consider¬ 
able quantitv, with poisonous excrementitious elements in solution. 

98 433 



434 


HYGIENIC VALUE OF WATER. 


Through still other channels water is removed, aggregating, in all, the 
amount of five pints in twenty-four hours in the average individual. 
This loss must be made good, in order to preserve the requisite fluid¬ 
ity of the blood ; and nature expresses the demand for water by thirst. 

Some people rarely drink liquid of any kind. Others consume 
several pints in a day. The nature of an individual’s occupation will 
in a measure determine the amount of drink .required. Stokers, 
glass-blowers, and others whose vocation necessitates profuse perspi¬ 
ration, . equire more water than others. It will be noticed, moreover, 
that the character of the diet has much to do with the demand for 
drink. Those who subsist mostly upon fruits and grains, and other 
vegetable productions, avoiding the use of stimulating and irritating 
condiments, require little or no addition to the juices contained in 
their food. Those who pursue an opposite course in dietetics, using 
largely animal food, salt, pepper, spices, and other condiments, and 
perhaps drinking a little wine or something stronger, are under the neces¬ 
sity of taking considerable quantities of fluid in addition to that provided 
by their food. 

Water is the only substance which will quench thirst. Beverages 
which contain other substances are useful as drinks just in proportion 
to the amount of water which they contain, and are unwholesome just 
in proportion as the added elements are injurious. 

Regulation of Temperature. —The evaporation of water from 
the surface of the human body is one of the most admirable adapta¬ 
tions of means to ends exhibited in animal life. All of the vital ac¬ 
tivities in constant operation in the body occasion the production of 
heat. Sometimes the amount of heat is greater than is needed, and 
so great as would destroy the vitality of certain tissues if it were not 
speedily conducted away. By evaporation of water from the skin, 
this is accomplished. When external heat is great, perspiration is 
more active than when it is less, and thus the temperature of the body 
is maintained at about 100° F. under all circumstances. By this won¬ 
derful provision of nature, man is enabled to exist under the great 
extremes of heat and cold presented in the frigid regions at the poles 
and the torrid climate of the equator. By the aid of clothing, human 
beings have survived a continued temperature of C0° to 100° below 
zero; and, by the protective influence of evaporation, an average of 
100° above zero has been endured in tropical climes. For short peri¬ 
ods, so great a degree of heat as 350° F., or even 600° has been borne 


DEPURATION. 


435 


with impunity in exceptional instances. In these cases the extreme 
heat which would otherwise reduce the body to a cinder in a few 
moments is rapidly conducted away by evaporation without occasion¬ 
ing any damage. 

Depuration. —Every thought, every movement, the most delicate 
vital action, occasions the destruction of a portion of the living tissues, 
which is thus converted into dead matter, and becomes poisonous. 
Many kinds of poisonous substances are produced within the body in 
this way. Some of them are very deadly, and must be hurried out of 
the system with great rapidity, as urea and cholesterine. Here the 
marvelous utility of water is again displayed. It dissolves these 
poisons wherever it comes in contact with them, and then as it is 
brought by the current of the circulation to the proper organs—the 
kidneys, liver, skin, lungs, and other emunctories—it is expelled from 
the body, still holding in solution the animal poisons which are so 
rapidly fatal if retained. 

Prof. Liebig and others have shown that the free drinking of water 
greatly favors the elimination from the system of the products of 
waste in the system; It not only increases the quantity of fluid elim¬ 
inated by the skin, the kidneys, and the liver, but also the amount of 
solid matter. The free use of water also hastens tissue change, thus 
enabling a person by this means to rapidly change or renovate his 
tissues when such a change is desirable. Experiments have shown, 
further, that the free use of pure water as a drink encourages assimi¬ 
lation. It is well known that it is conducive to fatness. Thus it ap¬ 
pears that water is the chief of all alterative remedies which can be 
administered internally. 

It may be further mentioned that water is useful as an aid to di¬ 
gestion in dissolving the elements of food. It is also of very great 
value as a means of applying heat to or abstracting it from the body 
for remedial purposes, as well as for cleansing purposes, being the uni¬ 
versal detergent. 

The following table gives a correct idea of the relative importance 
of water as an element of the body, according to the results obtained 
by the best observers:— 


43G 


THE USES OF WATER. 


PROPORTION OF WATER IN 1000 PARTS. 


The entire body, TOO 

Teeth,.100 

Bones, ........... 130 

Cartilage, 550 

Muscles, ........... 750 

Ligaments, ........... 768 

Brain, ........... 789 

Blood,.795 

Synovial fluid, .......... 805 

Bile, 880 

Milk,.887 

Pancreatic juice, ......... 900 

Urine, 936 

Lymph, ........... 960 

Gastric juice, .......... 975 

Perspiration, .......... 986 

Saliva, ............ 995 


The proportion of water found in the most common articles of food 
may be seen by reference to the table (page 370) giving the constituents 
of various food substances. 

Composition of Water. —Chemically considered, water is made 
up of two gases, oxygen and hydrogen, in the proportion of one vol¬ 
ume of the first to two of the second, and by weight, of eight parts 
of the first to one of the second, as oxygen is sixteen times as heavy 
as hydrogen in equal volumes. Water contains in addition, in solu¬ 
tion, a certain proportion of atmospheric air, unless the air has been 
removed by some artificial process, or unless the water has been re¬ 
cently produced by distillation. It is this dissolved air which sup¬ 
ports the life of fish and other marine animals. A fish will die as 
quickly in water which has been boiled as if removed from the water 
entirely. 

Pure Water. —Chemically pure water is not found in nature. 
All natural water, whether taken from springs, wells, lakes, streams, 
dug wells, deep artesian wells, or caught as it descends from 
the clouds, contains a larger or smaller proportion of impuri¬ 
ties. As a general thing, rain-water contains fewest impurities 
when it is freshly collected upon clean surfaces. Its character de¬ 
pends, however, in a very great degree upon the locality where it is 
obtained, and the manner in which it is collected. In and near large 













HAUL) WATER. 


437 


cities, rain-water is always considerably colored and contaminated 
with smoke, dust, animalcules, portions of hair, etc. In the country, 
remote from populous districts, a much greater degree of purity is ob¬ 
tainable. The character of water obtained from lakes, streams, 
springs, or wells, in a large measure depends upon the character of the 
soil through which it passes, as nearly all substances found in the 
earth, even the hardest rocks, are in some degree soluble, so that 
water passing through the soil and various strata near the surface, 
dissolves and holds in solution a great variety of mineral elements. 
The chief of these are compounds of lime and magnesia. 

H ard ~W ater. h ater is said to be hard when it whl not produce 
a good lather with soap, but forms curds instead. Hardness is due to 
the presence of earthy salts in the water ; salts of lime—chalk and 
gypsum—are the most common. T wenty grains per gallon of any of these 
salts is sufficient to render water hard and unfit for use, though some 
waters furnished to cities for general use contain from 70 to 1G0 grains 
per gallon of solid matter. Hard water is unfit for cleansing purposes 
because its mineral ingredients form insoluble compounds with fatty 
substances. When mixed with soap, the lime or other mineral takes the 
place of the soda or potash in the soap, and forms an insoluble curd, 
instead of a lather. When a large quantity of soap is added, a lather 
can be formed, as the minerals in solution are neutralized by the extra 
amount of soap. Water which contains a pound of lime, or its equiva¬ 
lent of other minerals, in ten thousand gallons, is said to be of one de¬ 
gree of hardness; that having two pounds of lime in the same quantity 
of water, two degrees of hardness, etc. 

Is Hard Water Wholesome ?—This question has been much dis¬ 
cussed by sanitarians and physiologists. Some have claimed that hard 
water is much more wholesome than soft, and even very important for 
the preservation of health and to secure proper physical development, 
while others have taken the opposite ground. The following are the 
principal arguments which have been urged in defense of hard water:— 

1. Nature provides hard water, and hence it must be more natural 
to employ it than to use soft water artificially purified. 

2. The body needs some of the salts held in solution by hard water, 
and is consequently deprived of them when soft water is used. 

3. People who use hard water are more healthy than those who em¬ 
ploy soft. 


4:38 


THE USES OF WATER. 


4. Hard water is less liable to become poisoned by passing through 
lead pipe. 

The first objection disappears when we consider the fact that with 
man drinking is a practice which is largely the result of other unnatu¬ 
ral habits and forced conditions. Comparative anatomy clearly proves 
that man is naturally frugivorous in dietetic character, his natural diet 
being mostly fruits, with a few of the most easily masticated grains. 
This being the case, it is evident that so far as the provisions or inten¬ 
tions of nature are concerned, the evident design was that man should 
obtain all the watery elements he requires from the juices of succulent 
fruits. That this may be done without inconvenience or failure of per¬ 
fect nutrition, has been again and again demonstrated by actual exper¬ 
iment. Indeed, persons who have discarded from their dietary, salt, 
pepper, spice, and all irritating substances of like nature, often find 
that they have no necessity whatever for drinking, and that weeks and 
months pass without the thought of drinking. 

In regard to the second objection, we may say that there is no evi¬ 
dence that water was ever intended as a medium for conveying to the 
body those elements of a mineral character which are thought to be 
necessary to the proper maintenance of the body. And, furthermore, 
there is no satisfactory evidence that the system can ever appropriate as 
nourishment any kind of mineral matter, either in solution or any other 
form; but there are many facts which indicate very conclusively that 
the human system can only assimilate such substances as have been 
organized by the action of vegetable life and growth. On this point, an 
eminent surgeon, lecturing before his class in a celebrated Western med¬ 
ical college, remarked, “ The administration of mineral salts in the form 
of solution will occasion an increase of their quantity in the excretions of 
the body, but will not remedy any deficiency of this kind of material 
which may be supposed to exist in any portion of the system.” 

Again, the mineral matter found in hard water is of a character 
which would render it of little value to the system were it capable of 
assimilation,—judging from analysis of the bones,—since the principal 
constituent of bony tissue is phosphate of lime, while the chief ingredi¬ 
ent of hard water is carbonate of lime, a substance which is found in 
the bones only in small quantity, and which may be by no means 
essential. 

Nothing could be more uncandid and deceptive'than the manner in 
which the statistics have been collected which seem to show that hard 


HARD WATER. 


439 


water is more conducive to health than soft water. The varying condi¬ 
tions of the inhabitants of the districts compared, as relates to other cir¬ 
cumstances which affect health, have been entirely ignored. Thus, the 
claim for the superior character of hard water is made when it is found 
that the inhabitants of elevated mountainous districts, where the ad¬ 
vantages of a pure and invigorating atmosphere, together with constant 
and vigorous exercise, are ever present, are more healthy, notwithstand¬ 
ing the use of hard water, than those who use soft water, living in low, 
malarious districts, or situations otherwise unfavorable to health. Or, 
again, a similar comparison is made between those who use hard spring 
water, free from organic impurities—as decaying vegetable and animal 
matter—and those who are compelled to use soft water which is filled 
with the many poisonous substances and compounds resulting from 
the decomposition of organic substances. Thus, it is found that the 
inhabitants of London, who use the imperfectly filtered water of the 
Thames River, into which is poured all the filth and offal of that great 
city, are much less healthful than the sturdy Highlanders of Scotland, 
who use hard water as it bubbles cool and pure from the springs of 
their native mountains. 

The fourth objection is hardly worthy of notice, though not infre¬ 
quently urged. It is true that hard water, in passing through lead 
pipes, after a time deposits a coating of lime upon the interior, thus pro¬ 
tecting the water from contamination by the lead; but this advantage 
is by no means sufficient to render it advisable to adopt the use of hard 
water, since poisoning from lead pipes may be still more effectually pre¬ 
vented by a lining of glass, as is now done. 

The evils resulting from the use of hard water are numerous, and 
many of them exceedingly painful. Some of the most common are tor¬ 
pid liver, and biliary, renal, and urinary calculi. 

The best advice we can give those who cannot obtain from wells, 
water which is nearly soft, is that they should by all means resort to 
the use of rain-water, cleansing it from impurities by means of a filter. 
A home-made one may be easily constructed. See pp. 444-448. 

The idea that the lime, magnesia, iron, and other minerals found in 
water are beneficial to the human system is as absurd as that the car¬ 
bonic acid, ammonia, sulphureted hydrogen, and othbr noxious gases, 
poisonous germs, etc., found in the atmosphere, are necessary for the 
maintenance of animal life. 

A final and conclusive argument which shows the utter weakness of 


440 


THE USES OF WATER. 


the reasoning in favor of hard water is that the amount of “ salts ” con¬ 
sidered so important, which would ordinarily be received through the 
use of hard water, even if it should he appropriated, of the possibility of 
which there is good reason to doubt, would be so inconsiderable, compared 
with the amount received through other and better means, as to be ut¬ 
terly insignificant. For example, hard water which is considered suita¬ 
ble for use, even by those who advocate hard water, is not often of 
more than twenty-four or five degrees of hardness. This would supply 
about sixteen grains of salts per gallon of water. Few people take more 
than two and one-half pints of water a day in the form of drinks, which 
would afford only five or six grains of “ salts,” and that in an inorganic 
state. More than double this quantity would be supplied by an ounce 
of oatmeal, a half-ounce of meat, an ounce of peas or beans, or a gill of 
milk. When we consider that the average amount of food taken daily 
supplies the system with from thirty to one hundred times as much min¬ 
eral matter as would be received in drinking hard water, the argument 
that hard water is necessary to supply mineral elements to the system 
becomes ridiculously absurd. 

No directions are needed for the detection of hard water, as every 
one is familiar with its effect upon soap. Undoubtedly many will be 
pleased, however, to learn— . 

To Soften Hard Water. —V ery hard water is objectionable, not 
only on account of its injury to health, but on account of the great in¬ 
convenience and expense which it involves through the waste of soap 
and the increased labor in using it for washing. There are several 
means of rendering water soft, or nearly so, based upon the fact that 
lime and magnesia are very insoluble in water unless it contains an ex¬ 
cess of carbonic acid. Hard water may be softened by adding soap 
until the lime and magnesia are neutralized, and then as much more as 
is needed for washing; but this is an expensive and troublesome mode. 
A better way is boiling for half an hour. This expels the carbonic acid 
and causes the lime to settle in a chalky deposit on the containing vessel. 

It is this which occasions the troublesome incrustations in steam boil¬ 
ers and the chalky deposits in tea-kettles used with hard water. A more 
commonly employed method is the use of washing-soda. The cheapest 
and best method* when large quantities of water are to be used is to em¬ 
ploy quicklime. For tolerably hard water, add one gallon of clear, 
freshly made lime-water to twenty gallons of the hard water, and allow 
it to settle twelve to twenty-four hours. A few experiments in testing 









Animalcules and Infusoria in Thames Water. 


Animalcules and Infusoria in Water. 



Plate XIII. 



























ORGANIC IMPURITIES IN WATER. 


441 


the water after the addition of the lime-water will suffice to determine 
the amount to add to any particular water to secure the best results. 

It should be remarked that the hardness due to the presence of gyp¬ 
sum or sulphate of lime in the water cannot be remedied by the last 
method described. The only remedy is the use of washing-soda or carbon¬ 
ate of soda, or distillation. A water which produces a chalky deposit in 
the tea-kettle will be benefited by the lime process. 

Distilled water is, of course, almost absolutely pure, though it has a 
“ flat ” taste and is not agreeable on that account. This is owing to the 
absence of air. Air may be readily restored, however, by agitation, as 
by pouring the water repeatedly from one vessel to another, or by get¬ 
ting it into a finely divided state by means of a spray. Distillation is 
the method employed on many ships for obtaining drinkable water from 
sea-water. 

Organic Impurities in Water. —For years it has been known that 
water may be the means of conveying into the system poisons of the 
most serious character. It has been positively shown in hundreds of 
cases that typhoid fever may originate in this way,—most frequently 
does, in fact,—and there is reason for believing that diphtheria, dysen¬ 
tery, cholera, and other epidemic diseases, may be carried by means of 
water. 

The organic impurities of water are of two kinds: first, decompos¬ 
ing animal or vegetable matter; and second, living animalcules and 
germs. Both of these forms of organic matter are in the highest de¬ 
gree dangerous to health. As the two kinds of impurities always ex¬ 
ist together, they may for the most part be considered together. The 
living creatures found in impure water are of numerous varieties, but 
are known by the general term animalcula. Excellent representations 
of some of these minute creatures are to be seen on Plate XIII. 

The sources of contamination of water are numerous. Wells, 
springs, and underground cisterns are very frequently contaminated 
by communication, either directly or indirectly, with a sewer or cess¬ 
pool, or by the drainage from a barn-yard or a privy vault. Thousands 
of cases of typhoid fever have been traced directly to the use of water 
thus contaminated. Wells, cesspools, privy vaults, and cisterns are 
often located so near each other that communication is exceedingly 
easy, through the porous earth, and the contents of one become min¬ 
gled with those of the other. The well, being deeper than either cess¬ 
pools or vaults, becomes a drain for these receptacles of filth. C areful 


442 


THE USES OF WATER. 


experiments have shown that the area a well will drain in a porous 
soil is in proportion to its depth, the diameter of the circle drained in¬ 
creasing six feet with each foot of depth. Thus a well ten feet deep 
would drain a circle sixty feet in diameter, and any cesspool or privy 
vault, manure heap, or other collection of decaying matter within 
thirty feet of the well, would he almost certain to discharge more or 
less of its foul matters into the well. How well-water may be con¬ 
taminated in this way is clearly shown in Plate XV. Twelve cases of 
typhoid fever occurred among persons using water from a well located 
as represented in Fig. 2 of the plate. When the surface of the ground 
or of the underlying rock is sloping, the danger is greatly increased. 

Wells also often become contaminated by means of the death and 
decay of worms, bugs, and small animals which fall into them and 
are not removed by frequent cleaning. We were acquainted with one 
instance in which the water became so bad that it was believed that 
“ a mineral spring had broken into it.” The prospect of discovering 
such an anomaly led to a critical chemical examination of the water, 
and an inspection, which revealed the fact that sundry dead cats, 
toads, rats, cast-off shoes, garments, and other decomposable substances, 
had been deposited in the well and imparted to the water its mineral¬ 
spring flavor. Wells and cisterns should be often cleaned, and should 
be located at least ten rods away from any cesspool, vault, barn-yard, 
garbage heap, or other possible source of contamination, and should 
be so protected above that vermin and small animals cannot get in. 

How to Detect Bad Water. —It is very important that every per¬ 
son should be familiar with the simple methods for determining with 
tolerable certainty and accuracy the character of water liable to be 
used for drinking and cooking purposes. The following methods are 
reliable:— 

The Fermentation Test. —Put some of the water to be tested in 
a small bottle, and add a pinch of pure white sugar. Place it un¬ 
corked in a warm place. If cloudiness appears within two days, the 
water is too impure to be used with safety. Care must be taken to 
have the bottle perfectly clean. The cloudiness can be most easily 
discovered by holding the bottle up against a dark or black ground, 
in a good light. 

Permanganate-of-Potash Test.— The following is the best form of 
this useful test, which is the most reliable of any simple method of ex¬ 
amining water for organic impurities:— 


IMPURE ICE. 


443 


Dissolve in an ounce of water twelve grains of caustic potash and 
three grains of permanganate-of-potash crystals. Keep in a glass-stop¬ 
pered bottle. Add a drop or two of this solution to a gill of the water 
to be examined, placed in a perfectly clean and clear bottle. The per¬ 
manganate solution has a beautiful pink or purple color. If this is 
changed to brown or disappears after standing a few hours, the water 
is impure and unfit for use. The permanganate alone is found to be 
unreliable, as it sometimes fails to detect the presence of some kinds 
of organic poisons. 

Suspended Impurities. —Water is often turbid from the suspen¬ 
sion in it of substances which are merely mechanical impurities, the 
water becoming entirely pure after the removal of the same. The 
water of the Mississippi, otherwise considered remarkably pure, is very 
turbid or roily. The same is true of the water which is supplied to 
many of our large cities, at some seasons of the year, when the streams 
which furnish the supply are swollen by recent rains. Impurities of 
this sort can be best detected by holding a clear goblet containing the 
water against a dark background in a good light. 

It is important, also, to observe the odor and color of water. The 
odor is best detected by shaking a quantity in a wide-mouthed bottle, 
half filled, and placing the nose to the mouth of the bottle. If no odor 
is detected, the liquid should be heated and examined again. The addi¬ 
tion of a little caustic potash will sometimes bring out a bad smell not 
otherwise apparent. 

Impure Ice. —Great quantities of ice are used in all parts of the 
United States, probably more than in any other country. Hence, it is 
of importance that ice, the solid form of water, should be pure as well 
as the liquid form of the article. There is a popular notion that water 
“ freezes pure,” which is in some degree true, but not to the extent com¬ 
monly believed. If the lake or pond from which the water is taken is 
very impure, the ice will be likely to retain an injurious quantity of the 
same impurities. Animalcules and low forms of vegetable life which 
appear in lakes and ponds, usually exist in largest numbers at or near 
the surface. Decomposing organic matter also usually floats upon the 
surface. These pernicious substances may be entangled in ice, which 
may thus become a source of serious disease. Low forms of life readily 
withstand a temperature much below the freezing point of water, so 
that as soon as the ice thaws they become active agents in producing 
disease. We have often seen ice which gave forth a very unpleasant 


444 


THE USES OF WATER. 


odor while melting, and gave to the water in which it was placed a dis¬ 
agreeable flavor. 

In the summer of 1875, a serious outbreak of sickness occurred at 
Rye Beach, a sea-side watering-place in New Hampshire, which was 
traced to the use of ice taken from a stagnant pond in which was a large 
quantity of decomposing sawdust. 

Hr. Austin Flint, of New York City, had occasion some time since 
to investigate the probable origin of several cases of typhoid fever, and 
was unable to trace the disease to any other source than ice. 

“ Great quantities of ice are taken from canals, from creeks, from 
stagnant ponds, and from streams that are either the natural or the artifi¬ 
cial recipients of surface drainage, of the outpourings of sewers, and of un¬ 
cleanliness from various sources,” and it is not at all improbable that it 
may be a vehicle for typhoid infection. 

It is important to notice that “ the danger from ice taken from im¬ 
proper places is not only from that which is drank, but from its use in 
refrigerators and preservatories, where milk, butter, fruits, vegetables, 
and meats are subjected to its saturating influence as it vaporizes.” All 
would do well to look sharply to this possible source of disease and 
death. Find out the source of the ice which is purchased, and if there 
is a possibility of its being contaminated, reject. It will be better to do 
without ice altogether than to run any risk of contamination. Ice 
should never be gathered from stagnant water, nor from streams which 
are contaminated by sewage. No doubt many cases of illness arise 
from this source without being suspected, and possibly many deaths 
occur without the true cause being discovered. 

The Purification of Water .—As impure water is so abundant, 
and pure natural water often so limited, it is important that simple and 
efficient means for the purification of water be generally understood and 
adopted. Some waters are so impure that no attempt to render them 
wholesome can be successful, at least sufficiently so to render their use 
safe or justifiable. Water which contains considerable quantities of 
sulphate of lime or magnesia, mineral waters, and water which is badly 
contaminated with sewage, or the drainage from cesspools, vaults, or 
barn-yards, are of this class. 

To Remove Turbidity. —The fine particles often suspended in 
water obtained from rivers are usually of the nature of fine sand or finely 
divided clay. The greater share of the suspended particles will be de¬ 
posited as sediment if the water is allowed to settle for a day or two. 


REMOVAL OF ORGANIC MATTER. 


445 


A quicker way of clearing such water is to add to it a small quantity of 
alum, decoction of logwood chips, or the white of egg, stirring well 
and then allowing it to settle for a few hours. 

To Remove Organic Matter, Color, and Foul Gases. —Organic 
matter is by far the most serious impurity usually found in potable 
waters, and upon its entire removal, more than upon anything else, de¬ 
pends the success of any method of purification. The methods described 
for removing turbidity will also in some measure remove the impurities 
mentioned in this paragraph, but by no means thoroughly. Boiling ac¬ 
complishes much more, by expelling the gases and destroying the poi¬ 
sonous properties of the organic matter, and to some degree precipitating 
it. A solution of permanganate of potash may be used for the same 
purpose, a strong solution being added to the water contained in a con¬ 
venient vessel and stirred thoroughly. The solution should be added 
drop by drop so long as its color changes in the water from a faint pink 
to a brown or yellowish color. Examinations may be made from time 
to time by placing a clear white glass goblet full of the water under¬ 
going purification, in the middle of a sheet of white paper, and placing 
beside it a goblet of pure water faintly tinted with the permanganate 
solution, and viewing the two solutions in a clear light. As soon as a 
pinkish color begins to appear in the water, it should be allowed to 
stand an hour or two, after which it should be examined again, and the 
operation repeated, if necessary, until the pink color remains permanent. 

Filtration. —The methods above described are, of course, only 
adapted to waters which contain but a very small proportion of organic 
or suspended matters. The only really efficient mode of purifying 
water, at least on any but a very small scale, is filtration. There are 
various forms of filters, of different degrees of efficiency. The chief fil¬ 
tering mediums are sand, spongy iron, and charcoal. Sand removes only 
the suspended matters. Spongy iron removes a small proportion of 
the organic matter, but impairs the water by impregnating it with iron. 
Charcoal removes the suspended matters, a great share of the organic 
matters, and animalcules and other low forms of life. Vegetable char¬ 
coal is very efficient, but animal charcoal is much more so. The fil¬ 
tering medium is employed either loosely packed or made into solid 
blocks or slabs. The water is filtered by being made to pass either 
downward or upward through the filtering material, the upward method 
being generally considered the most desirable, as filters constructed on 


446 


TEE USES OF WATER. 




this plan will last longer than those in which by the constant down¬ 
ward action the water becomes foul sooner with suspended impurities. 

The superior purifying power of charcoal is due to the oxygen 
which it contains, condensed in its pores in very active form, by which 

the organic elements are oxi¬ 
dized, or burned up, and thus 
rendered harmless. Charcoal 
possesses the property of con¬ 
densing in its pores a large 
amount of oxygen, the amount 
varying with each variety of 
charcoal, according to the fine¬ 
ness of the grain of the wood 
from which it is made. The 
hardest, finest-grained woods 
make the best charcoal. As 

Fig:. 169. A Reservoir Filter. . . , 

charcoal deteriorates with age, 

it should be newly burned 

when used for filters. 


Care of Filters.— The ma¬ 
jority of people who purchase 

Fig 1 . 170. Same as Fie. 163, but showing Filter in , 

Section. filters pay no attention to the 

directions for use which gener¬ 
ally accompany them, and which must be attended to scrupulously or 
the filter will become a means of contamination instead of purification. 
The first thins; essential in the care of a filter—and this is not often in- 

O 


Some of the most common 
and efficient forms of filters 
are represented in Figs. 169 
to 173. From the descriptions 
given, almost any one can con¬ 
struct, or hire made for a small 
sum, a really efficient filter. 


sisted upon by manufacturers—is that it should be allowed to become 
dry every day, or at least once in two or three days, being allowed to 
remain thus for an hour or two so that the charcoal may have an oppor¬ 
tunity to absorb fresh oxygen from the air to enable it to continue its 
purifying process. The oxygen contained in the charcoal when placed 
in the filter is soon consumed, and, unless often renewed, the filter will 




















































































CARE OF FILTERS. 


447 


become worthless ; and from the accumulation of organic matter may 
become a breeding-place for germs. We have seen filters which in 
consequence of this neglect had become so foul within a few weeks 
that water which was comparatively pure, after being passed through 
it was found to contain large numbers of animalcules, and organic 
matter in large quantity, and had an odor highly suggestive of de¬ 
cayed eggs. 



Fig. 171. Simple Form of Filter, 
for household use. a. Water-pan, or 
reservoir; 6. Sponge; c. Jug to re¬ 
ceive filtered water; d. Gravel; e. 
Charcoal; /. Faucet. 


rig-, 172. A Filter 
made after plan shown 
in the preceding cut. 


Fig 1 . 173. Pock¬ 
et Filter, arranged 
to use as a Siphon. 


In order to be safe and efficient, a filter requires cleansing every 
few weeks or months, according to the amount of water filtered, and 
its quality. When ordinary cistern water is used, a filter should not 
be used longer than six months without cleansing, and if a large 
amount of water is used, not more than half that time. The sponge 
should be cleansed and scalded at least two or three times a week. 
The charcoal should be renewed every time a filter is cleansed. Fresh 
charcoal may be used or the old may be renewed by heating to red¬ 
ness in a close vessel, excluding air. 

The gravel and sand and the inside of the filter vessel, reservoir 
for filtered and unfiltered water, should be thoroughly cleansed when¬ 
ever the filter is taken apart for cleansing. The surest way to secure 
thorough cleansing is to boil the gravel and sand in a large kettle or 
wash-boiler for half an hour, rinsing out the filtering vessels with boil¬ 
ing water. After rinsing all well with clean water, wash everything 
with a strong solution of permanganate of potash and caustic potash. 



























448 


THE USES OF WATER. 


A solution of one ounce of the permanganate and four of crude caus¬ 
tic potash in a pailful of water will be sufficient for an ordinary filter. 
If the permanganate solution becomes brown by the washing, more 
must be used, until a pinkish color remains when the gravel is rinsed. 
This will indicate that all impurities are removed. A few gallons of 
water will suffice to rinse away the remains of the permanganate, and 
the filter may be repacked as before, with fresh charcoal as directed. 
The closer the filtering medium is packed, the slower the water will 
filter through, but the more perfect will be the purification. 



rig. 174. Cistern filter, a. Receiving reservoir; b. Filtering medium, charcoal and gravel; 
c. Perforated slab; <1. Rain-pipe; e. Overflow;/. Water-pipe leading to cistern; g. Cistern. 


Cistern filters, as usually constructed, are not to be recommended, 
as they soon become clogged when placed in the cistern, and not be¬ 
ing readily accessible are not easily cleaned, so that they become 
sources of impurity instead of serving the purpose designed. It is 
possible, however, to connect a filter with a cistern in such a manner 
as to serve a very useful purpose in freeing water at least from the 
grosser impurities which are likely to be washed from roofs by rain. 
Fig. 174 shows the plan of filters which we had constructed for use in 
connection with two large underground cisterns at the Sanitarium, 
Battle Creek, Mich., which operate very satisfactorily. They require 
cleanin''’ about once in six months. 

o 

The Best Water. —The purest water is always the best. Soft 
water is far superior to hard, though hard water free from organic mat¬ 
ter is much to be preferred to soft water contaminated with organic 
impurities. In hard-water districts the use of filtered rain-water 




























































































DANGERS FROM WATER CONTAMINATION. 


449 


should be generally adopted. By making proper provision for storage, 
almost any house affords roof surface sufficient to supply the family 
living in it with an abundance of the softest water. The average an- 
nual rain-fall between the thirtieth and fiftieth degrees of latitude is 
about forty-five inches. With this amount of rain, a roof affording 
four hundred square feet of surface would collect sufficient water to 
supply more than one barrel a day during the entire year, if none were 
wasted. It is best to have two or three cisterns, not only to supply 
sufficient storage capacity, but to allow opportunity for emptying one 
so as to clean it thoroughly as often as once in four or six months. 
Unless made of stone, cisterns should be bricked up from the bottom 
with good hard brick, and arched over. It is also best to cover the 
brick inside with a thick layer of Portland Cement. When tanks are 
used, the best material is iron, coated on the inside with coal-tar or 
some other impervious and insoluble covering. 

Cesspools, water-closets, and sewers should never on any account be 
connected with tanks from which water is used for drinking purposes. 
Numerous cases of serious and even fatal illness have resulted from 
neglect of the observance of this precaution, as water has the property 
of absorbing foul gases to a considerable extent. On the same ac¬ 
count, water should not be stored in the vicinity of anything giving 
out an offensive odor. Nothing could be more offensive to good taste 
and to sanitary principles than the custom of placing the water-tank 
of railroad cars in the water-closet. The offensive practice ought to be 
frowned down. It is by its property of absorbing foul gases that 
water becomes so unwholesome by standing in a sick-room, or over 
night in a sleeping-room. 

It is essential that all of these particulars should be well looked 
after in order that water may be to the body only a blessing, and not 
a curse, as it becomes when the laws to which attention has been 
called are violated. 

Mention has been made on pages 441 and 442 of the great danger 
of contamination of water, especially the water in wells, by the drainage 
from privy vaults. The enormity of this evil is by no means appieci- 
ated as it should be. An eminent sanitarian asserted not long since that 
a very large share of the wells of New England are so situated as to be 
in danger of contamination with excrement through the drainage from 
vaults. When a vault is used year after year without cleansing, the soil 
becomes saturated to a distance of many feet, especially when of a por- 

29 


450 


THE USES OF WATER. 


ous nature. If a well is located within the area of saturation, as shown 
on Plate XVI, it will certainly be contaminated. Under such circum¬ 
stances a well becomes a drainage pit for the filth-impregnated soil, and 
with every rain great quantities of soluble excreta, and, in many cases, 
germs of disease, are washed down into the well. The only proper rem¬ 
edy for this danger, as it is often impossible to get sufficiently far away 
to escape danger, is to abolish vaults altogether; but as this cannot al¬ 
ways be done, the next best thing is to cleanse them frequently. This 
can be best done by means of the “ Ames Eagle Odorless Excavating 
Apparatus,” of which the accompanying cut is a good representation. 



Fig - . 174. The Ames Eagle Odorless Excavating Apparatus. 


Tliis apparatus has taken the precedence over every other of the kind 
wherever it has been introduced. 

Being personally acquainted with the president of the companv 
that manufactures this apparatus, we are sure that it is all that is rec¬ 
ommended, and we heartily wish that it may be introduced into every 
town and city in the United States. 



























STIMULANTS AND NARCOTICS. 


This subject is generally considered under the head of “Food and 
Diet; ” but from our firm conviction that such a consideration is an im¬ 
proper one on account of the wide difference between the substances in¬ 
cluded in this class and those which may be properly called food, we 
have chosen to consider them in a separate chapter. 

The history of narcotics and stimulants is one of the most interesting 
and curious of all subjects connected with the study of the manners, 
customs, habits, and characters of ancient and modern nations. Not¬ 
withstanding the generally admitted injury resulting from the use of 
stimulants and narcotics, it is an indisputable fact that every nation, 
tribe, and people, whether civilized, semi-civilized, or barbarous, almost 
without exception, makes use, more or less extensively, of some narcotic 
or stimulant. This fact has been mistaken by some as an argument in 
favor of the use of these drugs ; but, as we shall show, the opposite in¬ 
ference is the correct one. Before passing to consider the specific inju¬ 
rious effects of these almost universally used poisons, wo will take a brief 
glance at the various forms in which alcohol and other stimulants and. 
narcotics are employed in different parts of the world. 

Alcoholic Beverages. —Alcohol is a chemical compound resulting 
from the fermentation or decay of vegetable or animal substances con¬ 
taining starch or sugar. It never occurs in nature except as the result 
of fermentation. All fermented liquors used for intoxicating or stimula¬ 
ting purposes, owe their specific qualities wholly to the presence of alco¬ 
hol, unless, as is frequently the case, they contain accidental impurities or 
substances added by adulteration which possess similar properties. The 
following is a brief account, with the names, of the principal alcoholic 
liquors used by various nations, and the mode of producing them :■— 

Wine is the fermented juice of the grape. Wines vary greatly in 
strength, according to the amount of sugar contained in the grapes from 
which they are produced. The stronger wines are “ fortified ” by the 
addition of pure alcohol. The weak wines contain seven to ten per cent 
of alcohol, and the strong fifteen to twenty per cent. 


451 



452 


STIMULANTS AND NARCOTICS. 


Beer is the fermented liquid obtained from macerating in water 
barley which has been allowed to sprout sufficiently to convert the starch 
of the grain into sugar, and then roasted. Ale, stout, lager, and porter 
are different varieties of beer. Hops are usually added to beer to give 
a bitter flavor and to delay fermentation. The amount of alcohol con¬ 
tained in beer varies from one to three per cent in home-made or small 
beer to ten or twenty per cent in ales. 

Cider is the fermented juice of the apple. It is sometimes dis¬ 
tinguished as sweet cider when freshly made, and hard cider after having 
begun to work. The juice of apples, as well as of all other fruits, be¬ 
gins to ferment so soon after extraction from the fruit that it is not 

o 

often found in an unfermented condition, unless taken directly from the 
press. Perry is the fermented j uice of the pear. 

Alcohol, and various strong liquors, are obtained by distillation from 
some of the weaker fermented liquids. The art of distillation is said to 
have been discovered in the seventeenth century, though it is claimed 
that the Chinese have been familiar with the process for ages. What is 
termed proof-spirit, obtained in this way, contains fifty per cent of alco¬ 
hol. Strong alcohol contains ninety-five per cent. Absolute alcohol is 
obtained with difficulty, and can be kept only by complete isolation from 
air, so powerful is its affinity for water. 

Gin is said to be obtained by distilling fermented corn with j uniper 
berries ; but is really made by distilling any sort of crude, impure spirits 
with turpentine, carbolic acid, or creosote, and some other unimportant 
substances. It contains forty-eight to fifty-six per cent of alcohol. 

Whisky is obtained by distilling fermented grain or potatoes. It is 
made from almost any vegetable substance containing starch. 

Rum is made by distilling the refuse from the manufacture of sugar 
and molasses. 

Brandy is said to be obtained from the distillation of the fermented 
juice of grapes. The juice of any other fruit may be employed in the 
same way. Thus we have peach brandy. A large share of the brandy 
is simply whisky, colored and flavored. 

The above-mentioned alcoholic drinks are used more or less in all 
civilized countries and in many semi-civilized and even barbarous por¬ 
tions of the globe to which they have been carried by men eager for 
gain. In addition, many nations have peculiar drinks which they had 
made and used for ages before they had any communication with the 
civilized portions of the world. 


TOBACCO, TEA AND COFFEE. 


453 


Pulque is the fermented juice of a species of cactus which grows in 
Mexico and Central America. It is the favorite drink in those parts, and 
is freely indulged in. 

Chica is a liquor made by the natives of South America in a most 
peculiar manner, from corn. In the evening the family gather around 
a heap of shelled corn deposited in the center of the humble hut in 
which the natives of that country usually live. Beside the heap of corn 
is placed a large gourd vessel. Each one takes a handful of corn, places 
it in his mouth, and chews vigorously until it is well masticated, when 
he spits it out into the vessel and takes another mouthful. All continue 
this process until the whole pile is chewed, when the contents of the ves¬ 
sel are set aside or buried in the earth. Fermentation takes place very 
soon, and an intoxicating liquor is produced. The chewing process is. 
really useful, since it not only liberates the contents of the kernels of 
corn but converts some of the starch into sugar, which readily under¬ 
goes fermentation. The natives of some of the Pacific Islands make an 
intoxicating liquor in a similar manner. 

Palm-wine, or todcly, is made by the natives of warm countries 
where this tree is indigenous, by the fermentation of its sweet juices. 
A similar beverage is made by the fermentation of the juice of sugar¬ 
cane. 

Milk-beer, or koumiss, is made by the Tartars by the fermentation 
of the milk of mares. A very intoxicating liquor called arraca, or milk- 
brandy, is made by distilling koumiss. 

Arrack is a fermented liquor made from rice in rice-producing 
countries. 

Narcotics. —The number of narcotic or stupefying substances em¬ 
ployed in different parts of the world is fully equal to that of the al¬ 
coholic beverages used. We can mention but a few of the many dif¬ 
ferent substances employed. 

Tobacco. —This, the most widely used of all narcotics, is supposed to 
be employed by not less than 900,000,000 of the 1,400,000,000 inhab¬ 
itants of the globe. In India, Siam, Burmab, and China, the use of to¬ 
bacco is nearly universal among all classes of both sexes. The Turks 
are almost perpetual smokers. 

Opium .—This drug is said to be used by not less than 400,000,000 
people. It is used most freely by the inhabitants of Eastern countries. 

Tea, Coffee, Cocoa, and Chocolate .—These four narcotics, essen¬ 
tially alike in character and effects, though obtained from widely differ- 


454 


STIMULANTS AND NARCOTICS. 


ent sources, are very largely used in all civilized as well as barbarous 
countries. 

Mate, or Paraguay tea, is the leaves of a South American tree, the 
properties of which are essentially the same in character as those of 
China tea. 

Indian hemp, or hashish, is a narcotic largely used by the inhab¬ 
itants of Persia, and in all Mohammedan countries. It is said to have 
the peculiar property of producing wonderful and pleasing visions, from 
which the devotee of the drug reluctantly awakens. It sometimes pro¬ 
duces the most violent delirium and a homicidal propensity. 

Lettuce. —The general opinion that the ordinary garden lettuce is a 
narcotic plant is shown to be true by chemical examination of the plant 
and experiments with it. The milky juice which exudes when the stem 
is cut contains a narcotic principle known as lactucarium. The free 
use of the leaves causes sleepiness, as many persons have experienced 
after eating heartily of lettuce salad. On this account the use of the 
plant is not to be recommended. It is not well to take food and med¬ 
icine together. 

Hops are also well known to be narcotic in their effects, which has 
led to the use of hop pillows to induce sleepiness, and hop poultices to 
relieve pain. Their narcotic properties are due to the active principle 
lupuline which they contain. The drowsiness resulting from the use of 
beer is due to the presence of this principle. 

The Betel-nut, the seed of a species of palm grown in India, Mala¬ 
bar, and Ceylon, is used by about 100,000,000 people, being chewed like 
tobacco. It is probable that larger quantities of this drug are used than 
of any other narcotic excepting tobacco, it being estimated that not less 
than 500,000,000 pounds’ weight are consumed annually. Its devotees 
are as abject slaves to its use when once addicted as are the users of to¬ 
bacco or opium to their favorite narcotic. 

Cocculus Indicus and Sweet Gale are narcotic drugs used in the 
adulteration of liquors. They are very powerful in their effects, pro¬ 
ducing an intense degree of intoxication, particularly the first named. 
The second is used in Scotland. 

In Siberia a fungus resembling the mushroom of this country is 
chewed for its narcotic effects, which are very marked, producing in¬ 
tense intoxication. 

Stramonium, derived from the thorn-apple, is employed by some 
tribes of South American Indians in the form of a narcotic drink. It 
sometimes produces the most extreme and even violent excitement. 


NARCOTICS. 


455 


Absinthe is a narcotic and intoxicating- drink consisting of an in- 
fusion of the leaves of wormwood in alcohol. It is much used by the 
French, and to its enervating effects, both mental and physical, has been 
attributed the incapacity of the French soldiers when compared with 
their German combatants in the Fran co-Prussian war. 

Emetic holly is a narcotic which is used by the Indians of Florida. 
The leaves are made into an infusion, and the decoction, known as 
“ black drink,” is largely drank by the chiefs, especially when about to 
engage in a council, much as many other tribes of Indians smoke to¬ 
bacco under similar circumstances. 

Among other intoxicating beverages used by different nations may 
be mentioned said, samshoo, and sacio , all of which are made from rice, 
and are used by the Greeks, Chinese, and Japanese, respectively; kawa, a 
drink made from the macro-piper, or long-pepper, and used by the Pa¬ 
cific Islanders; bodki, made from the potato, used by the Russians and 
Poles; and tall ah, made from millet, and used by the Abyssinians. 

One very noticeable fact is worthy of attention in this connection; 
viz., that the various stimulants and narcotics mentioned, while very 
unlike in many of their properties, and differing in their effects, are all 
alike in that each contains some special poison which may be sepa¬ 
rated, and when taken pure, will produce serious and even fatal results- 
Some of these poisons, as morphia and nicotine, in a pure state are ex¬ 
tremely poisonous, being fatal in very minute doses. Others, as alcohol, 
caffeine, and theine, are equally fatal in somewhat larger doses. 

Having noticed very briefly the most commonly used stimulants 
and narcotics of many different nations, we shall now notice more par¬ 
ticularly a few of the more important ones, including alcohol, tea, coffee, 
tobacco, and opium, as these are the drugs most commonly used for 
stimulant or narcotic effects in this and all other civilized countries. 


456 


STIMULANTS AND NARCOTICS. 


EVIL EFFECTS OF ALCOHOL. 


The agitation of the temperance question during the last fifty years 
has had the effect to provoke a thorough investigation of the nature and 
effects of alcohol, and its relations to animal life, which has resulted in 
the determination of certain facts in relation to this subject which may 
be said to be demonstrated so far as it is possible for anything to be con¬ 
clusively settled by scientific investigations relating to the human sys¬ 
tem. One of the most active and efficient workers in this field has been 
Dr. B. W. Richardson, of London, Eng., who has long stood in the fore¬ 
most rank of scientific physicians the world over. The late Dr. Parkes, 
the eminent English sanitarian, and Dr. Edward Smith, also recently 
deceased, the author of some of the most scientifically accurate works on 
diet extant, have also done much in this field, as well as many French 
and German investigators. We shall endeavor to present to our read¬ 
ers the results attained by these laborious investigations as simply and 
concisely as possible. The results determined are decisive, and admit of 
no ambiguous interpretation ; and they should be treated and accepted 
with the respect and consideration due to scientific facts. 

Effects of Alcohol Definite and Constant. —The relation of al¬ 
cohol to living tissues, whether animal or vegetable, is always the same 
under the same circumstances. It is a poison, not only to man, but to 
lower animals and to vegetables as well. A leech thrown into alcohol 
dies in a few seconds. Plants whose roots are bathed in alcohol, even 
when very much diluted, not more than one part in a thousand of 
water, are retarded in their growth, become sickly and die. It is a 
drug which is in the highest degree inimical to the whole animated 
creation. Every form of life is destroyed by it. It is in man, how¬ 
ever, that its worst effects are seen. This is in one sense fortunate, 
for, as a brilliant writer wittily says, if lower animals were addicted to 
the drug in one-tenth the degree man is, in a short time there would 
not remain upon the face of the earth an animal which would be 
tamable, workable, or eatable. In whatever way alcohol is introduced 
into the body, whether through the stomach, through the skin, or 
through the lungs in the form of vapor, the effects are essentially the 
same. 



ALCOHOL IS A NARCOTIC. 


457 


Neither does it make a very great difference what form of alco¬ 
holic drink is taken, provided the same amount of actual alcohol is im¬ 
bibed. From the strongest rum down to hard cider and small beer 
the effects are those of alcohol. 

Alcohol ail Irritant. —Apply to the skin a small compress satu¬ 
rated with pure alcohol, covering it with oiled silk to prevent evapora¬ 
tion ; in a few minutes the skin will be reddened and irritated as 
though a mustard plaster had been applied. 

Take into the mouth a tablespoonful of alcohol. After holding it 
a few minutes the whole mucous membrane will seem blistered and 
benumbed. 

Alcohol a Narcotic. —The definition of a stimulant is that “which 
produces an increase of vital activity” [Webster]. According to 
the popular belief, not only among the common people, but among 
physicians as well, alcohol is an agent which will accomplish this; but 
in the light of recent investigations the popular belief is not the cor¬ 
rect one. Alcohol decreases vital action, rather than increases it, and 
therefore cannot be a stimulant, except when it acts as an irritant by 
contact with delicate tissues. The best medical authorities now acree 
that this drug is a most powerful narcotic. It deadens the sensibility 
of the nerves, like ether, chloroform, and nitrous oxide. Chloroform 
and ether are both compounds which are made from alcohol. Half an 
ounce of alcohol held in the mouth a few minutes will so deaden the 
nerves of taste that they can appreciate no difference between salt and 
sugar, between sour and bitter. When alcohol is taken into the blood, 
it produces a similar condition in the brain and all the great nerve 
centers. 

Says Hr. E. Smith, F. R. S., of alcohol, “ I hold that its action, in all 
doses, is always that of a narcotic and paralyzer.” 

Says the eminent Dr. Richardson, “ I cannot by any argument yet 
presented to me admit the alcohols by any sign that should distinguish 
them from other chemical substances of the paralyzing, narcotic class.” 

Alcohol Destroys the Blood. —When this fiery drug is taken 
into the stomach, it is soon absorbed into the circulation, where it 
comes in contact with the corpuscles of the blood The effect upon 
these delicate and important structures we can study by applying al¬ 
cohol to the blood outside of the body; for the corpuscles will retain 
their life and activity for several weeks after being removed from the 


458 


STIMULANTS AND NARCOTICS. 


body, if placed under proper conditions. To make sure of no mistake 
about this matter, we will perform the experiment while we write. Our 
microscope, which will magnify one million times, being in readiness, 
we thrust a needle into a finger and thus obtain a tiny drop of blood. 
Placing it upon a glass slide, we adjust it upon the instrument and 
look at it. Although the film of blood in view is so thin as to be 
transparent, it is crowded with beautiful bi-concave discs, the red 
blood corpuscles, each of which is perfectly formed, though only 
1-3500 of an inch in diameter. Now we apply a drop of alcohol, a 
very tiny drop; mark the effect. No sooner does it touch these little 
bodies than they begin to shrink, and soon lose all resemblance to 
their natural appearance. In a short time they are seen to be break¬ 
ing up into fragments; and in five minutes from the commencement 
of the experiment the once beautiful and symmetrical little bodies 
which compose one-half of the blood, are reduced to broken fragments 
and shapeless masses. They have been fairly cut in pieces and eaten 
up by the alcohol. 

The contact of aicohol with the corpuscles also causes them to lose 
their coloring matter, a very important part, as it is by means of this 
that they are enabled to perform their work as oxygen carriers. This 
effect may be observed in those which give no other evidence of injury 
from the alcohol. 

“ But what harm does this do ? ” says the drunkard or the moder¬ 
ate drinker; “ the loss of a few blood corpuscles cannot be of any great 
consequence.” The ultimate effect is the same as though the supply 
of air was cut off from the lungs by a cord tightly drawn around the 
neck. The business of the red corpuscles is to carry oxygen from the 
lungs to the tissues. If they are destroyed, oxygen cannot be carried 
in sufficient quantity, and the blood becomes foul, being charged with 
large quantities of carbonic acid, the poisonous substance which ought 
to be replaced by oxygen. One of the quickest known ways of de¬ 
stroying life is to cause an animal to inhale a poisonous gas known as 
carbonous oxide, which has the effect to paralyze all the blood corpus¬ 
cles. Alcohol does the same thing just in proportion to the quantity 
taken. 

In addition to its effects upon the corpuscles, alcohol produces other 
serious changes. One of the most important of these is coagulation or 
thickening of the fibrine of the blood, which occasions the formation of 
little clots which are swept along in the blood current until they reach 




































































0 0 0 
O 0. © 




Plate XIV .—EFFECTS OF ALCOHOL AND TOBACCO. 

A. Healthy stomach. B. Congested stomach of moderate drinker. C. Ulcerated stomach of 
habitual drunkard. D. Stomach in delirium tremens. E. a Healthy blood : b. Blood of tobacco- 
user; c. Blood of drunkard. F a. b. Fatty nerve fibres of drunkard; c. d. Fatty muscle fibres of 
drnnkard. G. Section of fatty liver of drunkard, magnified. 




















EFFECTS OF ALCOHOL ON THE HEART. 


450 


the finest capillaries, where they are lodged, thus obstructing the circula¬ 
tion, and, according to the eminent Prof. Carpenter of England, consti¬ 
tuting the first beginning of organic disease of the nerve centers and other 
important organs. These minute clots often constitute the cause of boils 
and troublesome abscesses; and when they become large, as they some¬ 
times do, they may produce instant death by the plugging up of a 
large artery in the brain, an accident which, there is every reason to be¬ 
lieve, is not uncommon in cases in which large quantities of alcoholic 
spirits are taken. 

Alcohol also greatly increases the amount of fat in the blood, probably 
by preventing the changes necessary to the complete digestion or assim¬ 
ilation of fat. 

There is also reason for believing that alcohol has a paralyzing effect 
upon the white blood corpuscles, interfering with them in such a manner 
as to prevent their passing out through the walls of the vessels in their 
usual manner. 

]t may be further objected that these changes do not occur unless 
very large quantities of alcohol are used. This, again, is an error. Dr. 
Carpenter is authority for the assertion that the changes in the corpus¬ 
cles and in the fibrine of the blood take place when not more than one 
part of alcohol to five hundred of blood is employed. Thus it will be 
seen that the very weakest wines are unsafe, since none of them contain 
less than three to five per cent. Even small beer would be capable of 
doing mischief in this way. The weakest wines would need to be di¬ 
luted with four times as much water, in order to prevent the injurious 
results described. 

The effects of alcohol upon the blood may be clearly seen by refer¬ 
ence to Plate XIV. 

Effects of Alcohol Oil the Heart. —When alcohol is taken into the 
blood, it soon comes in contact with the nerve centers which govern 
the action of the heart. Its effect is the same as upon the other nerve 
centers. It paralyzes them, just as chloroform does the brain. Then 
the heart is like a steam engine without a governor, or a clock from 
which the pendulum weight has been removed. It runs down with 
wonderful rapidity. This effect is largely due, also, to the influence 
of alcohol upon the small blood-vessels, the nerves which control them 
becoming paralyzed, they become dilated or relaxed, and so afford less 
resistance to the action of the heart, allowing it to beat too rapidly. 
This increased action is most unfortunately mistaken for increase of 


460 


STIMULANTS AND NARCOTICS. 


strength on the part of the organ, when it is mere increase of action^ 
wasted force. The amount of extra work (lone by the heart under 
the influence of liquor may be readily estimated. Dr. Parkes, by a 
series of careful experiments, found that the pulse of a man whose 
heart beat about 74 times a minute, or 106,000 times in twenty-four 
hours, when drinking only water, was, when under the influence of 
one ounce of alcohol per day, compelled to beat 430 times more in a 
day. Two ounces of alcohol per day caused an increase of 1,872 beats 
a day. Four ounces required 12,960 extra beats. Six ounces drove 
the pulse up to 18,432 extra beats; and eight ounces to 25,488 un¬ 
necessary beats, or nearly one-quarter more than when taking only 
water. 

The results of this experiment are of great value. They show very 
clearly how alcohol wastes not only the force of the heart, but of the 
whole body. The force exerted by the heart at each beat has been 
variously estimated at from five to fifty pounds. Assuming ten 
pounds as the actual amount of force expended, we may readily ascer¬ 
tain the amount of force wasted through the increased action of the 
heart by different quantities of alcohol. Thus, one ounce of alcohol, 
with 430 extra beats, caused a waste of 4,300 pounds of force; that 
is, of force equivalent to that expended in lifting 4,300 pounds one 
foot high in a minute. When two ounces were employed, the wasted 
force was 18,720 pounds. With eight ounces of the poison, the force 
wasted was 254,880 pounds, or more than 127 tons extra. When we 
consider how much labor would be required to lift 127 tons of coal a 
foot high, or one-tenth of that amount ten feet high, the result seems 
almost incredible; but there is neither reason nor opportunity for 
doubting the fact. Other observers have repeated the experiments, 
and with similar results. Dr. Richardson finds the results confirmed 
by his experiments upon animals. If the force of the heart should be 
taken at fifty pounds, as estimated by some of the most eminent 
physiologists, the results would, of course, be five times as great as 
those given. Dr. Parkes observed that after the conclusion of the 
experiment, five or six days elapsed before the young man recovered 
his natural condition, before the alcohol was fully eliminated, the heart 
in the meantime remaining weaker than natural, as shown by the 
sphygmograph. 

The Whisky Flush •—The flushing of the face caused by alcohol 
is an evidence of relaxation or paralysis of the small blood-vessels al- 


ALCOHOL LESSENS MUSCULAR STRENGTH. 


4G1 


ready mentioned. This flushing is not confined to the face. It ex¬ 
tends to the liver, the kidneys, the muscles, the lungs, the spinal cord, 
the brain,—every part of the body. It means paralysis. 

Alcohol Lessens Muscular Strength.— The use of alcohol, even 
in moderate, doses, lessens the muscular strength of an individual, first 
temporarily, and then permanently. Actual experiments have shown 
repeatedly that a man cannot lift so much immediately after drinking 
an alcoholic liquor as he could before. 

Dr. Parkes in another experiment gave a strong, healthy man only 
water for drink for three days, and kept him digging during the time 
ten hours a day. The average number of heart-beats was sixty-six 
per minute. Then he worked three days more in the same manner, 
only taking twelve ounces of brandy each day. The average num¬ 
ber of heart-beats during the latter period was seventy-one per min¬ 
ute. The laborer began with the belief that he could work easier 
with brandy than without it; but he entirely changed his opinion. 
He stated that during the first two days the brandy made him 
feel as though he could accomplish more; but when he attempted 
to do it, he found himself unable to succeed. On the third day he 
was feverish and thirsty, had palpitation of the heart, and was obliged 
to stop his work very often because “ his breathing was not good.” 

The reason why the laborer could not accomplish so much work with 
alcohol as without is evident. He was wasting a part of his available 
force in eliminating the poison. The increased action of the heart is but 
one of the sources of loss of energy, and by this means alone he wasted 
fifty pounds of force a minute, or three-fourths of a ton air hour, or 
eighteen tons in each twenty-four hours. By the lungs as much more 
force was wasted, to say nothing of the immense waste occasioned by 
increased work imposed upon the kidneys, skin, liver, and other im¬ 
portant vital organs. 

The same thing has been repeatedly demonstrated in cases m which 
total abstainers have been brought into competition with drinkers, in 
trials of endurance. When other circumstances have been equal, the 
teetotalers have always come off victorious in such contests. 

Says Dr. Brinton, a recognized medical authority, “ Even a moderate 
dose of beer or wine diminishes the maximum weight which a person 
can lift to something below his teetotal standard.” Facts obliged Dr. 
Brinton to make this statement, though himself not a teetotaler. 

Dr. E. Smith, F. Pc. S., refers to “the diminution of muscular power ” 


4 62 


STIMULANTS AND NARCOTICS. 


as one of the properties of alcohol, and adds, “ In whatever dose, the di¬ 
rection of the action of the alcohol must be the same.” 

Alcohol Decreases Aiiimal Heat.— Notwithstanding: alcohol has 
long been used by those exposed to cold, under the supposition that it 
increases heat, the investigations of Dr. Richardson and others have 
demonstrated that alcohol invariably decreases animal heat in all cases, 
and in proportion to the dose. The deceptive sensation of warmth 
which immediately follows its use is due to the increased surface circula¬ 
tion. The temperature of the body quickly falls below the normal 
standard, in persons who are drunk reaching to three or more degrees 
below the natural temperature of the body, according to Dr. Dobell. In 
cases of deep intoxication by alcohol the temperature has been known to 
fall six or seven degrees below normal. 

The dram-taker feels warmer after drinking ; but the thermometer 
shows that his temperature is really less, just as actual experiment shows 
that he is weaker, though he may feel increased strength. It is com¬ 
monly observed that persons recovering from drunkenness feel chilly 
when coming out from under the influence of the drug. It is often 
some hours before the bodily heat is recovered. 

Alcohol as a Cause of Disease. —From the effects of alcohol upon 
the several important organs and systems of the body, briefly described, 
it is clear that it must be a powerful cause of disease. That this is the 
case we shall now attempt to show. 

\\ liile the body is growing, and before full maturity of physical 
structure has been attained, the effects of alcohol are for the most part 
temporary. Great disturbances are produced by its invasion of the vital 
economy, but as these are only the result of deranged functions, or func¬ 
tional disease, recovery is usually quite rapid when the cause is sus¬ 
pended. Some of the functional maladies resulting from alcohol we 
will now consider. 

Drunkard s Dyspepsia. —A drunkard is certain to become a dys¬ 
peptic. Alcohol tans the stomach, rendering it inactive, and causing 
atrophy of the glands which form the gastric juice. The supply of this 
digestive fluid is thus diminished. Alcohol precipitates the pepsin from 
the gastric j uice, and so renders useless that which is secreted. Digestion 

O 

cannot progress while alcohol is in the stomach, being delayed until the 
poison can be absorbed. 

Dr. Beaumont had an excellent opportunity for observing the ef- 


NUMEROUS FUNCTIONAL DISEASES. 


463 

fects of alcohol upon the stomach in the case of Alexis St. Martin, a 
young man the interior of whose stomach was exposed to view through 
an opening in the abdomen. St. Martin had been addicted to the use 
of liquor, and sometimes broke away from the restraints imposed upon 
him by the doctor’s experiments, and indulged his appetite for alco¬ 
holic drink. After these occasions, Dr. Beaumont always noticed that 
the mucous membrane of the stomach was greatly congested. Even 
the use of a small quantity of alcoholic drink was sufficient to pro¬ 
duce an inflamed appearance, while greater excess caused the stomach 
to present a surface swollen and roughened with inflammation, with 
ulcers and numerous black patches of deadened tissue. 

Notwithstanding this terrible condition of his stomach, St. Martin 
was scarcely conscious of any disturbance, and thought himself as well 
as usual! Why was this ? Because the stomach has few nerves of 
general sensibility, and suffers long before it remonstrates. 

The stomach of an habitual drinker resembles pounded beefsteak 
more nearly than any human tissue, as may be seen by reference to 
Plate XIV. 

When long continued, alcohol produces worse effects; it causes in¬ 
flammation of the stomach, foul ulcers, and cancerous disease of the 
organ. Not long since, we saw in Bellevue Hospital, New York, a 
case of most violent gastritis produced by taking a small quantity of 
alcoholic drink. The patient was a woman, and for several days she 
was unable to retain any food in the stomach. Nutrition was main- ' 
tained by nutritive enemata. The most obstinate cases of gastric 
ulcer are found in drunkards. 

Numerous Functional Diseases. —Close upon the derangement 
of the stomach, which is certain to come sooner or later with all drink¬ 
ers, follows nearly every other functional disease possible to the human 
system. Every organ is disturbed. The whole vital machinery is de¬ 
ranged. Strange noises are heard in the head, occasioned by the 
rushing of the hot torrent of poisoned blood through the distended 
blood-vessels of the head, which pass near the ear. Black spots and 
cobweb appearances annoy the sight. Alcoholic amaurosis or am¬ 
blyopia comes on, and sight becomes impaired; sometimes blindness 
follows. The dilated blood-vessels of the skin become permanently 
enlarged, especially in the face and nose, and the drinker gets a rum 
blossom. Skin diseases of various sorts are likely to appear, particu¬ 
larly eczema of the fingers or toes, or on the shins. An unquenchable 


464 


STIMULANTS AND NARCOTICS. 


thirst seems to be ever consuming the blood, and nothing but alcohol 
will even temporarily assuage the desire for drink. Notwithstanding, 
large quantities of fluids will be taken, often amounting to several 
quarts a day, which overworks the excreting organs. 

The liver and kidneys are disturbed in their function, one day 
being almost totally inactive through congestion, and the next rally¬ 
ing to their work and doing double duty. 

Every organ feels the effect of the abuse through indulgence in 
alcohol, and no function is left undisturbed. By degrees, disordered 
function, through long continuance of the disturbance, induces tissue 
change. The imperfectly repaired organs suffer more and more in 
structure until the most extensive and disastrous changes have taken 
place. 

Organic Diseases Induced by Alcohol. —The most common form 
of organic or structural disease due to alcohol is fatty degeneration, 
which may affect almost every organ in the body. 

The Drunkard’s Heart. —The fatty particles which exist in such 
increased abundance in the blood of those who use alcohol, are, after a 
time, deposited in various tissues where they are not needed, and in too 
great quantities. This deposit often occurs in the heart, and gradu¬ 
ally replaces the muscular tissue of its Avails, thus weakening the 
heart’s power, and rendering it liable to fail altogether when called 
upon for a little extra exertion, and even to rupture from the force of 
its own feeble contractions. It is a fact well known to physicians 
that this is one of the most common causes of heart disease. We ha\ r e 
seen scores of cases of heart disease in the large hospitals of New York, 
and elsewhere, the larger share of which were in persons addicted to 
the use of liquor. 

Alcohol a Cause of Apoplexy. —The fatty particles contained in 
the blood are very liable to be deposited in the walls of the arteries, 
as well as in those of the heart. The arteries of the brain are more 
frequently the seat of this degeneration than those of any other part of 
the system. Its presence here can be detected by the arcus senilis, an 
almost certain sign hung out by nature to give warning of the dangerous 
changes taking place. The arcus senilis is a yellowish ring formed in 
the cornea, just within the outer edge. It is caused by a deposit of 
fat, and indicates that the same change is taking place in the brain. 

Alcoholic Consumption. —Dr. Bichardson points out the fact 
that alcohol, instead of preventing, actually produces consumption, 


ALCOHOLIC INSOMNIA. 


465 


and of a most fatal type. He states that a person suffering from alco¬ 
holic phthisis shows no improvement under treatment. The disease, 
steadily, surely, and usually quite rapidly, progresses to a fatal termi¬ 
nation. The disease is most liable to attack those who seem to be al¬ 
most invincible to the effects of alcohol, and who are often pointed to 
as examples of the harmlessness of alcoholic drinks. The disease often 
makes its appearance just when the drinker, alas ! too late, is making 
up his mind that the poison is really hurting him, and is thinking of 
reforming. 

The Gill Liver. —The appearance of a drunkard’s liver is charac¬ 
teristic. “ Hob-nailed liver ” is another name for the diseased organ 
as found in spirit-drinkers. It is shrunken, hard, and almost totally 
useless, insensible alike to pain and to proper sensibility. Externally 
it looks like the hob-nailed sole of an English cartman’s shoe, from 
which resemblance it received its name. 

This kind of liver is found in those who have indulged in drink 
for several years. The livers of more moderate drinkers are found 
filled with fat. 

These derangements of the liver give rise to numerous other dis¬ 
turbances, of which abdominal dropsy is one common form. 

Diabetes, a very fatal malady, especially in spirit-drinkers, is a 
peculiar disease which is generally caused by some of these derange¬ 
ments of the liver. 

Alcohol a Cause of Kidney Disease, —All of the different forms 
of disease of the kidneys, commonly known under the name of Bright’s 
disease, are common consequences of the use of liquor. The kidneys 
become worn out with overwork, and undergo the same degenerative 
changes suffered by other important vital organs. An eminent au¬ 
thority states that in England seven-eighths of all cases of disease of 
the kidneys are due to alcohol. This fact may account for the increas¬ 
ing prevalence of disease of the kidneys, especially in countries where 
strong liquors are used. 

Alcoholic Insomnia. —While alcohol at first acts in many persons 
as a soporific, its final effects are to produce inability to sleep; or, if 
sleep is not wholly broken, a disturbed, unnatural, unrefreshing state 
of unconsciousness, hardly worthy of being called sleep, is induced. 
In natural sleep the supply of blood to the brain is greatly diminished, 
only a sufficient amount of the nutritive fluid circulating in the arte- 
30 


46G 


STIMULANTS AND NARCOTICS. 


ries to carry on the reparative work of the brain. Unconsciousness is 
due to this fact. A condition of unconsciousness may also be produced 
by extreme congestion of the brain, a condition closely allied to that 
which just precedes apoplexy. This is the sleep of the drunkard. If 
he is not kept awake, through morbid, disordered action of the 
brain, due to an increased blood supply in its paralyzed arteries, he 
falls into an apoplectic slumber, in which he is haunted by horrid 
nightmares, goblins, ghosts, and frightful imagery, and awakes unre¬ 
freshed, unrecuperated. This unrefreshing sleep is produced by 
chloral and other narcotics, as well as by alcohol, a fact which shows 
the folly of attempting to remedy the alcoholic disease by dosing the 
natient with other drugs equally bad if not worse. The only proper 
remedy is total abstinence, and this will usually effect a cure, unless 
the condition of paralysis of the cerebral blood-vessels has been so 
long continued that the power of contraction cannot be restored to 
them. 

Nervous Disorders of Driukers. —No class of persons are so sub¬ 
ject to nervous diseases due to degeneration of nerves and nerve-cen¬ 
ters as drinkers. The constant congestion of the brain and spinal 
cord occasions thickening of the membranes which inclose and protect 
these delicate parts, and gives rise to fatty degeneration and hardening, 
which causes loss of function. The paralytic condition which is at 
first temporary, existing only while the person is under the influence 
of alcohol, and manifested as partial or complete loss of muscular 
power, according to the dose, by degrees becomes permanent, as does 
also the loss of power to regulate or co-ordinate muscular effort, shown 
in the staggering steps of the drunkard. Partial or general paralysis, 
locomotor ataxia, epilepsy, and a host of other nervous disorders, are 
directly traceable to the use of alcohol. 

Alcoholic Insanity and Idiocy. —The wild delirium of drunken¬ 
ness, mania a potu, is too common to require description. By degrees, 
this condition may become permanent, through degeneration of the 
brain. The effect of alcohol upon the brain is particularly marked. 
It is possible to distinguish by the microscope and other means, the 
drinker’s brain from that of an abstainer. 

The brain, when healthy, is so soft that it would not retain its 
shape but for the skull. The sharpest knife is required to cut it with¬ 
out mangling its structure. It is necessary to immerse the organ in 
alcohol for weeks or months in order to harden it when a careful ex- 


ALCOHOL PREDISPOSES TO DISEASE. 407 

animation is essential. A drunkard’s brain presents a marked con¬ 
trast. It is already hardened, pickled almost. In the dissecting room, 
it affords rare pleasure to a medical student to secure the dessicated 
brain of an old toper. The quantity of alcohol in the brain is some¬ 
times so great that it can be collected by distillation after death. Al¬ 
cohol has been found in the ventricles of the brain in a sufficiently 
pure state to burn when a match was presented- to it. 

Intemperance is now generally recognized as the greatest of all 
causes of insanity. According to the statistics of insanity in France, 
thirty-four per cent of the cases of lunacy among males were due to 
intemperance. One-half of the inmates of the Dublin insane asylum 
owe their disease to the use of liquor. 

Lord Shaftesbury, chairman of the English Commission on Lunacy, 
in his report to Parliament stated that six out of every ten lunatics in 
the asylums were made such by alcohol. 

Dr. Willard Parker, one of the oldest and most eminent physicians 
of New York City, remarks as follows on this point:— 

“ Pritchard and Esquirol, two great authorities upon the subject, at¬ 
tribute half of the cases of insanity in England to the use of alcohol. 
Dr. Benjamin Rush believed that one-third of the cases of insanity in 
this country were caused by intemperance, and this was long before 
its hereditary potency was adequately appreciated. Dr. S. G. Howe 
attributed one-half of the cases of idiocy in the State of Massachusetts 
to intemperance, and he is sustained in his opinion by the most relia¬ 
ble authorities. Dr. Howe states that there were seven idiots in one 
family where both parents were drunkards. One-half of the idiots in 
England are of drunken parentage, and the same is true of Sweden, 
and probably of most European countries. It is said that in St. 
Petersburg most of the idiots come from drunken parents.” 

Alcohol Predisposes to Disease. —The great number of observa¬ 
tions on this subject leaves no room to doubt that the use of alcohol 
is one of the most potent influences in increasing the susceptibility to 
the influence of disease. It is in no sense a preventive. 

Dr. Anderson, of Glasgow, says, “ I have found the use of alcoholic 
drinks to be the most powerful predisposing cause of malignant chol¬ 
era with which I am acquainted. In Warsaw, ninety per cent of all 
who died of cholera during the epidemic of 1832 were habitual drink¬ 
ers.” In the city of Tiflis, containing 20,000 inhabitants, every 
drunkard was swept away by cholera. In the Park Hospital, New 


4G8 


STIMULANTS AND NARCOTICS. 


York, there were two hundred and four cases of cholera during an 
epidemic of the disease. Of these, only six were temperate, and they 
recovered, while two-thirds of the remainder died. 

In the late epidemic of yellow fever in this country the proportion 
of victims among inebriates was nearly as large. 

“ Four-fifths of those who were swept away by the dreadful visita¬ 
tion of the cholera in 1832 were addicted to intoxicating drinks.” 

The whole population of St. Petersburg and Moscow ceased drink¬ 
ing liquor, being convinced that it was almost certain death to con¬ 
tinue its use. 

M. Huber said, “ Persons given to drinking were swept away like 
flies.” 

Alcohol predisposes to other diseases as well as cholera. A very 
slight injury to an intemperate man is likely to result fatally. Sur¬ 
geons in city hospitals find that they cannot expect the same degree 
of success in operations upon drinkers that they expect in the cases of 
temperate persons, a very slight operation, which would have occa¬ 
sioned no inconvenience in a total abstainer, often ending fatally. 

Stanley says, “No drunkard can live in Africa.” It is also well 
known that English soldiers in warm climates suffer from disease just 
in proportion as they indulge in liquor or abstain from its use. Dr. 
W. B. Carpenter cites in proof of this fact the returns of the sickness 
of European troops of the Madras army for 1849, in which the men 
were classed as abstainers, temperate, and intemperate. The report 
showed that the relative proportions of these classes admitted to hos¬ 
pitals were sixty abstainers and sixty-six temperate, to one hundred 
intemperate. 

The same difference is shown in England between the Sons of 
Temperance and the Odd Fellows’ Associations. The average number 
of days of annual sickness for each member of the Sons of Temperance 
was five; that for the members of the Odd Fellows’ Unity, many of 
whom, though not all, used liquor in a moderate degree, was seven 
and seven-tenths days, or an excess of more than one-half. 

The following formidable array of maladies has been attributed to 
the direct or indirect influence of alcohol:— 

Gout, rheumatism, heart disease, dyspepsia, disease of kidneys, 
dropsy, obesity, disease of the liver, apoplexy, degeneration of the 
muscles, tremors, ulcers, insanity, palsy, jaundice, epilepsy, consump¬ 
tion, melancholy, cancer, amaurosis, paralysis, hysterics, convulsions, 


ALCOHOL DECREASES LONGEVITY. 


469 


gastritis, enteritis, ophthalmia, carbuncle, boils, fatal obstruction of 
lacteals, tabes, syncope, diabetes, lockjaw, idiocy, impotency, mania, 
delirium tremens, Bright's disease, disease of the arteries, atrophy of 
the liver, congestion of the liver, and numerous other organic and 
fundional derangements. 

W e were informed by one of the visiting physicians of Bellevue Hos¬ 
pital, New ^ ork, that at least two-thirds of all the diseases treated there 
originated in drink. 

Much additional testimony and an almost unlimited number of facts 
might be further adduced in support of these statements, but the above 
may suffice. We shall now undertake to show that—- 

The Use of Alcohol Decreases Longevity. —It is very easy to 
prove that the influence of alcohol, as of every other poison, is to shorten 
life. Dr. Willard Parker, of New York, shows from statistics that for 
every ten temperate persons who die between the ages of twenty-one 
and thirty, fifty-one intemperate persons die. Thus it appears that the 
mortality of liquor-users is five hundred per cent greater than that of 
temperate persons. These statements were based on the tables used by 
life insurance companies. 

Notwithstanding the constant protest of both moderate and immod¬ 
erate drinkers that alcohol does not harm them, that it is a necessary 
stimulus, a preventive of fevers, colds, consumption, etc., and the asser¬ 
tion of certain scientists that it is a conservative agent, preventing waste 
and so prolonging life, the distinguished English actuary, Mr. Neison, 
has shown from statistical data which cannot be controverted, that while 
the temperate man has at twenty years of age an average chance of 
living forty-four and one-fifth years, the drinking man has a prospect 
of only fifteen and one-half years of life. At thirty years of age the 
temperate man may expect to live thirty-six and one-half years, while 
the dram-drinker will be pretty certain to die in less than fourteen years. 

A London Life Insurance Society divides its insurers into two classes, 
abstainers and moderate drinkers. It is found that during the last 
twelve years the mortality has been one-fourth less among abstainers 
than among the moderate drinkers; that is, only three abstainers die 
to four moderate drinkers. 

Dr. Magnus Huss asserts that in Sweden 1,500,000, or about one- 
half the whole population, annually consume an average of one hundred 
and sixty pints of spirits each. By this excessive indulgence in drink, 
the Swedes already show distinct marks of deterioration in stature and 
longevity. 


470 


STIMULANTS AND NARCOTICS. 


Between 60,000 and 100,000 persons die annually in America alone 
from the effects of liquor. A still larger number die in Europe from the 
same cause. Then in these two countries a human being dies every two 
and one-half minutes from alcoholic poisoning. 

The graves of the victims, allowing twelve square feet for each, 
would in fifty } r ears nearly cover a township. Arranged end to end, 
their coffins would make a continuous line from Gape Horn to the North 
Pole. 

Arranged in one long funeral procession, with a hearse and a single 
vehicle for mourners for each, this vast army of dead drunkards would 
occupy two and a half years in passing a given point, and would wind 
two and one-half times around the globe. 

Effects of Moderate Drinking. —Moderate drinkers do not es¬ 
cape. “ Chronic alcoholism ” is the disease which fastens upon them, 
and its symptoms are as distinct as those of any other disease. Gout 
and rheumatism are the special patrons of the moderate topers, the 
wine-bibbers. Neuralgia is another comforter of small tipplers. Gen¬ 
eral nervous debility and dyspepsia also find a great proportion of this 
class among their victims. 

It is quite useless for moderate drinkers to suppose that by using 
alcohol in small quantities they escape its evil effects. It is a poison 
in all doses. As Dr. Smith says, “ In whatever dose, the direction of 
the action of the alcohol must be the same.” 

Says Dr. Chambers, “The action of frequent divided drams is to 
produce the greatest amount of harm of which alcohol is capable, with 
the least amount of good.' It may be said, without exaggeration, 
that moderate drinking occasions all the ill effects of intemperance; 
for every drunkard begins his course as a moderate drinker. 

James Miller, in his work on Alcohol, says, “Alcohol to the work¬ 
ing human frame is as a pin to the wick of an oil-lamp. With this 
you raise the wick from time to time, and each raising may be fol¬ 
lowed by a burst of brighter flame ; but, while you give neither cotton 
nor oil, the existing supply of both is, through such pin-work, all the 
more speedily consumed.” 

Dr. W. B. Carpenter has shown that the largest quantity of alco¬ 
hol which can be taken daily without producing the poisonous effects 
and serious consequences pointed out is one to one and one-half ounces. 
A lai’ger amount may seem to be tolerated, but it is doing its slow 
work of death all the same, gradually, but surely. Judged by this 


HEREDITARY EFFECTS OF ALCOHOL. 


471 


standard, which is based upon scientific facts admitted alike by the 
advocates and opponents of the use of alcohol, a large proportion of 
those who use alcohol at all are being slowly poisoned by it. The 
effect of the constant action of a small quantity of the poison is far 
greater than that of excessive, but only occasional, quantities. Hence 
the habitual moderate drinker, even of wine, beer, or hard cider, is 
much more subject to chronic nervous disorders and degenerations of 
various sorts than the man who goes on a spree once in two or three 
months. 

Hereditary Effects of Alcohol .—The drinker himself is not the 
only sufferer from his vice. Indeed, it seems in many cases that he 
is not the greatest sufferer. He may even live out his threescore 
years and ten, in apparent defiance of the laws of nature and the warn¬ 
ings of friends; but look at his children. Are they as strong and robust 
as he ? Oh! no; instead, we often see them frail, nervous, imbecile, idi¬ 
otic,—poor specimens of the race. The iniquities of the father are 
visited upon the children. 

“ There are those [thousands] who have had diseased physical organ¬ 
isms bequeathed to them, and they are suffering from an irritable brain 
and an eccentric habit of thought, because their fathers drank spirits.”— 
Dr. Edmunds. 

Says the eminent Dr. Parker, whom we have before quoted:— 

“ The hereditary influence of alcohol manifests itself in various ways. 
It transmits an appetite for strong drink to children, and these are likely 
to have that form of drunkenness which may be termed paroxysmal; 
that is, they will go for a considerable period without indulging, placing 
restraints upon themselves, but at last all the barriers of self-control give 
way; they yield to the irresistible appetite, and then their indulgence is 
extreme. The drunkard by inheritance is a more helpless slave than his 
progenitor, and the children that he begets are more helpless still, unless 
on the mother’s side there is engrafted upon them untainted stock. But 
its hereditary influence is not confined to the propagation of drunkards. 
It produces insanity, idiocy, epilepsy, and other affections of the brain 
and nervous system, not only in the transgressor himself, but in his chil¬ 
dren, and these will transmit predisposition to any of these diseases.” 

Probably nowhere in the civilized world;—unless it be among the na¬ 
tives of the Sandwich Islands who are being rapidly exterminated by 
drink—are the baneful effects of alcohol upon the race seen more vividly 
than in Norway and Sweden. In Norway the spirit duty was removed 


472 


STIMULANTS AND NARCOTICS. 


in 1825. In the next ten years insanity increased fifty per cent, and the 
number of children born idiots increased one hundred and fifty jper cent. 

In Sweden there are at least a million and a half persons each of 
whom annually consumes eighty to one hundred quarts of whisky. 
Young children drink with their parents; and even infants are quieted 
to sleep by giving them a rag soaked in whisky to suck. According to 
Dr. Huss, the consequence of this is that “ the whole people is degenerat¬ 
ing; that insanity, suicide, and crime are frightfully on the increase; 
that new and aggravated diseases have invaded all classes of society; 
that sterility and the premature death of children are much more com¬ 
mon; and that congenital imbecility and idiocy are in fearful proportion 
to the numbers born.” 

Effects of Alcohol upon the Character. —The ultimate effects of al¬ 
cohol upon the character are well shown by its immediate effects. As the 
cerebrum is gradually brought under the influence of the drug, the will 
becomes dormant and the leading characteristics of the mind become 
predominant. A man under the influence of liquor shows out his real 
character. The restraining influences of culture and education are lost, 
and those tendencies and properties which have been held in check by 
force of will, assert their sway, and all that is low and beastly in the in¬ 
dividual comes to the surface. It is this that causes individuals to com¬ 
mit, under the influence of drink, crimes which they would never have 
perpetrated in their sober moments. It is rare indeed that a premedi¬ 
tated murder is committed without the murderer being' under the influ- 
ence of drink. He feels the need of something to paralyze the voice of 
conscience and make powerless the moral force of education, of natural 
regard for human life; and alcohol does just that. 

When liquor is frequently indulged in, the lowered moral status be¬ 
comes, after a time, a permanent state, which has been thus graphically 
pictured by Dr. Fothergill:— 

“ The most pronounced product [of alcoholic demoralization] is found 
in the hopeless drunkard, who, in squalid rags, with rotten tissues, the 
embodiment of intellectual and moral degradation, utterly beyond hope, 
the line of possible restoration long past, hangs around the tavern door, 
and with the odor of alcohol floating on his breast, whiningly begs a cop¬ 
per from the mass of vitality around him, of which he himself is a 
withered and decaying branch. This man is incapable of labor; he is 
unwilling to entertain the idea of toil. He is beyond any capacitv for 
labor; he is no longer capable of discharging his duty as a citizen; he is 


EFFECTS OF ALCOHOL UPON THE CHARACTER. 


473 


a social parasite of the lowest and foulest order, as useless as a tape-worm. 
He has abandoned all self-respect, because there is nothing left in him for 
himself or any one else to respect. He is a shameless liar, who will 
make the most solemn protestations as to the truth of what it is patent 
enough is false. There is no depth of moral degradation to which he 
will not descend for means to purchase a little more of the fluid which 
has ever been his bane.” 

It has been estimated oy competent judges that intemperance is the 
cause of nine-tenths of all the crime among civilized nations. Alcohol 
benumbs the intellect, deadens conscience, and stifles reason. It leads its 
victim to theft to secure the means of indulgence, and steels the heart of 
the assassin for his bloody work. 

To the crimes committed by the users of alcohol, themselves, should 
be added those committed by the wives and children of drunkards, who 
are driven to desperation and crime by the want and suffering occa¬ 
sioned by the cruel monster, drink. 

The influence of liquor in inci’easing crime has often been well illus¬ 
trated by the sad results which have invariably followed its first intro¬ 
duction into any community. Many newly settled districts have existed 
for several years with entire exemption from crime; no murders, no 
thefts, no public broils, no assaults upon persons or property, no act of 
violence of any kind occurring to mar the peace and destroy the feeling 
of security of the community. At last a public house is opened in the 
midst of this prosperous and peaceful society, and a bar is erected, from 
which alcoholic liquors are dispensed. The evil consequences are imme¬ 
diately apparent. Drinking engenders idleness. Idleness necessarily 
brings want, and want leads to theft; for a man who spends money for 
illegitimate purposes will not long continue particular to obtain his 
means from legitimate sources. Idleness and the conscience-searing, pas¬ 
sion-stimulating influence of alcohol soon lead to acts of violence against 
persons and disregard of individual rights. Midnight carousals and 
drunken revels become frequent, outbreaking crimes are not uncommon, 
and the once peaceful community becomes a scene of constant disturb¬ 
ance and disquiet. The sheriff and constable, who previously found no 
occasion for the exercise of the functions of their offices, now find con¬ 
stant employment. A jail becomes a necessity, and is never without an 
occupant. 

To say that alcohol is responsible for the revolution in the condi¬ 
tion of such a community, would be to state a fact too plain to be 
mistaken. 


474 


STIMULANTS AND NARCOTICS. 


Another evidence of the influence of liquor-drinking upon crime is 
seen in the fact that crime increases and decreases in any particular 
locality almost in proportion to the increase and decrease of the use 
or sale of liquor. 

During seven years, from 1812 to 1818, the annual consumption 
of liquor in England and Wales was 5,000,000 gallons; during the 
same period, 11,000 persons were annually arrested and committed for 
trial. During the seven years from 1820 to 1832, 9,000,000 gallons of 
liquor were annually consumed, and the annual number of arrests was 
21,700. It will be observed that the amount of liquor sold during the 
last period was almost double that consumed during the first, and also 
that the number of arrests was nearly doubled during the last period. 
That this increase of crime was due to the influence of liquor and not 
to increase of population, is shown by the fact that while crime had 
doubled, the population had increased but one-third. 

Says Dr. Nott, “ In Scotland, in 1823, the whole consumption of 
intoxicating liquors amounted to 2,300,000 gallons; in 1837, to 6,776,- 
715 gallons. In the meantime, crime increased 400 per cent , fever 
1,000 per cent, death 300 per cent, and the chances of human life di¬ 
minished 44 per cent. . 

“ In Ireland, when the distilleries were stopped, in 1808, crime de¬ 
creased amazingly. Again, when in 1810 they recommenced opera¬ 
tions, the commitments increased nearly fourfold .”—Bacchus Dethroned. 

The increase of crime incident to the increased use of liquor is, of 
course, due to the influence of alcohol upon the moral nature of indi¬ 
viduals. The direct effect of this poisonous drug seems to be to para¬ 
lyze the will, to render the sensibilities obtuse, to deaden the con¬ 
science, to inflame the passions, to weaken the judgment, and to de¬ 
throne reason. Kleptomania (an uncontrollable disposition to steal) 
is one of the acknowledged effects of drink. 

It is a well-established fact that the “ social evil ” is largely sup¬ 
ported by the use of liquor. Brothels and public houses are fre¬ 
quently connected. Liquor and licentiousness go hand m hand. 

An eminent physician remarks with reference to the moral effects 
of alcohol, “ When alcoholism does not produce insanity, idiocy, or ep¬ 
ilepsy, it weakens the conscience, impairs the will, and makes the in¬ 
dividual the creature of impulse and not of reason. Dr. Carpenter 
regards it as more potent in weakening the will and arousing the more 
violent passions than any other agent, and thinks it not improbable 


adulteration of alcohol. 


475 


that the habitual use of alcoholic beverages, which are produced in 
such great quantities in civilized countries, has been one great cause 
of the hereditary tendency to insanity.” 

Dr. Elisha Harris, late President of the American Public Health 
Association, and Corresponding Secretary of the New York Prison As¬ 
sociation, states that of 100,000 prisoners 82,000 were committed 
through the influence of drink. 

Adulteration of Alcohol. —\Ve have scarcely mentioned the fact 
that alcohol is subject to adulteration to an almost unlimited extent, 
as we do not regard this fact as of so very great importance, since alco¬ 
hol is the chief poison in all liquors, whether adulterated or not, and, 
with rare exceptions, is worse in its effects than any of its adulter¬ 
ants. It may be remarked, however, that there is very little pure 
liquor to be obtained. The following substances with many others 
are used in adulterating: the various alcoholic beverages hi common 
use:— 

Burnt sugar, sulphate of potash, sulphate of iron, alum, salt, coc- 
culus Indicus, picric acid, colchicum, tobacco, capsicum, ginger, 
wormwood, sulphuric acid, cream of tartar, carbonate of potash, 
hartshorn, strychnia, lead, laurel-water, cochineal, logwood, sugar of 
lead, oil of turpentine, gentian, and opium. 

THE MEDICAL USE OF ALCOHOL. 

This question is one which at the present time is exciting a great 
degree of interest in the medical world, and we should neglect an im¬ 
portant part of our task if we should fail to devote the space to it 
which its importance well demands. 

The medical use of alcohol is the strong fortress into which the 
moderate drinker runs when hard pressed by the advocates of total 
abstinence. It has always been a sort of Gibraltar for intemperance. 
The admission of the medicinal use of alcohol as a stimulant, tonic, 
conservator or generator of vital force, has been the rotten plank in 
the temperance platform. It has made the defenses of teetotalism, 
otherwise impregnable, exceedingly vulnerable. Temperance reform¬ 
ers have kept this part of the subject in the background as much as 
possible; but moderate drinkers have persisted in making it promi¬ 
nent on every possible occasion, often to the great discomfiture of the 
advocates of total abstinence for the well, but unlimited indulgence 
for the sick. 


47G 


STIM ULA NTS A XD NA RCOTICS. 


It has become evident to those who have given the matter candid 
thought, that either the common employment of alcohol as a medicine 
is a stupendous error, or teetotalism is a fanatical delusion. W hich 
of these positions is the true one ? It must certainly be that one 
which best agrees with facts—scientific facts—and the dictates of rea- 
son and common sense. 

No other drug is employed so largely in medicine as alcohol. It 
is not only prescribed in the form of alcoholic drinks, but, in combina¬ 
tion with other drugs, in all tinctures, and many other pharmaceutical 
preparations. Still greater quantities reach the stomachs of the peo¬ 
ple through a host of quack remedies, patent medicines, known under 
various delusive names, as cordials, bitters, tonics, restoratives, etc. 

Medical Properties of Alcohol. —According to the classical au¬ 
thors on materia medica, alcohol is a nervine, stimulant, tonic, nar¬ 
cotic, diaphoretic, diuretic, and caustic. Its varied properties are 
urged as sufficient apology for its so general use, they making it ap¬ 
plicable, as supposed, to almost any actual or imaginary case of 
disease. 

It should be remarked that a medical property is not, as generally 
supposed, a certain mode of acting upon the system possessed by a 
drug, but rather an indication of the manner in which the system acts 
toward the drug. It is evident, then, that the medicinal properties of 
alcohol, before enumerated, are so many terms for indicating a corre¬ 
sponding number of disturbances or disorders which the drug occa¬ 
sions in the body. 

When medical authors say that alcohol acts so and so, we must 
understand them to mean only that the drug occasions such an action 
on the part of the system. 

As the relations of any drug to the body in disease are determined 
by observing its effects upon the body in health, it will be instructive 
for us to glance again, for a moment, at the effects of alcohol upon liv¬ 
ing tissues as determined by experiment. 

When applied to plants, says Pereira, a noted medical writer, ‘ al¬ 
cohol acts as a rapid and fatal poison.” 

Says the same author, “ Leeches immersed in spirit die in two or 
three minutes.” Frogs and snakes are affected in the same manner. 

We have seen the heart of a turtle contracting vigorously several 
hours after removal from the body of the reptile. When placed in 
alcohol, its contractions cease in less than a minute. 


MEDICAL PROPERTIES OF ALCOHOL. 


477 


Alcohol causes paralysis when applied directly to the trunk of a 
nerve. It has the same effect when applied to a ganglion. If a pig¬ 
eon’s brain be exposed by removing a portion of its skull, alcohol may 
be applied directly to the cerebellum. The effect produced is essen¬ 
tially the same as that which follows the removal of the cerebellum 
by the knife. The poor pigeon plunges and staggers about like a 
drunken man, and for precisely the same reason. 

If a little alcohol is added to a vessel of water containin'; live min- 
nows, they will speedily die. 

Applied to the skin, and retained by some impervious covering to 
prevent evaporation, alcohol produces irritation and numbness. 

Applied to the mucous membrane of the eye or mouth, still greater 
irritation is occasioned. When taken into the stomach undiluted, it 
produces intense irritation, inflammation, and ulceration, as proved by 
Dr. Beaumont’s observations upon Alexis St. Martin. 

When mingled with the blood, alcohol destroys the blood corpuscles, 
increases the proportion of fat, renders the blood less capable of passing 
readily through the capillaries, coagulates the fibrine, and injures the 
nutrient elements of the plasma of the blood. When a considerable 
quantity of alcohol is taken, the distinction between venous and arterial 
blood is almost destroyed, all of the blood assuming a dark hue. It was 
thus that the English nobility, through habits of dissipation, became dis¬ 
tinguished for their blue blood, which was by them considered an evi¬ 
dence of noble origin. 

But alcohol does not remain in the blood. It permeates every tissue, 
and for some curious reason not yet satisfactorily explained, accumulates 
in nerve tissue more than in any other, unless it be the liver, which 
would very naturally receive the most, since alcohol when received by 
the stomach is carried directly to the liver by the portal vein, as soon as 
absorption occurs. 

The effect of alcohol upon the nerves is to lessen sensibility. A man 
whose nerves are bathed in alcohol has the acuteness of all of his senses 
somewhat impaired. The degree of impairment depends upon the 
amount of alcohol present. A large quantity of alcohol destroys sensi- « 
bility entirely. 

We have observed that alcohol is ‘‘a rapid and fatal poison to 
plants,” that it kills leeches, frogs, reptiles, and minnows, that it irri¬ 
tates the skin and mucous membrane, destroys the blood, and paralyzes 


478 


STIMULANTS AND NAIWOTICS. 


the nerves. In considering these effects, Prof. Christison, Dr. Pereira, 
Dr. Taylor, Prof. Orfila, and other authorities of equal note, pronounce 
it a “ narcotico-acrid poison.” 

Says Dr. E. Smith, “ It is a poison of the nervous centers.” 

Says Dr. Edmunds, of England, “ There is no great city on our 
side of the ocean where there are not inquests held upon men who 
drink a bottle of brandy, and fall down and die just as if you had 
given them a spoonful of prussic acid. Alcohol is a poison.” 

Says Dr. Willard Parker, of New York, “ By physiological inqui¬ 
ries it has been established that alcohol is a poison.” 

The Vital Instincts Treat Alcohol as a Poison. —If there 
should remain the least shadow of a doubt in the mind of any one 
that alcohol is a poison, it must certainly be removed by considering 
how the system treats this drug when it is taken into the stomach. 
At first the mucous membrane becomes congested, and throws out a 
quantity of mucus to protect itself from the alcohol, while the ab¬ 
sorbents increase their activity for the purpose of getting the drug 
out of the stomach as quickly as possible. 

Having entered the blood, it is transported at once to the liver, which 
does its best to extract as much as possible of the poison, though at im¬ 
minent peril to itself. Very soon the poison-laden blood reaches the 
heart. This organ also recognizes the drug as something which has no 
place in the blood and ought to be removed ; and, as it cannot directly 
effect the removal itself, it pumps a little harder at the circulation in 
order to hurry the impure blood along to those organs which are espe¬ 
cially designed to remove impurities. Hence the increased force and 
frequency of the pulse. 

The first of these organs which the hastening blood reaches, is the 
lungs, and here the volatile poison is sent out in volumes. Every one 
knows that a drunkard’s breath smells like a beer shop. The alcohol 
is also expelled by the kidneys and the skin, and can be found in the 
urine and the perspiration. In fact, every excretory organ of the body is 
engaged in getting rid of this poison. 

A food or a friendly substance is not treated in this way. If alcohol 
is a good thing, it is certainly very much abused by the vital instincts. 
But the vital instincts are not easily deceived. They recognize food in 
an entirely different manner. An apple, a potato, milk, or bread, when 
taken into the body, is utilized. It disappears, and never re-appears as 


NAME AND PROPERTIES. 


479 


milk, or bread, or apple, or potato. Not so with alcohol. It enters the 
system alcohol, and leaves it precisely the same as it entered, remaining 
the same all the way through. Instead of retaining the drug, digesting 
and assimilating it, the system hurries it out in every possible way. 
The escaping poison can be detected in the breath for more than twenty- 
four hours after a small quantity has been taken. It is long retained 
in the body, and has been distilled from the brains of drunkards thirty- 
six hours after its reception into the body. 

If, after eating apples, potatoes, and sundry other articles, the same 
articles should be found, upon a post-mortem examination, in various por¬ 
tions of the body, apples in the brain, potatoes in the liver, and other * 
articles in other parts, it would be considered as the most indubitable 
evidence that those articles,—apples, potatoes, etc.,—were not food, since 
they were not used or changed in the body. If we found these same 
articles passing out of the body, we should be led to the same conclusion. 
This is just the experience with alcohol. The conclusion, then, is una¬ 
voidable, that it is not food, but poison, as eminent physicians have de¬ 
clared. 

Says Dr. Parker, again, of alcohol, “ It is not a food, nor should it be 
used as a common beverage.” 

Does a Change of Name Change Properties? —Here we are 
met with the argument that alcohol, though a poison to the well, is still 
a good remedy for the sick. This paradoxical statement is explained by 
the assumption that the conditions of the system in disease are so differ¬ 
ent from those present in health that the relations of the vital organs to 
alcohol are totally changed. 

If this assumption be true, then tcetotalism is a terrible delusion; for 
where can a drunkard be found whose system is not in a state of disease? 
If it is true, then what a curse to the world temperance reformers have 
been ! How many reformed sots have been deprived of the “medicine” 
which was “ curing ” them ! But is it true ? Let us see. 

Does a simple change of location from the whisky barrel to the drug¬ 
gist’s shelf change its properties ? Will a change of name make it whole¬ 
some ? Will it make a negro white to call him a Caucasian ? Certainly 
not. Alcohol is a poison because it cannot be used in the body for any 
useful purpose, and because it produces serious disturbances in the vital 
processes. It is unfriendly to the tissues, and incompatible with them. 
When a man is sick, are not his tissues essentially the same in character 
as when he is well ? Are not his muscles still composed of muscular 


480 


STIMULANTS AND NARCOTICS. 


tissue ? his nerves of nerve tissue ? his bones of osseous tissue ? Cer¬ 
tainly. Then, since the composition of alcohol also remains the same, 
there can be no change in its relations to the tissues. 

Does Alcohol Supply Force %—Many years ago Prof. Liebig an¬ 
nounced the theory that alcohol was “ respiratory food.” By the term 
respiratory food he meant that it underwent combustion in the body 
and thus produced heat and developed force. All the moderate drink¬ 
ers and topers rejoiced at this supposed discovery, and consoled them¬ 
selves with the idea that taking a whisky punch was only a pleasant 
way of eating; and that a man when “ gloriously drunk,” was merely 
developing a tremendous amount of force. But scientists ascertained, 
after a time, that Prof. Liebig, to use the language of Prof. Davy, 
F. It. S., “ adduced no physiological evidence in support of his asser¬ 
tion.” Prof. Liebig observed that his neighbors and most of his coun- 
trymen loved beer, wine, and brandy; he loved the beverages himself. 
He observed also that nearly every nation employed some kind of alco¬ 
holic drink. The very natural conclusion in his mind was, alcohol is 
used in the body for some good purpose; and his theory was merely 
an attempt to explain such a use. 

If Liebig’s theory were true, then alcohol would disappear in the 
body, and only its ashes, the products of its combustion, would ap¬ 
pear. Unfortunately for the theory, MM. Lallemand, Perrin, and 
Duroy, three French chemists, by careful experiments proved that, 
when taken into the body, alcohol passed out again unchanged. 
Hence it was not burned ; and hence it did not produce either heat or 
force. Dr. Edward Smith, F. It. S., repeated their experiments and 
confirmed their results. The fact that alcohol is unchanged in the 
body was still further confirmed by the observation that none of the 
products of the combustion of alcohol, its ashes, were to be found in 
the blood or the excretions. 

The inevitable conclusion from these experiments is that alcohol 
does not contribute to the production of either heat or force. 

Says Dr. Edward Smith, “ Its direct action is to lessen nervous 
force.” 

“ Is ‘ vital force ’ augmented by it, or not ? All the facts seem to 
answer in the negative .”—British Medical Journal. 

Says Dr. T. K. Chambers, “ Alcohol is primarily and essentially a 
lessener of the power of the nervous system.” 

“ As their general action is quickly to reduce animal heat, I can- 


ALCOHOL AS A STIMULANT. 


481 


not see how they can supply animal force. I see clearly how they re¬ 
duce animal power, and can show a reason for using them to stop 
physical pain ; but that they give strength, that they supply material 
for the construction of fine tissue, or throw force into tissues supplied 
by other material, must be an error as solemn as it is widespread .” 
“ To resort for force to alcohol is to my mind equivalent to the act of 
searching for the sun in subterranean gloom until all is night.”— Dr. 
B. W. Richardson. 

Is Alcohol Useful us a Stimulant ?—If by a stimulant we are 
to understand something which imparts force to the body when weak¬ 
ened by disease, then it is evident that alcohol can be of no service in 
this direction ; for, as already shown, it is incapable of supplying force, 
undergoing no change in the body. All force arises from changes in 
matter. The forces manifested by the living system are the result of 
vital changes occurring in its tissues. 

If by a stimulant is meant something which excites nervous action, 
which calls out the manifestation of force, then alcohol is certainly a 
stimulant. And it is in this sense only that it is a stimulant. The 
lash is a stimulant to a tired horse. It does not increase his force, or 
make him any less tired. It only compels him to use a little more of 
his already depleted strength. A goad, a spur, a red-hot iron, would 
have the same effect. So with alcohol. It arouses the vital instincts 
by its presence in contact with some of the tissues, and, in obedience 
to the law of self-preservation, the vital organs are excited to in¬ 
creased action for the purpose of expelling the poison. This increased 
activity is what is called stimulation. Can it benefit a person already 
weak with overlabor ? Says Dr. Edmunds, “ A stimulant is that 
which gets strength out of a man.” Such a process could not be very 
beneficial to a person already debilitated. 

But a weary man feels better after taking wine; why is that the 
case ? Alcohol diminishes sensibility, as chloroform does. It is a 
narcotic. The weary man feels better after taking wine, because he 
does not know that he is weary, that his tissues need repair. If he 
continues to labor, he continues to wear out his tissues, and increases 
the necessity for rest, even though he may not know it. When the 
narcotizing influence of the alcohol is removed, he will be made pain¬ 
fully conscious of the fact by a degree of prostration far greater than 
he would have suffered if he had taken no alcohol. 

So with the sick. If a man is debilitated by disease, by a long- 
31 


482 


STIMULANTS AND NARCOTICS. 


continued fever, for example, his system is weary with the task of 
expelling impurities from the body. Now if alcohol is administered, 
it is expelled as the other impurities have been. It renders the ex¬ 
hausted organs no aid ; it imparts no force ; it simply imposes an ad¬ 
ditional task. Such aid is surely not desirable. Who would think 
of relieving an overburdened horse by adding another burden to his 
load ? No sensible man, certainly. If fever patients recover after 
taking great quantities of wine and brandy, it is in spite of the al¬ 
cohol, and not by the aid of it; for it has been proved in hundreds of 
instances that fever patients do far better without brandy than with 
it. 

Twenty years ago, when a man had fever he was puked, purged, 
bled, and salivated, under the notion that he had too much vitality,— 
too much life,—some of which must be got out of him. The plan of 
abstracting vitality was so successful that thousands of fever patients 
were killed who might have lived half a century if they had been so 
fortunate as to have had for a doctor only an old woman, or a harm¬ 
less homeopathist. 

In later times there has been a most remarkable revolution in the 
treatment of fevers. Calomel, emetics, purgatives, and the lancet are 
no longer employed in treating fevers. Instead of depleting their 
patients, or robbing them of their vitality, by the barbarous methods 
of olden times, “ regular ” physicians have adopted the theory that in 
fever the patient has too little vitality, and so they attempt to in¬ 
crease his vital force by potations of brandy, wine, and other alcoholic 
liquors. 

Of course, this practice is founded upon the theory that alcohol 
supplies force ; but we have already proved that alcohol does not sup¬ 
ply force to the body, but that it exhausts, abstracts, and paralyzes. 
This, then, cannot be the proper agent to employ when an addition of 
force is required. 

Says Dr. James Edmunds, of England, “ I believe, in cases of 
sickness, the last thing you want is to disguise the symptoms, to 
merely fool the patient; that if alcohol were a stimulant, that is not 
the sort of thing you would want to give to a man when exhausted 
from fever.If your patient is exhausted by any serious dis¬ 

ease, surely it would be the more rational thing to let him rest qui¬ 
etly, to save his strength, and in every possible way to take care to 
give him such food as will be easily absorbed through the digestive 
apparatus, and keep the ebbing life in the man.” 



WILL ALCOHOL PREVENT CONSUMPTION ? 


483 


The following is the opinion of Dr. Richardson on this subject:— 

“ It is assumed by most persons that alcohol gives strength, and 
we hear feeble persons saying daily that they are being ‘ kept up by 
stimulants.’ This means actually that they are being kept down; but 
the sensation they derive from the immediate action of the stimulant 
deceives them and leads them to attribute passing good to what, in 
the large majority of cases, is persistent evil. The evidence is all-per¬ 
fect that alcohol gives no potential power to brain or muscle. During 
the first stage of its action it may enable a wearied or feeble organism 
to do brisk work for a short time ; it may make the mind briefly brill¬ 
iant ; it may excite muscles to quick action; but it does nothing sub¬ 
stantially, and fills up nothing it has destroyed, as it leads to destruc¬ 
tion. A fire makes a brilliant sight, but leaves a desolation. It is the 
same with alcohol.” 

Does Aleoliol Prevent Waste ?—So said Prof. Liebig, who sup¬ 
posed that alcohol might serve as a substitute for the tissues in main¬ 
taining the combustion necessary to produce heat. But Prof. Liebig 
was mistaken. Dr. Smith, of England, proved that alcoholic drinks 
increase waste. It is useless, then, to give alcohol to the sick for the 
purpose of preventing the wasting of the body, for it will only accel¬ 
erate the undesirable process. 

Will Alcohol Prevent Consumption ?—The notion has lately be¬ 
come prevalent that alcohol will, in some mysterious manner, check 
the ravages of that dread disease, consumption. It might almost be said 
that in our large cities, in the practice of regular physicians, few con¬ 
sumptives die sober, so fashionable has this remedy become. 

The evidences upon which the utility of the drug in this disease is 
based are quite too inconclusive to amount to anything like demon¬ 
stration. In those cases in which recovery has taken place under the 
use of alcohol, the improvement can be attributed to other far more 
probable causes than alcohol, as impi’ovement in sanitary or hygienic 

surroundings or habits. 

© 

But the most conclusive evidence against the curative virtues of 
alcohol in this disease is found in the fact pointed out by Dr. B. W. 
Richardson, of London, that alcohol is itself a CAUSE of consumption. 
There is no evidence that spirit-drinkers are as a class less subject to 
consumption than abstainers, while it is certain that their mortality is 
much greater. Dr. Richardson has recently pointed out that the mast 
fatal form of consumption known is produced by alcohol. According 


484 


STIMULANTS AND NARCOTICS. 


\ 


to his observations, about two per cent of deaths by consumption are 
from this cause. 

The Medicinal Use of Alcohol Leads to Drunkenness.— Thou¬ 
sands of victims of intemperance have acquired their appetite for the 
fatal drug from a physician’s prescription. The doctor prescribed it 
as a tonic. The patient continued to feel the need of a tonic, and so 
he continued taking his dram as a medicine, a tonic, until he finally 
found, when too late, that he had become a confirmed inebriate. 

Hundreds of reformed drunkards who had been induced to sign 
the pledge, and who had kept their resolution for years, have fallen 
back into the gutter again through the careless administration of al¬ 
cohol by the family physician, and have thus been hopelessly lost to 
themselves and to society. We might present the touching details of 
many such cases; but all have been familiar with instances of the 
kind, and we will not present them here. 

In addition to the alcohol prescribed by regular physicians, there 
is a still greater quantity sold and used under the name of bitters, 
which always consist of a filthy mixture of poisonous drugs with poor 
whisky. Not one of them is free from alcohol. This statement is 
true, notwithstanding the false asseverations of the manufacturers to 
the contrary. Even “ temperance bitters ” are no better than the rest. 
Some of these “ bitters ” contain more alcohol than the strongest 
liquors. By these infernal compounds, thousands of unsuspecting hu¬ 
man beings have been lured down to death and ruin. The popular 
theory that alcohol is a good medicine, helps to inspire confidence in 
them, and so becomes in a measure responsible for the results. 

The Medical Use of Alcohol an Ally of Intemperance. —The 
doctor gives a man alcohol because he is sick or weak. The moderate 
drinker takes it for the same reason. The drunkard prescribes his 
own “ poison ” because he feels uncomfortable,—sick. The moderate 
drinker takes a glass of wine to give a “ lively play of the imagina¬ 
tion.” When its influence is gone, his intellect is dull, his imagination 
clouded. He takes another glass to “ cure ” the difficulty, not consid¬ 
ering that the remedy is the very tiling that is making him ill. The 
drunkard wakes up after a night’s debauch with an aching head, ener¬ 
vated muscles, and trembling nerves. He takes a glass of rum to 
cure his bad feelings, and at once feels better. Is not rum a good 
medicine for him ? He thinks it is, and he has the doctors on his side, 
for the principle is the same whether the patient is suffering from fe- 





DELIRIUM TREMENS. 


485 


ver debility or whisky debility,—whisky cures in each case, and in the 
same way. Why has not the drunkard as good an excuse for curing 
his weak ness and bad feelings by alcohol as any other person ? 

Alcohol in Delirium Tremens. —Alcohol is the acknowledged 
cause of delirium tremens, and yet it has been long considered an es¬ 
sential remedy in the treatment of the very disease it had produced. 
While this practice would seem to be most ludicrously absurd, it has, 
nevertheless, been wholly consistent with the theory that alcohol sup¬ 
plies nervous force; for what condition can be found in which the ev¬ 
idences of loss of nerve power and tone are more distinct than in this 
disease ? Practically, however, the use of alcohol in this disease has 
been a most convincing- demonstration of the fact that alcohol does not 
supply nerve force; for a great proportion of the patients treated with 
it have died. 

The most observing physicians have already abandoned the use of 
alcohol in delirium tremens, as v T e hope they will soon do in many 
other diseases. Here are a few testimonies:— 

“ I have come to the conclusion that the use of spirits in the case 
of delirium tremens does nothing but injure the patient, and probably 
hastens his death. I now, without the slightest hesitation, in every 
case should immediately stop the spirit, and I find that very few cases 
of delirium tremens that I have are fatal.”— Dr. James Edmunds. 

“ If you follow" the old treatment, you will lose half your cases. If 
you follow the treatment I give you, you wall save nearly all. In the 
hospitals of Edinburgh, the expectant treatment is found to save nearly 
all patients. They used to lose nearly all.”— Prof. Palmer, of Michi¬ 
gan University. 

Dr. Palmer recommended the expectant treatment. He also stated 
that, in Edinburgh, instead of narcotics the patient is given a glass of 
v r ater with the assurance that it will make him sleep, which it usually 
does. 

Alcohol for Mothers. —It has become a notorious fact that the 
use of stimulants by women is increasing very rapidly, and the evil 
has already acquired alarming proportions. It has doubtless very 
largely arisen from the practice of physicians and nurses of recommend¬ 
ing w r ine and beer to nursing mothers. The habit thus acquired is 
continued. 

But the mothers are not the only victims. A large share of the 
alcohol finds its way out of the system in the milk, and in this way 


48G 


STIMULANTS AND NARCOTICS. 


delicate babes are kept in a state of semi-intoxication from birth 
until they are weaned. A mother finds her child nervous and fretful. 
She takes a glass of ale an hour or two before nursing the infant, and 
is pleased to find that he becomes quiet. She little dreams that his 
quietude is only the stupid narcotism of alcohol poisoning; yet such 
is the truth. Every one knows that a dose of castor-oil given to a 
nursing mother will affect the child as promptly as the mother. The 
same is true of alcohol; but the delicate organization of the infant is 
far more susceptible to its poisonous influence than is the mother’s sys¬ 
tem. Dr. James Edmunds says that a large majority of English ladies 
use stout while nursing, so that their infants “ are never sober from 
the earliest period of their existence until they have been weaned.” 

Beginning life under such a regimen, is it any wonder that so large 
a number of young men, and young women also, develop into drunk¬ 
ards ? Such a result is only the fruit of the seeds sown in earliest 
infancy. The ancient Romans were so well aware of this fact that 
the use of alcoholic drinks was by law prohibited to a Roman mother 
while an infant was dependent upon her for support. 

What Does Experience Prove ?—The testimony of many emi¬ 
nent physicians is that the use of alcohol as a supporter of vitality, 
a tonic, or a stimulant, is wholly unnecessary. 

In London, there is a temperance hospital under the charge of Dr. 
James Edmunds, who delivered a very interesting series of lectures on 
this subject in New York City a year or two since. In this hospital, 
all alcoholic medicines are excluded “ without incurring any risk or 
delay in recovery, and with advantage rather than detriment.” The 
death rate, from the first establishment of the hospital, has been but 
six per cent, a rate far below that of other hospitals. Of more than 
three hundred surgical cases, which are generally supposed to espe¬ 
cially demand alcohol, not a single one proved fatal without it. 

Other hospitals are following the example of the temperance hos¬ 
pital, and with equally favorable results. 

Says Prof. Miller, M. D., of Scotland, “ Alcohol cures nothing.” 

Dr. Higginbottom said before the British Medical Society, “ I have 
never known a disease cured by alcohol.” 

Dr. Johnson, an English physician, says that alcoholic liquors are, 
“as medicines, wholly unnecessary.” 

A few years ago, two thousand English physicians publicly ex¬ 
pressed their disapproval of the use of alcohol as a medicine. 


AEG UMENTS CONSIDERED. 


487 


In London alone, three hundred physicians signed a petition for 
the suppression of the liquor traffic, “ alcoholic drink being, in their 
opinion, wholly unnecessary for medical purposes.” 

Prof. L. P. Yandell, a distinguished Southern physician, in a letter 
from Europe to the Louisville Medical News, wrote as follows of the 
opinion of English physicians respecting alcohol:—• 

“ After a very extended intercourse with the profession here, I am 
inclined to believe that a majority of the strong men consider alcohol 
harmful as a beverage, and a very large number are very doubtful of 
its efficacy in disease. Such are. my own views of alcohol.” 

At a recent meeting of the British Medical Temperance Associa¬ 
tion, at which many members of the British Medical Association were 
present, Dr. Ernest Hart, editor of the British Medical Journal, 
stated that “ the medical profession were nearly all agreed that alcohol 
was neither a food nor a tonic.” 

At the present time there exists in England an organization known 
as the British Medical Temperance Association, which comprises in its 
ranks many of the ablest medical men in Great Britain. 

We have treated several hundred cases of all forms of acute and 
chronic diseases, and have found very little occasion for the use of 
alcohol. Of over sixty cases of typhoid fever treated in one epidemic, 
not more than one or two received alcohol or stimulant of any kind, 
yet all recovered, without any unpleasant after-effects, and without 
the prolonged convalescence so common after this disease. 

If brandy, or alcohol in any form, is ever admissible, it is only 
when its poisonous effects as an irritant may be desirable, just as a 
dash of cold water, the application of a hot poker to the spine, or of 
ammonia to the nostrils, may each under some possible circumstances be 
serviceable in arousing the vital energies from a sudden collapse, and 
thus preventing death. 

ARGUMENTS IN FAVOR OF ALCOHOL CONSIDERED. 

In order to call attention to some other facts of importance, neces¬ 
sarily omitted in the consideration of the subject thus far, we will 
devote a few pages to an examination of some of the principal argu¬ 
ments urged in favor of the use of alcoholic liquors. 

1. Alcohol Is Food. —The aristocratic toper, who wishes to give 
an air of respectability to his vice, will claim that alcohol is a food. 
He will cite, in proof, instances in which persons have lived for weeks 


488 


STIMULANTS AND NARCOTICS. 


by the aid of no other nutriment, taking nothing but alcohol and 
water. This semblance of argument scarcely needs exposure ; for the 
most that can be claimed is that it proves merely that persons have 
lived several weeks while taking only alcohol and water. The fact 
that individuals have in several instances been known to live from 
thirty to sixty days while taking only water, shows conclusively that 
those persons who lived a shorter time on brandy and water lived in 
spite of the alcohol instead of by the aid of it. A conclusive evi¬ 
dence that alcohol is not a food is found in the fact that when taken 
into the system it undergoes no change. It is alcohol in the still, alco¬ 
hol in the stomach, alcohol in the blood, alcohol in the brain, in the 
liver, in all the tissues, and alcohol in the breath, in the perspiration, 
and in all the excretions. In short, alcohol is not used in the body, 
but leaves it, as it enters, a rank poison. 

“ I can no more accept them as food than I can chloroform or 
ether. ’ ’— Richardson. 

2. Alcoholic Beverages Preserve the Body. —Alcohol is a pow¬ 
erful antiseptic. An apple or the body of an animal placed in the 
fluid, cannot undergo decomposition. From this, some lovers of the 
article are very ready to infer that the use of alcohol will prevent de¬ 
composition of the tissues of the body, and thus tend to its preserva¬ 
tion. A greater fallacy could not be conceived. Corrosive sublimate, 
blue vitriol, copperas, and carbolic acid are excellent antiseptics; but 
who would think of taking any of these articles for the purpose of 
prolonging life ? 

But if alcohol did really hinder the destruction of the tissues, so 
as to prevent the natural process of disintegration, it would still be 
very injurious; for all the processes of life are dependent upon de¬ 
structive changes of tissue; and hence, anything which would hinder 
this process would hinder vital action, would interfere with the life 
processes which are essential to the manifestation of life. 

But it can be shown that the evidence upon which the scientific 
advocates of the use of alcohol base their arguments is quite unsatis¬ 
factory. They claim to find that the body wastes less while a person 
is using alcohol than when abstaining, the other conditions being the 
same. Hence, they tell us alcohol prevents vital changes, and so saves 
the body from wearing out. With this view they recommend the use 
of liquor to those who are obliged to undergo any hardship, or to per¬ 
form any severe physical labor. 


ARGUMENTS CONSIDERED 


489 


Let us examine this argument. It is found that the urine and 
other excretions contain less of the worn-out material of the tissues 
when a person is using alcohol than when he is abstaining. From this 
alone it is concluded that alcohol prevents the wearing out or disin¬ 
tegration of tissue,—a most astonishing conclusion. No one but a 
man stoutly prejudiced in favor of alcohol would think of forming 
such a conclusion. A far more rational deduction from the premises 
would be that the presence of alcohol in the system 'prevents the ex¬ 
cretory organs from eliminating from the body the dead and poison¬ 
ous products which result from the wearing out of the tissues. This 
conclusion would seem to be far more reasonable, since alcohol itself is 
a poison which is thrown out by the same organs whose proper func¬ 
tion it is to remove the debris of the tissues. These organs cannot 
perform more than a certain amount of labor. If most of their 
activity is expended in eliminating alcohol, of course they can perform 
less of their proper labor, and so the dead products of disorganization 
will be left to accumulate in the body and produce a deceptive increase 
of weight. It is by this means that the drunkard often acquires a 
bloated appearance. Every one knows that such an accumulation of 
tissue is not healthy flesh ; yet it is of the same character as that 
which leads some prejudiced scientists to pronounce in favor of alco¬ 
holic beverages as a preventive of waste. 

Surely, such science must be of the kind referred to by the apostle 
Paul when he spoke of “ science falsely so-called.” 

If it were any recommendation to alcohol that it diminishes the 
waste of the tissues, or is supposed to do so, this would be an equally 
good recommendation for the habitual use of nitric acid and mercury, 
which Dr. Fyfe of Edinburgh has shown to have the same effect. 

Again, as already observed elsewhere, Dr. E. Smith and others 
have proven that alcohol does not diminish the waste of the body, but 
rather increases it, as is shown by the increased amount of carbonic 
acid thrown off by the lungs, although the amount of urea eliminated 
by the kidneys may be less. This, of course, completely upsets the 
argument used by those who maintain that alcohol is a sort of nega¬ 
tive food. 

3. Alcohol Strengthens the Muscles.— The laborer, the traveler, 
and the soldier use alcohol under the delusion that it strengthens. 
When fatigued, the laborer takes a glass of grog and feels better, or 
thinks he does. He imagines himself stronger. His increased 
strength, however, is wholly a matter of the imagination. 


41)0 


STIMULANTS AND NARCOTICS. 


The use of alcohol makes a man feel stronger,—makes him believe 
that he can do more work, endure more fatigue and hardship, and 
withstand a greater degree of cold than he could do without it ; but 
when an actual trial is made, it soon becomes apparent that the ability 
is lacking. Feeling and doing are two wholly different things; and 
here is where alcohol is so deceptive. It is a narcotic, and paralyzes 
the nerves so that they lose their normal sensibility. The weary man 
takes a glass of brandy, and continues his toil,—not because he has 
been strengthened, not because his vital forces have been re-inforced, 
but because he no longer knows that he is tired. Weariness is an ap¬ 
peal for rest on the part of the tissues. They have become worn and 
broken by action, and they require time to repair themselves. Alco¬ 
hol has the same effect upon the nerves which control the building up 
of the body that chloroform has upon the nerves of general sensi¬ 
bility, and it allays the sense of weariness in the same way that chloro¬ 
form allays pain during a surgical operation,—by paralysis. A person 
whose hand has been rendered insensible to pain by intense cold may 
place his fingers in the fire without suffering at the time, but he is not 
thereby prevented from being burned, any more than though his sen¬ 
sibility was unimpaired; and the effects of the destructive action of 
heat will ultimately become painfully apparent. 

When a man has labored until his tissues are so broken down that 
they demand time for reconstruction, alcohol will so paralyze his sen¬ 
sibilities that he may continue laboring for a time, but he does so at a 
terrible cost; for he is all the time continuing the process of breaking 
down his tissues beyond the point at which nature warned him to de¬ 
sist. Not infrequently this reckless expenditure is continued so long 
that the life forces become so completely exhausted that the individual 
becomes a victim of delirium tremens, or perhaps dies from exhaustion. 

Numerous experiments have shown that alcohol decreases muscular 
strength. Says Dr. Brinton, “ The smallest quantity takes somewhat 
from the strength of the muscles.” Says Dr. Edmunds, of London, 
“ A stimulant is that which gets strength out of a man.” 

Said Prof. Willard Parker, M. D., of New York, “It has been 
proved that when taken into the system it diminishes the tempera¬ 
ture, lessens the strength, and by about forty per cent shortens human 
life.” 

4. Alcohol Warms the Body.— The sensation of warmth pro¬ 
duced by taking a glass of wine or brandy is delusive. The circula- 


ARGUMENTS CONSIDERED. 


491 


tion is unbalanced, and for a few moments there is a seeming increase 
of heat; but the thermometer shows that the temperature is lessened. 
Says Dr. Parkes, the eminent English sanitarian, “ All observers con¬ 
demn the use of spirits, and even of wine or beer, as a preventive 
against cold.’ The names of Dr. King, Dr. Kane, Captain Kennedy, 
and Dr. Hayes, may be cited as holding to this opinion. In the last 
expedition in search of Sir John Franklin, the whole crew were tee¬ 
totalers. 

Prof. Janeway, M. D., professor of materia medica in Bellevue Med¬ 
ical College, stated in a lecture before his class that alcohol does not 
assist those who use it to endure cold. In proof of the assertion, he re¬ 
lated the following incident, which was given to him by the first gen¬ 
tleman mentioned in the account:— 

A gentleman was appointed by the government to go on a survey 
in the Eastern States in the depth of a severe winter. He chose for his 
assistants men who were total abstainers. At the same time, another 
party set out upon the same business, the members of which were ad¬ 
dicted to the use of whisky. Only one of the first party gave out, 
while nearly every one of the whisky-drinkers succumbed to the influ¬ 
ence of cold. 

“ Plenty of food, and sound digestion, are the best sources of heat.” 
“ I am quite satisfied that spirituous liquors, though they give a tempo¬ 
rary stimulus, diminish the power of resisting cold.”— Sir John Rich¬ 
ardson. 

a When a continuance of exertion or endurance is called for, spirit 
does harm ; for you are colder or more fatigued a quarter of an hour 
after [taking] it than you would have been without it.”— Dr. Hooker , 
'physician of the Arctic expedition under Sir John Ross. 

Prof. Miller states that the Russian military authorities “ interdict 
its use absolutely in the army, when troops are about to move under 
extreme cold; part of the duty of the corporals being to smell carefully 
the breath of each man on the morning parade, and to turn back from 
the march those who have indulged in spirits, it having been found that 
such men are peculiarly subject to be frost-bitten and otherwise 
injured.” 

“ The Hudson Bay Company have for many years entirely excluded 
spirits from the fur countries to the north, over which they have exclu¬ 
sive control, ‘to the great improvement,’ as Sir John Richardson states, 

‘ of the health and morals of their Canadian servants, and of the Indian 
tribes.’ ”— Dr. Carpenter. 


492 


STIMULANTS AND NARCOTICS. 


5. Alcohol Protects against Excessive Heat.— The advocates 
of drinking, like the man in the fable, “ blow both hot and cold,” in 
their arguments. Thev love the beverage, and so it must be useful in 
some way. Dr. Parkes says on this point, “ Not only is heat less well 
borne, but insolation (sunstroke) is predisposed to.” “ The common no¬ 
tion that some form of alcoholic beverage is necessary in tropical cli¬ 
mates is, I firmly believe, a mischievous delusion.” His statements are 
supported by all the best authorities on tropical diseases, Dr. Carpenter 
and others. 

Said Prof. John Bell, M. D., an eminent medical author, “ They who 
drink nothing but water have been found to be more enduring of fatigue 
and great labor, and of hardships and exposures in every extreme of 
climate and season, than they who use alcoholic beverages. The com¬ 
parisons have been made in almost every conceivable manner (seldom, it 
is true, designedly), and with the result just announced. Men who have 
to carry on laborious occupations at a high temperature, as in iron- 
foundries, gas-works, sugar-houses, etc., find that the use of alcoholic 
liquors, while they are so employed, is decidedly prejudicial to them. 
Of twelve workmen—smiths in the dock-yard at Portsmouth, En¬ 
gland—who tried the experiment for a week, six drank nothing but 
waiter, the other six took the usual allowance of beer. After the first 
day, the water-drinkers complained less of fatigue than the others, and 
after each successive day the advantage was on the side of the abstain¬ 
ers, until the conclusion of the week, when the water-drinkers declared 
that they never felt so fresh in their lives as they had done during this 
period.” 

According to Sir James McGregor, quoted by Dr. Bell, the Anglo- 
Indian army was never so healthy as when in Upper Egypt, where no 
ardent spirits were supplied to the troops on account of the difficulties 
of transportation. The soldiers were often exercised in the sun, the heat 
of which was so great that the thermometer indicated 118° F. in the 
shade. 

It has been observed that among English soldiers in India those who 
are strict teetotalers endure long marches under exposure to a tropical 
sun much better than those addicted to the use of liquor. 

During the hot season in this country it has been found that by far 
the larger share of all the cases of sun-stroke which occur are of intem¬ 
perate persons. Total abstainers have little to fear from sun-stroke. 

6. Alcohol Stimulates. —So, then, do opium, strychnia, and prussic 
acid stimulate. What is a stimulant? “Stimulant” is only another 


AEGUMENTS CONSIDERED. 


4'Jo 

name for poison. Stimulation means poisoning. When alcohol, or any 
other one of a hundred poisons which might be mentioned, is taken into 
the body, every vital organ sets to work to get it out. The liver filters 
it out in the bile; the lungs pour out volumes of it in the form of a 
vapor, making a drunkard’s breath smell like a distillery; the skin 
pours it out as sweat; the kidneys do their part in expelling the vile 
drug; and all the time the heart pumps away with violence to hasten 
the departure of the intruder. This great commotion in the vital econ¬ 
omy is called “stimulation.” 

These are the first effects of alcohol, or the effects of small doses,—such 
effects as the moderate drinker feels. The later effects, and those which 
result from larger doses, are depressing. The excitement is followed 
by a corresponding degree of depression, or partial paralysis, since 
the drug supplies no force in return for that which it expends. Many 
of the ablest physicians pronounce alcohol a narcotic. 

If alcohol is a stimulant, that fact is one of the best arguments 
against its use. Says Sir B. Brodie, “ Stimulants do not create nerve 
power.” 

7. Alcoholic Drinks Protect the System against Disease.— 

One finds an excuse for the use of liquor in small or great quantities in 
the theory that it will fortify his system against the ravages of small¬ 
pox or cholera. Another takes liberal doses of brandy to “ keep off the 
chills.” Another keeps his system saturated with alcohol so that he will 
not take cold. Any one of these diseases, or almost any other, would be 
infinitely less harmful than alcohol itself, even if the opinion were true, 
that alcohol is a preventive; but alcohol is not a preventive of disease, 
according to the experience of the most reliable observers. Dr. Parkes, 
Sir John Hall, Inspector General of the English army, Dr. Carpenter, 
Dr. Mann, Henry Martin, and others of equal eminence, all concur in 
this opinion. 

Indeed, the most indubitable evidence can be cited to prove that al¬ 
cohol is directly the cause of a vast amount of disease, instead of being, 
as many suppose, a preventive. If alcohol were a preventive of disease, 
then those who use it ought to be the most healthful; but we find the 
contrary to be the case. The liquor-drinker, instead of living longer 
than the teetotaler, as he ought to do if this theory were true, lives, on 
an average, after reaching adult age, only one-fifth as long as the ab¬ 
stainer, as shown by life-insurance statistics. 

8, Alcohol Aids Digestion. —The moderate drinker takes his 
morning dram to fortify his stomach for the reception of his breakfast. 


494 


STIMULANTS AND NARCOTICS. 


Immediately after breakfast he must have another glass to assist di¬ 
gestion. But how does alcohol assist digestion ? Not by dissolving 
the food, for its effect is to harden tissues. It does not render the gas¬ 
tric juice more efficient, for it destroys it and causes its active element, 
pepsin, to be deposited as a white powder. In dogs to which alcohol 
was given with food, it was found that the process of digestion had 
not begun, twelve hours after eating. The stomach is obliged to re¬ 
move all the alcohol before digestion can begin. This, then, is a mon¬ 
strous fallacy. 

9. Alcohol Is Made from Grain.—“ But,” says one, “ alcohol is 
made from grain, and if it is so very bad, why should not the grain 
be injurious also ? There is a little poison in everything, any way.” 

Alcohol is made from grain, but it is not found in it. Smoke is 
made from wood, yet there is no smoke in wood; it is made by the 
destruction of the latter. Alcohol is made by the destruction of fruits 
and grains. 

It is an absurd popular notion that there is, necessarily, poison in 
everything. In these days of wholesale adulteration it is often diffi¬ 
cult to obtain food unmixed with poisonous products; but nature does 
not serve us so badly. Poison is not essential to life. 

10. Whisky Does not Hurt Me . —The opium smoker, the absin¬ 
the taker, the arsenic eater, all use the same argument, yet each falls 
a victim to his vice. You do not know what alcohol is c[oing for you. 
“Wine is a mocker [deceiver].” You cannot see its depredations. 
Your blunted sensibilities cannot feel its ravages. Your friends see 
its influence. Your wife notes it and mourns over it. You can your¬ 
self see it in others. Are your tissues different from those of every 
other man ? Are they made of iron that they cannot be destroyed ? Is 
the alcohol you drink different from all other alcohol ? No ; vour good 
sense tells you, No. Then reform before it is too late. 

11. Pure Liquor Is not Bad.—“If we only had such pure liquor 
as they used to make, it would not be so very bad,” says one. “ Only 
take a little of my wine; I made it myself, and it cannot hurt any 
one,” says the good housewife. 

These are two mischievous errors. Alcohol is the worst poison 
found in liquor. No drug added by adulteration is so bad as the fiery 
liquid itself. Pure liquor is simply pure poison. Alcohol is always 
the same, and its effects are always identical, whether it is found in 
the whisky barrel, or the cider barrel; in rum, brandy, lager-beer, 


AEG UMENTS CONSIDERED. 


40;* 


home-made wine, or “ temperance bitters.” Alcohol is the horrid fiend 
we are fighting, no matter under what guise it comes. 

12. Moderate Drinking not Harmful. —Every man, even the 
drunkard himself, admits that liquor in excess is injurious ; but a large 
and very respectable class claim that it is an evil only in excess, and 
is a harmless luxury, if nothing more, in moderate quantities. This, 
too, is an error which has proved fatal to thousands. A small dram 
soon grows to be a large one ; claret is exchanged for grog or toddy ; 
and so, by degrees, the moderate drinker becomes a drunkard, the first 
“ small drop ” engendering a love for succeeding larger doses. 

It is not necessary that a man should be dead drunk to be intoxi¬ 
cated. Intoxication is derived from a Latin word meaning poison, 
and means, literally, a condition of poisoning. Alcohol is a poison. 
If a man takes it into his system, he is poisoned, or intoxicated, in 
proportion to the amount taken. 

Moderate drinking produces a disease well known to physicians as 
chronic alcoholism. It is especially dangerous to the old, as it is one 
of the most powerful predisposing and exciting causes of apoplexy, as 
well as of numerous other diseases. 

13. Doctors Recommend Wine and Brandy. —It is a lamentable 
fact that a large class of physicians use alcohol in their practice in a 
most reckless manner. The result is seen in hundreds of drunken 
sots who haunt saloons and groggeries. That the free use of alcohol 
is wholly unnecessary has been already shown. 

Id. Scientific Men Recommend the Use of Alcohol. —This, too, 
is a deplorable fact; for it is a sad spectacle when science stoops to 
cater to the demands of morbid appetites and vices. It is a signifi¬ 
cant fact that those scientific authorities who recommend the use of 
alcohol are themselves addicted to its use. It is not an unjust infer¬ 
ence that their judgment, in this case, is biased by their appetite. 
But there are a great many of the most eminent scientists who are 
the strongest advocates of total abstinence. Among them are Dr. W. 
B. Carpenter, Dr. Parkes, Dr. Richardson, Dr. Parker, and Sir John 
Hall. 

“ If alcohol were unknown, half the sin and a large part of the 
poverty and unhappiness would disappear from the world. Dr. 
Parkes, Practical Hygiene, p. 242. 

“ There is, of course, no doubt that wine is unnecessary as an arti¬ 
cle of diet.”— lb., p. 241. 


496 


STIMULANTS AND NARCOTICS. 


A long list of names of eminent scientists and physicians might be 
presented against alcohol as a beverage, and a very respectable list 
against its common use as a medicine. There is no doubt that many 
popular medical works which have recommended alcohol as a remedy 
for almost every ill, have done much toward creating an incorrect 
popular opinion on this subject; and it is the duty of every intelligent 
physician, as well as all others who are informed on the subject, to do 
what he can to correct this pernicious error. 

15. All Nations Use Stimulants. —Some will argue from the fact 
that the use of liquor of some kind is almost universal, that the appe¬ 
tite for it is a natural one. Admitting that inheritance may have 
made it such, the argument is still worthless; for what nation is there 
among whom lying, stealing, and other crimes and vices do not also 
exist ? If intemperance is a universal evil, the fact should be most 
deeply deplored, instead of being made an excuse for perpetuating the 
vice. 

But intemperance is not universal. Until taught the use of alco¬ 
hol by white men, the North American Indians were wholly unac¬ 
quainted with the fiery beverage which they have appropriately named 
“ fire water.” And the introduction of liquor among these savages has 
done more toward their extermination than any other cause. Many 
other barbarous tribes are still in happy ignorance of this enticing 
poison. 

Again, the appetite for fermented drinks is not a natural one. 
Offer an infant brandy; it is repulsed at once, as it should be. No 
beast naturally loves alcohol, though there are several animals which, 
like man, may be taught to love liquor and demand it as imperiously 
as any old toper. The hog is an animal of this kind. The resem¬ 
blance of man to this animal, in this respect, is not flattering, at least. 

Dr. Floyer, a writer in the early portion of last century, relates 
the case of a brewer’s dog which learned to like beer and ale, and 
formed the habit of licking ale and yeast from the brewer’s trough. 
After a few years he began to suffer greatly from gout, his feet and 
limbs swelling prodigiously. The drunken dog finally died, as thou¬ 
sands of other drunkards have, of dropsy. 

Even though an artificial appetite has in some cases been created, 
this fact does not change the relation of alcohol to the system in the 
least. Alcohol is a poison still ; and the system will treat it as such, in 
spite of an inherited or an acquired appetite for it. 


ARGUMENTS CONSIDERED. 


497 


16. The Use and Sale of Alcoholic Liquors Is a Source of 
Great Revenue to the Government.— Says the liquor-dealer, “The 
manufacture and sale of alcoholic drinks gives employment to more 
than 500,000 men. It furnishes a market for more than 40,000,000 
bushels of grain each year, and pays to the government an annual tax 
of $60,000,000, or about two-fifths of the whole revenue of the country.” 

Such arguments are actually urged by the dram-sellers and their in¬ 
fatuated customers. What a damage to the government would be the 
loss of $60,000,000 of revenue ! and what a pity that 500,000 poor 
laborers should be thrown out of employment ! Ah, yes; and what a 
pity that 40,000,000 bushels of grain, equivalent to 600,000,000 four- 
pound loaves of bread, should be wasted—worse than wasted, manufact¬ 
ured into poison! The same liquor which brings to the government a 
revenue of $60,000,000 makes 800,000 paupers, who require for their 
maintenance $100,000,000. There is very little profit in this, surely. 
The cost of crime resulting from drink is still greater. The expense of 
caring for 30,000 idiots and lunatics must also be charged to alcohol. 
Where, then, are the profits ? We have said nothing of the loss result¬ 
ing from the unproductive labor of those employed by the liquor bus¬ 
iness, or from idleness, disease, and death occasioned by drink, which ag¬ 
gregate an enormous sum. 

17. The Moderate Use of Wine is Necessary to Maintain 
Nervous Activity in Old Age. —Many, even of those who profess to be 
instructors of the people in the laws of health, advocate the use of wine 
in old age, on the ground that age renders the system somewhat slug¬ 
gish in its activities, and hence a little stimulus is needed to maintain its 
functions, and especially nervous activity. 

A consideration of this argument will show that the use of alcohol is 
not only unnecessary in old age, but absolutely hazardous. Why are 
the bodily functions less active in old age than in youth? Why is the 
mind less brilliant? Because the organs of the body have become worn 
and disabled by long usage and imperfect repair. The tissues are not 
kept intact by assimilation. The reason why they are less active, then, 
is that they are less qualified to act. They are incapable of that vigor¬ 
ous action which they sustained in youth and middle age. 

This decreased activity is an admirable provision of nature for the 
prolongation of life to the utmost limit. The waste of tissue depends 
upon its activity ; the more action, the more waste and wear, the sooner 

32 


498 


STIMULANTS AND NARCOTICS. 


worn out. Using alcohol produces an increased activity, but does not 
increase the capability of the system to sustain action. In other words, 
it tears down tissue, but does not build it up. It interferes with the re¬ 
pair of tissues. The increased vigor seemingly imparted by alcohol, 
therefore, is dangerous, rather than desirable. If alcohol enables a man 
to live faster, it shortens his existence by so doing. 

Again, alcohol, even in moderate quantities, produces a peculiar de¬ 
generation of the walls of the blood-vessels, by which they become 
weakened, the muscular tissue composing the small vessels being re¬ 
placed by particles of fat or carbonate of lime. This kind of degenera¬ 
tion is also a frequent incident of old age, even in those who are not 
spirit-drinkers, and is especially liable to occur in the small arteries of 
the brain. The use of alcohol not only facilitates this morbid process, 
but adds to the danger which is always present with it under the most 
favorable circumstances. When the arteries are thus weakened, a little 
extra supply of blood in the brain, a “ rush of blood to the head,” will 
often occasion rupture of some one of them, and apoplexy, with paralysis 
or immediate death, is the result. Alcohol, even in very small quantity, 
produces congestion of the brain, and thus renders an aged person doubly 
liable to death from apoplexy. 

Are we not j ustified. then, in the position that alcohol is not only less 
desii'able for the old than for the young, but is far more dangerous ? 

18. Alcohol Drives away Dull Care.— It will not be disputed 
that alcohol will dissipate cares, and pains, and sorrows. It makes a 
poor, homeless, friendless, poverty-stricken wretch feel as rich as a king. 
It makes the doomed murderer forget that he is soon to swinsr into 
eternity from the gallows. It makes the fallen outcast from society 
forget her shame. In short, it makes the user momentarily oblivious to 
all that is unpleasant in life. 

But the release thus obtained is only for a moment, and it is inevi¬ 
tably succeeded by a return of the same old burden, rendered more gall¬ 
ing and onerous by the stings of conscience and the goadings of remorse. 

When a man’s brain is so benumbed that he does not know his real 
condition, and loses sight of the realities of life, he is likewise incapable 
of appreciating any of those higher experiences and sentiments which 
constitute the highest enjoyments, the true realities of life. Only gross 
and sensual pleasures can be experienced when the mind is befogged by 
alcohol. 


A EG U ME NTS CONSIDERED. 


499 

19. Alcohol Increases Mental Power.— Thousands of editors, 
lawyers, students, authors, and even clergymen, keep beside their mid¬ 
night lamps a bottle of wine or brandy, and consider one as indispensa¬ 
ble as the other. They imagine that with the frequent drams they 
quaff from that green bottle, they imbibe an increase of mental vigor. 
Thousands of lecturers, orators, and ministers, sip a glass of sparkling 
poison just before they step upon the platform. The first imagines that 
alcohol is necessary to enliven his energies and sharpen his memory. 
The second relies upon alcohol to burnish his eloquence. The third de¬ 
pends upon the poisonous beverage to quicken his pious zeal, intensify 
his fervor, and lend him inspiration for the duties of his office. 

We might justly dwell upon the absurdity of such practices, and 
well question the efficiency of a gospel shrouded with the fumes of al¬ 
cohol ; but we will only quote the words of Dr. James Edmunds, of 
London, Eng. He says, in speaking of the narcotic influence of 
alcohol:— 

“ That is the effect when a minister, who cannot preach without a 
glass of wine, has a glass in him. He finds his tongue will run on a 
little faster than his brains would be able to drive it if he had not got 
the alcohol in him. I submit to you broadly that if you take a man 
with a single glass of wine or spirits in him—if you test that man’s 
mental accuracy and real debating power, you will find that the man 
who has spirit in him won’t do it as well as the man who does not use 
it.” 

20. Alcohol Is a Good Medicine; and if it Will Make a Man 
Well when Sick, Will it not Keep him Well ?■—Alcohol is not a 
good medicine, as elsewhere shown. It is a poison, always, under all 
circumstances. But if it were a medicine, this would certainly be reason 
enough for discarding it; for a medicine is supposed to be a substance 
peculiarly adapted to meet the demands of the system when in a state 
of disease. Almost any one of those substances popularly known as 
medicines will make a man sick if used habitually. 

Dr. Gully pertinently remarks, “ Healthy men, and men with 
chronic disease, do not require medicinal means every day after dinner. 
Yet there are men silly enough not only to take a nauseous pill of drugs 
before dinner, but this more pleasant but equally deleterious draught of 
physic [wine] after dinner. Strange infatuation! 

21. The Bible Sanctions the Use of Wine. —At the present time 
there is a powerful party who claim that the use of fermented, or in- 


500 


STIMULANTS AND NARCOTICS. 


toxicating liquors is permitted and even sanctioned by the Bible. 
This party is headed by a few eminent scholars and clergymen, who 
are chiefly supported by a promiscuous throng of rich rumsellers, re¬ 
spectable moderate drinkers, and gutter drunkards. 

The Bible has been quoted to sustain polygamy, slavery, and other 
evil institutions, as well as intemperance. Rightly understood, it sup¬ 
ports none of these evils. 

If it can be proven that the Bible favors the use of intoxicating 
drinks in any degree, then there is placed in the hands of the infidel a 
most powerful weapon with which to attack the authenticity and sa¬ 
credness of the Scriptures. If, on the other hand, it can be shown that 
there is no such conflict between science and common sense, and in¬ 
spiration, then the difficulty vanishes. A careful examination of the 
subject will convince any candid man that the support which the ad¬ 
vocates of the use of liquor claim to derive from the Bible is wholly 
imaginary; and that the use which is made of the Scriptures in de¬ 
fense of intemperance is a most flagrant perversion of the language 
and import of inspiration. 

Inspiration, true science, and sound common sense always agree. 
Any apparent conflict arises either from a misunderstanding of the 
meaning of the language employed, or from an imperfect knowledge 
of the scientific facts supposed to necessitate a disagreement. Science 
says, distinctly and unequivocally, All fermented drinks contain alco¬ 
hol ; alcohol is a poison under all circumstances and in all doses. 
The decision of science is sustained by that of reason; for common 
sense teaches that a substance with properties like those possessed by 
alcohol can be nothing else than poisonous. If it is true that the 
Bible teaches that alcohol—in the form of wine, or otherwise—is good 
and harmless, then it will be made to appear that inspiration is less 
wise than reason and science; that man, the creature, has outstripped 
the Creator in knowledge. 

Such a conclusion, though correctly drawn from the premises, is too 
absurd for belief by one who has a modicum of faith in inspiration, 
and its manifest falsity would seem to be sufficient to fully expose the 
weakness of those who would make the Bible responsible for intem¬ 
perance. The utter worthlessness of all arguments in favor of the use 
of alcoholic drinks, founded on the Bible, becomes still more apparent 
by a careful examination of the character of the wines mentioned in 
the Scriptures, and a consideration in detail of the texts which are 
claimed to be favorable to the use of alcoholic liquors. 


SC RIP TUB A L DISTINCTIONS. 


501 


Two Kinds of Wine Recognized in the Bible. —It is undoubt¬ 
edly true that intoxicating liquors are mentioned in the Bible; and it 
is equally true that a kind of liquor or wine is recognized and often 
mentioned which is not intoxicating. Ancient historians preserve the 
same distinction, making frequent reference to intoxicating wine and 
its effects, and also to unintoxicating wine and its wholesome proper¬ 
ties. 

Unintoxicating Wine .—The intoxicating property of wine is due 
to the alcohol which it contains. Wine which contains no alcohol is 
unintoxicating. Alcohol is produced only by fermentation. Wine 
■which has not undergone fermentation, then, is unintoxicating, since 
it contains no alcohol. All that is required to preserve wine free 
from alcohol, and thus from intoxicating properties, is to prevent fer¬ 
mentation. That the ancients were acquainted with several modes of 
preventing fermentation, is clearly shown by reference to history. 

Intoxicating Wine .—As already stated, the intoxicating element 
of wine is alcohol, which is produced by the decomposition of sugar in 
the process of fermentation. Alcohol can be made from any juice 
which contains sugar. The ancients made intoxicating drinks from 

o o 

millet, dates, beans, palm juice, pears, figs, pomegranates, and other 
fruits, besides the grape. These liquors were known to the Jews, and 
are frequently referred to in the Scriptures. In Prov. 23 : 31, we have 
a striking reference to the fermentation of wine, as follows, according 
to Dr. Kitto’s translation : “ Look not thou upon the wine when it is 
turbid, when it giveth its bubble in the cup, when it moveth itself up¬ 
right.” 

Scriptural Distinctions of Wines. —In the English version of 
the Scriptures, the distinctions made in the original are often obscured 
or wholly lost. This is especially true in the present instance. In 
the Hebrew, the language in which the Old Testament was written, 
different kinds of wine are indicated by different words, which are all 
rendered in the English translation by the one word wine. The prin¬ 
cipal words thus employed are f-, yayin, “W, shekar, and c/n '^, tirosh. 

Yayin, according to Biblical critics, refers to the juice of the grape 
in any form. It might be sweet or sour, fermented or unfermented. 
Shekar, or shechar, was the term applied to any sweet juice derived 
from any other source besides the grape. It is sometimes translated 
honey. It usually refers to the juice of the palm-tree or of its fruit, 
the date ; and, like yayin, it included the fermented as well as the un¬ 
fermented condition of the juice. 


502 


STIMULANTS AND NARCOTICS. 


Tirosh was applied to the ripe fruit of the vine, and to the fresh 
juice of the grape before fermentation had begun. It is often trans¬ 
lated “ new wine.” 

In brief, then, yayin means fermented or unfermented wine or 
juice of grapes; shekar means fermented or unfermented wine or juice 
of the palm-tree, of dates or other sweet fruit. Tirosh means the 
sweet, unfermented juice of the grape, or new wine. 

The Hebrews used the term yayin for wine made from grapes, in 
any of its stages, just as we apply the term cider to the fresh juice of 
the apple, or to the same juice after it has fermented or become 
“hard” by age. The Greek oivoc, oinos, corresponds exactly with the 
Hebrew yayin. 

The foregoing is certainly sufficient to show, beyond all chance for 
reasonable doubt, that there are two kinds of wine recognized in the 
Bible, one of which was sweet, unfermented, and unintoxicating, and 
the other fermented and intoxicating. The same term is often used 
for both kinds. If, then, we find the Bible in some instances speaking 
of wine in terms of commendation, and in others condemning it in the 
most forcible manner, would it not be most reasonable to suppose that 
in those cases in which wine is commended, the unfermented kind is 
referred to ? and in those in which it is condemned, that which has un¬ 
dergone fermentation is meant ? Any one who has confidence in the 
inspired character of the Scriptures will have no hesitancy in answer¬ 
ing in the affirmative. 

The Causes of Intemperance. —We have not space to devote to 
the subject sufficient to allow us to point out more than a few of the 
more powerful influences which in our opinion lead to the encourage¬ 
ment and perpetuation of one of the most potent evils of the age. 

The most confirmed and irreclaimable drunkards are those who 
have inherited the appetite from ancestors who drank. There are many 
such. They are really less responsible for their condition than are those 
whose vices have entailed it upon them. Many instances are known 
in which the tendency to drink extended to the fifth generation from 
a drinking ancestor. 

Probably this is the most active cause of the great and unabating 
increase of intemperance. Drunkard’s sons become drunkards through 
inheritance, and transmit the propensity to their children, stamping it 
still more deeply upon their depraved organizations. 

The use of alcohol in cookery has clone not a little to cultivate a love 


TEA AND COFFEE ENCOURAGE DRUNKENNESS. 


503 


for the burning beverage. Wine and brandy sauces, and other prepara¬ 
tions containing alcohol, early excite and form a love for alcoholic drink 
in children whose natural tastes would discard it at once. It is not at 
all uncommon to find alcohol taken in this form, even by people who 
consider themselves strict teetotalers. 

Still another charge of far more universal application must be laid 
at the door of the cook, though the ignorance of the latter may cancel 
part of the responsibility. We refer to the general and excessive use of 
stimulating and irritating condiments in the preparation of food. Pep¬ 
per, spices, and large quantities of salt and most other condiments, have 
an unmistakable influence in creating and exciting a love for stimulat¬ 
ing foods and drinks, and thus ultimately lead toward intemperance. 

The moderate use of liquor is the stepping-stone to greater excesses. 
All drunkards are at first moderate drinkers. Were there no moderate 
drinkers, there would soon be no drunkards. No man sets out in the 
drunkard’s career with the expectation and determination of becoming 
an inebriate. It may be justly said that moderate drinkers are fresh 
recruits for the ranks of intemperance. 

Tea and Coffee Encourage Drunkenness.— This statement will 
doubtless startle those who have been taught to believe that there is no 
evil in “ the cup that cheers and not inebriates; ” but we are prepared 
to show that the influence of the use of these poisons (for such they are) 
directly tends to encourage drinking stronger stimulants, though our 
present space will not allow us to enter into a discussion of the subject. 

Tobacco-using and drunkenness go hand in hand. Nearly, if not 
quite, every drunkard chews or smokes. The great majority of drunk¬ 
ards became addicted to the use of tobacco first. Thus they learned to 
demand a stimulus of some kind. The feverish heat produced by tobacco 
required quenching, and liquor was resorted to. The white man gave 
the Indian rum, and the latter gave him tobacco in return. The ex¬ 
change was a bad bargain for both. Either is bad enough alone ; but 
rum and tobacco together are blasting the human race like a simoon 
from the heart of hell. 

Thousands of men, and women too, have acquired an appetite for 
alcohol through a doctor’s prescription. An unwise physician gave ale, 
beer, wine, or brandy, as a “ tonic,” “ to improve digestion,” “ to 
strengthen the system,” “ to counteract debility,” or for some similar 
reason. The patient thus acquired a love for the stimulation of alcohol, 
and soon came to regard it a necessity, and took the duty of prescribing 


504 


STIMULANTS AND NARCOTICS. 


into his own hands. In a few years he became a drunken sot, and died 
a drunkard’s death. 

Ambition to excel on some particular occasion, or a desire to compel 
nature to forego rest beyond reasonable limits, has led many to take 
“ an occasional drop,” to their final ruin. The “ fine exhilaration,” the 
“ lively play of the imagination,” which accompanies slight stimulation, 
has led captive thousands of poets, authors, orators, statesmen, and even 
clergymen. Poverty, trouble, grief, disappointment, bad example, and 
other minor causes too numerous to mention, have their influence in the 
production of the omnipresent vice, intemperance. 

The Cure of Intemperance. —The only cure for a drunkard is 
total abstinence. A person who has once been greatly addicted to the 
use of alcohol cannot use it in moderation. A person who is suffering 
from an}? of the functional diseases induced by alcohol must relinquish 
all stimulants if he would recover. Substitutes in the shape of tobacco, 
strong tea and coffee, even of soda-water, are dangerous. Tobacco produces 
a desire for liquor in one who has been accustomed to drink. Tea and 
coffee have similar effects, though in much less degree. The drinking of 
large quantities of fluid of any sort is injurious, as it produces a relaxed 
state of the stomach which causes a craving for stimulus. The “ cin¬ 
chona cure ” of the appetite for liquor is worthless. The only plan which 
affords a way of escape from the haunting clamors of appetite in a per¬ 
son trying to reform is that proposed by Mr. Napier, who a few years 
ago read before a learned society in England a paper giving an account 
of the cure of a large number of cases of drunkenness by the adoption 
of a vegetarian diet. The great chemist, Prof. Liebig, observed, more 
than twenty years ago, that people who used only vegetable food did not 
take wine. Becoming acquainted with this fact, Mr. Napier made a 
practical application of it, with the result already stated. The following 
is a brief report of a few of his cases:— 

“ An analytical chemist, aged thirty-two, who was given to intem¬ 
perance, on having his attention called to Liebig’s statement, was in¬ 
duced to adopt a vegetarian diet, and before six weeks he was a total 
abstainer. A lady of independent means, a clergyman, a girl of nine¬ 
teen, a man and his wife and sister (all over forty years of age), a bed¬ 
ridden gentleman (cured in thirty-six days), a captain in the merchant 
service, a half-pay officer, a clergyman and his wife, were all cured bv 
a diet mainly farinaceous [vegetable]. Two sisters, members of a family 
noted for intemperance, were cured in about a year. A clerk who had 


THE CURE OF INTEMPERANCE. 


505 

lost several situations because of intemperance was cured by vegeta¬ 
rianism and taken back at an increased salary. A governess aged forty, 
two military pensioners, a man of sixty, and three old sailors, were per¬ 
manently cured in a few months.” 

Beans, peas, rice, and highly glutinous bread (graham bread), were 
observed to be of special value as articles of diet. ‘This testimony is a 
powerful one in support of the position that the use of animal food is in 
some degree favorable to intemperance, and may perhaps be a remote 
cause of that vice in many cases. Both before and since seeing the re¬ 
port of Mr. Napier’s experiments, personal observation has convinced us 
that the appetite for liquor is much less in a person addicted to its use 
while subsisting upon a vegetable diet than when using meat freely. 
We have also observed that those accustomed to use both alcohol and 
tobacco are rarely able to abandon one without the other. We might 
relate numerous cases which have occurred in our own practice in which 
we have succeeded in reforming inebriates when all other means had 
failed by enforcing a farinaceous or vegetable diet. There can be no 
doubt but that the effect of stimulating food of all kinds is in the high¬ 
est degree conducive to a love for stimulating drinks and for tobacco 
and other narcotics. 


i 


50 G 


STIMULANTS AND NARCOTICS. 


TOBACCO AND TOBACCO-USING. 


Origin of the Habit.— 

Four centuries ago, tobacco 
was unknown in civilized 
lands, its use being confined 
to the few savages who in¬ 
habited the then undiscovered 
American continent. 

In the month of Novem¬ 
ber, 1492, when Columbus 
discovered the island of Cu¬ 
ba, he sent two sailors to ex¬ 
plore it, who reported, when 
they returned, among many 
other strange and curious dis¬ 
coveries, that the natives 
carried with them lighted 
fire-brands, and puffed smoke 
from their mouths and noses, 
which they supposed to be 
the way the savages had of perfuming themselves. They afterward 
declared that they “ saw the naked savages twist large leaves together, 
and smoke like devils.” 

To civilized human beings this was the first sight Gf the vile habit 
which has become so common that every city, town, and village is 
actually perfumed, or more properly fouled, with the vile stench of 
the poisonous weed. The impression made upon the unsophisticated 
Europeans was evidently not greatly in favor of the custom, since 
they compared the smoking Indians to devils. 

Tobacco-using, together with the implements of its use and all the 
different modes of taking it, originated wholly with the heathen bar¬ 
barians who roamed like wild beasts over the plains and through the 
dense forests of this continent four centuries ago. Civilized men 
have made no improvements or discoveries of any account in connec¬ 
tion with its use ; they have simply followed the example of those 












THE ORIGIN OF THE HABIT. 


507 


naked savages whom the discoverers of America saw chewiner, snuff- 
ing, and smoking “like devils” almost four hundred years ago. It is 
evident, then, that tobacco-using is a barbarous custom in the fullest 
sense. As to how savages learned the use of the weed, history does 
not give us any hint; but the fact that pipes and snuff-taking tubes 
are found in their most ancient burial mounds, which are often sur¬ 
mounted by huge trees that must have required many centuries for 
their growth, is evidence of its great antiquity. 

Originating with the wild barbarians of America, the smoking 
habit was after some years introduced into Europe, and receiving the 
sanction of physicians who just at that time chiefly occupied them¬ 
selves in searching for some new nauseous compound with which to 
experiment upon the lives of their patients, it was rapidly adopted. 

It must not be supposed, however, that the world was conquered 
by this most pernicious and tyrannical of vices without a struggle. 
The good, the wise, and the prudent, everywhere opposed. In most 
instances, kings and others in authority placed every obstacle in the 
way of its introduction and propagation, and even imposed severe 
penalties upon those who used the weed. 

In Russia, the use of tobacco was prohibited under the penalty of 
the bastinado (a severe whipping) for the first offense, cutting off the 
nose for the second, and loss of life for the third. History gives ac¬ 
count of several persons who were subjected to punishment for a 
second offense, their noses being amputated in public. 

Pope Innocent XII. issued a bull of excommunication against all 
who used tobacco in any form in church. Many years afterward, 
however, the bull was revoked by Pope Benedict, who was himself an 
immoderate user of tobacco. 

In Persia, the laws against tobacco-using were so stringent that the 
devotees of the weed were obliged to flee to the mountains, where 
they preferred to wander in exile among the rocks and caves with 
liberty to use their fascinating drug, rather than dwell in the peace 
and purity of home without it. In Switzerland, all users of the weed 
were punished as criminals. Punishment was inflicted upon a man in 
that country for smoking, so late as in the last century. 

The opposition to the use of tobacco was not confined to the Old 
World. The governors of the American colonies followed the example 
of King James I. of England, in many instances, issuing edicts against 
its use, and placing every obstacle in the way of its introduction. 


508 


STIMULANTS AND NARCOTICS. 


The old “ blue laws ” of Connecticut and of several other States con¬ 
tained restrictions of its use of a most strenuous character. In the 
city of Boston a law against smoking still exists; and less than a 
dozen years ago a workman was arrested on the public streets for the 
offense, and was fined in accordance with the law. 

By degrees, the rulers who opposed the introduction and use of to¬ 
bacco themselves became devotees of the weed, so that their opposi¬ 
tion was withdrawn. Being thus without restraint, the evil habit 
rapidly spread throughout all civilized lands, enslaving alike all classes 
of people, from the ignorant peasant to the king upon the throne. 

The history of tobacco-using furnishes a most striking illustration 
of the readiness of human nature to seize upon anything which 
promises gratification to the senses, no matter how disgusting, how 
pernicious, or how fatal in its ultimate consequences. The history of 
the world affords no other example of a vice which spread so rapidly 
and fastened itself so securely upon its victims. 

The Nature of Tobacco. —Chemists, botanists, and physicians 
unite in pronouncing tobacco one of the most deadly poisons 
known. No other poison, with the exception of prussic acid, will 
cause death so quickly, only three or four minutes being required for a 
fatal dose to produce its full effect. It belongs to a class of plants 
known as the volanacece, which includes the most poisonous of all 
species of plants, among which are henbane and belladonna. There 
are more than forty distinct varieties of the plant, all of which pos¬ 
sess the same general properties, though varying in the degree of 
poisonous character. 

The active principle of tobacco, that is, that to which its narcotic 
and poisonous properties are due, is nicotine, a heavy, oily substance 
which may be separated from the dried leaf of the plant by distilla¬ 
tion or infusion. The proportion of nicotine varies from two to eight 
per cent, Kentucky and Virginia tobacco usually containing six or 
seven per cent. A pound of tobacco contains, on an average, three 
hundred and eighty grains of this deadly poison, of which one-tenth 
of a grain will kill a dog in three minutes. A case is on record in 
which a man was killed in thirty seconds by this poison. 

The poison contained in a single pound of tobacco is sufficient to 
kill three hundred men if taken in such a way as to secure its full 
effect. A single cigar contains poison enough to extinguish two hu¬ 
man lives if taken at once. 


POISONOUS NATURE OF TOBACCO. 


509 


The essential oil has been used for homicidal purposes. Nearly 
thirty years ago it was employed by the Count Bocarmd to murder 
his brother-in-law for the purpose of securing his property. 

The Hottentots use the oil of tobacco to kill snakes, a single 
minute drop causing death as quickly as a lightning stroke. It is 
much used by gardeners and keepers of green-houses to destroy grubs 
and noxious insects. 

A number of instances are recorded in which instant death has 
been produced by applying a little of the oil from the stem or bowl 
of an old pipe to a sore upon the head or face of a small child. 

The poison of tobacco is so potent and violent in its action that 
even the external application of the moist leaves to the skin is suffi¬ 
cient to produce most serious symptoms. If a cigar be unrolled and 
the leaves composing it be applied over the stomach, great nausea will 
be produced in a very short time. This method has been used to in¬ 
duce vomiting. Cowardly soldiers have been known to place tobacco 
leaves under their arms just before a battle, for the purpose of pro¬ 
ducing sickness. 

Some years ago a man was detected in attempting to smuggle a 
quantity of tobacco by placing the leaves next to his skin. The 
nearly fatal symptoms which followed led to the discovery of the 
smuggler. 

If tobacco is poisonous when applied to the skin, it is doubly so 
when inhaled. The smoke of tobacco contains, in addition to nicotine, 
several other poisons, the chief of which are 'pyridine, picoline, sul- 
phureted hydrogen, carbon di-oxide, carbonous oxide, and prussic 
acid, all of which are fatal poisons when received into the system in 
any other than the most minute quantities. Thus, it is not to nico¬ 
tine alone that the evil effects of smoking are due, but to all of these 
poisons combined. 

Birds, frogs, and other small animals, die when exposed to the 
fumes of tobacco in a confined space. 

Inhalation is the most speedy way of getting any volatile poison 
into the system. The reason of this is obvious when the fact is made 
known that the lungs present a mucous surface fourteen hundred 
square feet in extent, every inch of which is in the highest degree ca¬ 
pable of absorbing gaseous substances brought in contact with it. 
This membrane is of the most marvelously delicate character, being of 
such exceeding thinness that it forms scarcely any obstacle to the pas¬ 
sage of gases which enter the lungs by respiration. Just underneath 


510 


STIMULANTS AND NARCOTICS. 


this delicate membrane passes all the blood in the body, or an amount 
equivalent to the whole volume of the blood, once every three minutes. 
The vapory poison inhaled by the tobacco-smoker is not simply taken 
into the mouth and then expelled, but it penetrates to the remotest 
air-cells, and spreads itself out over the whole of the immense extent 
of membrane stated. Thus it is plain that the blood of the smoker is 
literally bathed in the narcotic fumes drawn from his pipe or cigar. 

So readily does the system receive the poison of tobacco in this 
way, that it has been repeatedly observed as a fact that persons who 
are engaged in the manufacture of cigars often suffer much from the 
characteristic effects of nicotine poisoning. 

When tobacco is applied to the mucous membrane, as in chewing 
and snuff-taking, its poisonous elements are absorbed in essentially 
the same manner as when applied to the skin, but much more rapidly. 
In chewing, considerable quantities are also absorbed through the 
stomach, being swallowed with the saliva. 

Poisonous Effects of Tobacco. —Very few users of the weed need 
to have a description of the effects of a moderate degree of poisoning 
with tobacco. The giddiness, nausea, and deathly sickness which fol¬ 
low the first attempt to use the poisonous drug are indubitable evi¬ 
dence of the poisonous character of tobacco, which evidence is con¬ 
firmed by the difficulty—in many cases very great—experienced in 
becoming accustomed to its use. In severe cases of poisoning, violent 
vomiting and purging, vertigo, deathly pallor, dilatation of the pupil, 
a staggering gait, disturbed action of the heart, interference with res¬ 
piration, and in extreme cases insensibility and syncope, are commonly 
observed. Only a very small quantity is necessary to produce these 
sjnnptoms in a person not accustomed to the use of the drug; but in 
persons who have accustomed their systems to the poison, a much 
larger amount is required. 

Dr. Richardson, who has recently given the effects of tobacco upon 
the human system a very thorough investigation, thus describes the 
condition of a person learning to smoke :— 

“ From analogy derived from the lower animals, which must be very 
perfect, the conditions of the vital organs are as follows:— 

“ The brain is pale and empty of blood, the stomach is reddened in 
round spots, so raised and pile-like, that they resemble patches of dark 
Utrecht velvet; the blood is preternaturally fluid ; the lungs are pale 
as the lungs of a calf, when we see them suspended in the shambles; 



EFFECTS OF TOBACCO ON THE BLOOD. 


511 


while the heart, overburdened with blood, and having little power left 
for its forcing action, is scarcely contracting, but is feebly trembling* 
as if, like a conscious thing, it knew its own responsibility and its 
own weakness. It is not a beating, it is a fluttering heart; its mech¬ 
anism is perfect, but each fibre of it to its minutest part is impreg¬ 
nated with a substance which holds it in bondage and will not let it 
go. 

Why all Smokers do not Die of Tobacco-Poisoning.—It is 

often objected that while chemistry and scientific experiments seem to 
prove that tobacco is a powerful poison, the experience of thousands 
of persons disproves the theory of its poisonous character, since if it 
were so intense a poison as described, cases of death from tobacco- 
poisoning would be much more frequent. 

To this objection we answer,— 

1. One reason why so few persons are reputed to die of nicotine 
or tobacco poisoning, is the wondei’ful faculty the system possesses of 
accommodating itself to circumstances. Through this means the worst 
poisons may by degrees be tolerated, until enormous doses can be taken 
without immediately fatal effects. Corrosive sublimate, strychnia, 
belladonna, and many other poisons, may be thus tolerated. 

2. In our opinion, the majority of tobacco-users do die of tobacco¬ 
poisoning. Death as surely results, ultimately, from chronic as from 
acute poisoning, though the full effects are delayed, it may be, for 
years. A man who dies five or ten years sooner than he should, in 
consequence of tobacco-using, is killed by the poison just as truly as 
though he died instantly from an overdose. 

Effects of Tobacco on the Blood. —The blood is the life-giving 
stream which carries to each of the tissues and organs of the body the 
material out of which it is to be built and repaired. In it are found 
the various elements which are received into the system through the 
stomach, the lungs, and the skin, the three great inlets to the body. 
If poisons are taken into the system, it is through the blood that they 
do their devastating work. Anything which affects the blood must 
affect every organ and tissue of the body. When taken in any form, 
tobacco very readily finds its way into the blood, and, according to Dr. 
B. W. Richardson, it produces in the vital fluid very serious changes. 
He describes these changes in the following graphic words:— 

“ On the blood the prolonged inhalation of tobacco produces 
changes which are very marked in character. The fluid is thinner 


512 


STIMULANTS AND NARCOTICS. 


than is natural, and in extreme cases paler. In some instances the 
deficient color of the blood is communicated to the body altogether, 
rendering the external surface yellowish white and puffy. The blood, 
being thin, also exudes too freely, and a cut surface bleeds for a 
long time, and may continue to bleed inconveniently, even in opposi¬ 
tion to remedies. But the most important influence is exerted over 
those little bodies which float in myriads in the blood and are known 
as the red corpuscles. These bodies have naturally a double concave 
surface, and at their edges a perfectly smooth outline. The absorp¬ 
tion of fumes of tobacco necessarily leads to rapid changes in them; 
they lose their round shape, becoming oval and irregular; and instead 
of having a mutual attraction for each other and running together, 
a good sign of physical health, they lie loosely scattered before the 
eye, and indicate to the learned observer, as clearly as though they 
spoke to him and said the words, that the man from whom they were 
taken is physically depressed and deplorably deficient both in muscu¬ 
lar and mental power.” For a representation of the effects of tobacco 
on the blood, see Plate XIV. 

Tobacco not only deteriorates the blood, poisons it, and greatly im¬ 
pairs the blood corpuscles, but also disturbs the circulation through its 
influence upon the nervous system. 

Having seen the effects of this poison upon the blood, it may be 
readily understood that it cannot but be a cause of disease. 

Tobacco Predisposes to Disease. —By its deteriorating influence 
upon the system, tobacco lessens the vital resistance of the body to 
other causes of disease, and so produces a predisposition to nearly all 
classes of maladies. As bearing upon this point we may quote the fol¬ 
lowing from eminent authorities:— 

“ Look at the pale face, imperfect development, and deficient mus¬ 
cular power of the inhabitants of unhealthy, malarious districts. 
They live on, but with only half the proper attributes of life. So it 
is with the habitual smoker.”— Mr. Solly, F. E. S. 

“ I do not hesitate to say that if a community of both sexes, whose 
progenitors were finely formed and powerful, were to be trained to 
the early practice of smoking, and if marriage were confined to the 
smokers, an apparently new, and a physically inferior, race of men and 
women would be bred up.” 

“ The effects of this agent, often severe even in those who have at¬ 
tained to manhood, are especially injurious to the young who are still 


EFFECTS OF TOBACCO. 


513 


in the stage of adolescence. In these the habit of smoking causes im¬ 
pairment of growth, premature manhood, and physical prostration.” * 

A British officer in India stated that of eleven officers sent out on 
an expedition, only two escaped in good health, and they were non- 
smokers. 

In speaking against tobacco, Dr. Edward Smith, an eminent En¬ 
glish author and sanitarian, remarked, “ The whole tendency of its ac¬ 
tion is toward disease, and it is impossible to say how much of good 
it has prevented.” 

Smokers’ Sore Throat. —The redness and dryness of the mucous 
lining of the mouth and throat so common with smokers, is the result 
of the direct irritation of the hot fumes of the poisonous weed which 
are drawn in through the pipe or cigar. This cause of chronic disease 
of the throat is so very common that “ smokers’ sore throat ” has come 
to be recognized as a distinct malady. Some smokers pretend to 
smoke for the cure of throat difficulties; but the excuse is a mere pre¬ 
tense in most cases. Tobacco never cures sore throat. It may tem¬ 
porarily relieve local irritation, but can do no more, and always in¬ 
creases the disease. 

Tobacco and Consumption,— The relation of impure air to dis¬ 
ease of the lungs is everywhere recognized. It has been very clearly 
demonstrated that breathing impure air is the great cause of consump¬ 
tion, on account of the effect of poisonous elements upon the blood 
and upon the lungs. Even the impurities gathered from the blood it¬ 
self exist in such cpiantities in air which has been once breathed as to 
render it unsafe to breathe again. This being the case, it will be read¬ 
ily seen that filling the lungs with nicotinized smoke and the hot fumes 
of tobacco from a pipe or cigar for several hours a day, cannot but be 
a most certain cause of lung disease. Moreover, experience shows this 
to be the case. Dr. C. R. Drysdale, the chief physician to the Metro¬ 
politan Free Hospital of London, declared, in an article in Public 
Health, that “ smoking in youth is no uncommon cause of pulmonary 
consumption.” 

Tobacco a Cause of Heart-Disease. —The effect of tobacco upon 
the heart is indicated by the pulse, which is a most accurate index to 
the condition of the heart. The pulse of a tobacco-user says, in terms 
as plain as any words could, that his heart is partly paralyzed, 


33 


* Diseases of Modern Life. 


514 


STIMULANTS AND NARCOTICS. 


that its force and vigor are diminished, that it is, in fact, poisoned. 
Old smokers, and not a few of those who have indulged but a few 
years, often suffer with palpitation of the heart, intermittent pulse, 
angina pectoris, and other symptoms of derangement of this most im¬ 
portant organ. There is, in fact, a diseased condition of the heart 
which is so characteristic of chronic tobacco-poisoning that it has been 
very appropriately termed “ narcotism of the heart.” Medical statis¬ 
tics show that about one in every four smokers has this condition. 
There is good evidence for believing that not only functional but or¬ 
ganic disease of the heart may be occasioned by the use of tobacco. 

Tobacco and Dyspepsia. —Notwithstanding the fact that tobacco 
is very frequently recommended as a sovereign remedy for dyspepsia, 
we have become convinced by careful observation in hundreds of cases, 
that it is never a cure, and is in hundreds of instances a cause of dvs- 
pepsia. Tobacco is a narcotic. The effect of narcotics generally is 
to lessen the secretion of gastric juice, and to decrease the activity of 
the stomach. Tobacco does this in a very marked degree. A man 
who is hungry may appease his desire for food by using tobacco if he 
is accustomed to it, or by the employment of some other narcotic. The 
desire is appeased, although the want still exists. It is through this 
same paralyzing influence that tobacco impairs digestion. Snuff-tak¬ 
ing occasions dyspepsia by producing irritation of the nasal mucous 
membrane, which affects the stomach through sympathy. 

A man cannot use tobacco to any considerable extent without be¬ 
coming a dyspeptic. It is the impairment of digestion which renders 
tobacco so efficient an agent, in most cases, in reducing flesh. We 
have treated scores of tobacco dyspeptics and have no hesitation in 
affirming that the disease is incurable without the discontinuance of 
the habit. Even when the habit is abandoned, a cure is often difficult, 
requiring months of careful attention to diet and treatment. 

Tobacco a Cause of Cancer. —There is no chance to doubt that 
tobacco-using is often a cause of this terrible disease. All eminent 
surgeons testify that they frequently meet cases of cancer of the lip 
and tongue which have been occasioned by smoking. A number of 
such cases have come under our observation, and we do not doubt that 
a large share of cancers of the lip and tongue originate in this way. 
This view is further strengthened by the fact that in the great cancer 
hospital of London, where more than ten thousand cases of this terrible 
disease have been treated, the number of men suffering from the disease 


EFFECTS OF TOBACCO. 


515 


upon the lip and tongue was three times as great as the number of 
women so affected, although the female cancer patients outnumbered 
the men five to one. 

Tobacco Paralysis. —In the last thirty years there has been a 
great increase in the frequency of the occurrence of a peculiar form of 
paralysis which seems to affect especially the nerves that supply the 
muscles, causing gradual wasting and loss of muscular power, which 
is fairly attributable to the increasing use of tobacco, as it most often 
occurs in tobacco-users. 

A form of progressive paralysis of the optic nerve, causing “ to¬ 
bacco amaurosis,” or blindness, is well recognized by oculists. These 
cases generally recover when the tobacco is discontinued, and will not 
get well so long as it is used. 

Tobacco-blindness is very common in Ireland, where very strong 
tobacco is used. It is caused both by smoking and chewing. 

Color-blindness, an affection which is increasing to an alarming ex¬ 
tent, especially in Belgium and Germany, where smoking is more ex¬ 
tensively practiced even than in this country, has been found to be 
largely attributable to the use of tobacco. This fact was first made 
known by an eminent Belgian physician who made extensive investi¬ 
gations upon the subject at the request of the Belgian government. 

Nervousness from Tobacco. —Tobacco-users suffer much from 
nervousness, which is manifested in a great variety of ways. One per¬ 
son is easily startled, another is unnaturally irritable, is cross and irasci¬ 
ble ; another cannot sleep at night; still another suffers with trembling 
of the hands, which greatly discommodes him in writing. In scores of 
cases we have seen these symptoms all disappear when the use of to¬ 
bacco was discontinued. Temporarily, tobacco seems to give tone and 
strength and steadiness to the nerves, but the seeming strength is de¬ 
ceptive. It is purely artificial, and the ultimate effect is to increase the 
very difficulty which it seems to cure. 

We have often known wives and young children to suffer very se¬ 
verely from various nervous disorders which were wholly due to the 
effect upon their delicate organizations of the poisonous fumes of to¬ 
bacco which they received through the poison-laden exhalations of their 
smoking 1 husbands and fathers. 

Dr. L. G. Alexander, of Kentucky, in a late article in the Philadel¬ 
phia Medical and Surgical Reporter, in which he gave an account of 


51G 


STIMULANTS AND NARCOTICS. 


several cases of tobacco-blindness, remarks as follows respecting tobacco 
and nervous diseases :— 

“ The use of tobacco is so general that its bad effects can hardly be 
estimated. So much has been written, pro and con, that to discuss the 
subject is superfluous. The rapid increase of nervous people, nerve pain, 
neuralgia, and obscure nervous disease, is seen in practice every day by 
the physician, and is so frequent as to attract the attention of the laity; 
and it is my belief that the common use of tobacco, as well as of alcohol 
and opium, is the most prominent cause of so many nervous troubles.” 

Plenty of evidence exists to show that tobacco-using is a very com¬ 
mon cause of impotence, together with the many other forms of nervous 
disease arising from its poisonous effects. Numerous other maladies 
might be mentioned as being caused, either directly or indirectly, but it 
will suffice to say that there is scarcely a functional disorder or an or¬ 
ganic disease to which the human system is subject, which may not be 
either produced or aggravated by this subtle poison. 

Hereditary Effects of Tobacco-Using. —There is no vice or habit 
to which men are addicted the results of which are more certainly trans¬ 
mitted to posterity than are those of tobacco-using. A vigorous man 
may use tobacco all his life and be able to convince himself all the time 
that he is receiving no injury; but the children of that man, who ought 
to inherit from him a vigorous constitution and high health, are instead 
robbed of their rightful patrimony, and enter upon life with a weakly 
vital organism, with a system predisposed to disease and destined to pre¬ 
mature decay. The sons of an inveterate tobacco-user are never as ro¬ 
bust as their father; and the grandchildren, in case the children are 
tobacco-users, are certain to be nervous, weakly, sickly creatures. This 
fact we have verified in so large a number of cases that we make the 
statement fully prepared to maintain it by indisputable facts. 

The physician last quoted, in the same article referred to, remarked 
on this question as follows :— 

“ From observation I have found that the children of parents addicted 
to the use of tobacco are more likely to have nervous diseases than others 
born of parents who do not use it; and if both parents use it, we are 
almost certain to find the offspring of a nervous temperament, and espe- 
cially liable to nerve derangement. It is from this class that drunkards 
are mostly recruited. Growing up with a weak nerve development, any 
physical or mental exertion brings on the disease now so common, neu¬ 
rasthenia.” 


APOLOGIES FOR TOBACCO-USING CONSIDERED. 


517 


Moral Effects of Tobacco-Using. —There can be no question but 
that tobacco has a seriously deteriorating effect upon the character, blunt¬ 
ing moral sensibility, deadening conscience, and destroying that delicacy 
of thought and feeling which is characteristic of the true Christian gen¬ 
tleman. This effect is far more clearly seen, as would be expected, in 
youth who begin the use of tobacco while the character is receiving its 
mold, than in those who have adopted the habit later in life, though too 
often plainly visible in the latter class of cases. There can be no ques¬ 
tion but that the use of tobacco is a stepping-stone to vices of the worst 
character. It is a vice which seldom goes alone. It is far too often ac¬ 
companied with profanity and laxity of morals, and leads directly to the 
use of alcoholic drinks. It is indeed the most powerful ally of intemper¬ 
ance ; and it is a good omen for the temperance cause that its leaders are 
beginning to see the importance of recognizing this fact and promulgat¬ 
ing it as a fundamental principle in all temperance work. By this means 
only can any real headway be made against the great evils of intem¬ 
perance. 

Apologies for Tobacco-Using Considered. —We have already 
devoted as much space as is proper to the subject of tobacco-using, and 
can only notice briefly one or two of the more specious arguments used 
in favor of the drug. 

Probably the most powerful argument offered in behalf of the to¬ 
bacco habit is the assertion by certain physicians that tobacco, along 
with alcohol and kindred drugs, is a sort of “ negative food,” diminishing 
the necessity for food by lessening the wastes of the body. As already 
shown, in reference to alcohol, this argument is ingenious; but instead 
of proving the desirability of the drug, it proves the opposite. The ar¬ 
gument is just as good for tobacco as for alcohol. The fact that the nat¬ 
ural secretions are diminished by the use of tobacco, cannot be any more 
of a recommendation to the drug than to nitric acid and mercury, which 
will do the same, or indolence and malaria, which will have the same 
effect. What people of the present day need, with their gross habits of 
eating and drinking and deficient physical exercise, is not less excretion, 
but more. Torpidity of the liver, inactivity of the skin, deficient activ¬ 
ity of the kidneys, and constipation of the bowels, are among the great¬ 
est impediments to real mental and moral growth and culture in the 
present age ■ and these conditions are certain results of the use of 
tobacco. 

Another argument often strongly urged is, that, admitting, the un- 


518 


STIMULANTS AND NARCOTICS. 


natural character of the habit of tobacco-using, it is nevertheless 
made necessary by the artificial conditions of civilized life, by the ex¬ 
cessive mental strain and nervous excitability resulting. It is claimed 
to be essential as a means of soothing the tired brain and securing 
sleep. A full and complete answer to this argument is the fact that 
tobacco is itself a cause of the very conditions which it is supposed to 
remedy, as elsewhere shown; and while it seems to act with tem¬ 
porary benefit in some cases, it ultimately aggravates the very 
troubles which it is used to relieve. 

Much more might be said upon this subject; but we must leave 
it here, hoping that the candid reader will find no difficulty in agree¬ 
ing with us in the conclusion that tobacco is an unmitigated evil, and 
one which should be thoroughly and faithfully exposed on every 
proper occasion, until the public are well informed of its dangers. 
We conclude with the indorsement of the sentiment expressed by 
Charles Lamb, in his “ Farewell to Tobacco,” in the lines,— 

“ Stinking’st of the stinking kind, 

Filth of the mouth and fog of the mind, 

Afric, that brags her foison, 

Breeds no such prodigious poison. 

Henbane, nightshade, both together, 

Hemlock, aconite-,” etc. 



TEA, COFFEE, AND CHOCOLATE. 


519 


TEA AND COFFEE. 



Under this head we 
shall consider tea, coffee, 
and cocoa, or chocolate. 

Tea consists of the 
dried leaves of a plant 
which is native to China, 
but is also grown in India 
and various other parts of 
the world, to which it has 
been introduced. The 
active principle of tea is 
theine, a narcotic alka¬ 
loid, of which it contains 
three to six per cent. 
The other most abundant 
constituent is tannin, of 
which it contains about 
twenty-six per cent. The 
remainder is made up of 
gum, vegetable fibre, sug¬ 
ar, fat, starch, and an 
aromatic oil to which its 

Fig - , 176. Stem of Tea Plant, showing Flowers. Varying flavor IS chiefly 

due. See Fig. 176. 

Coffee is the roasted berry of a plant native to Arabia and Abys¬ 
sinia, known as Coffcea Arabica, which is closely allied to the plant 
from which Peruvian bark is obtained, the source of quinine. Its 
active principle is caffeine, which is identical with theine, of which it 
contains about one-third as much as tea. It also contains tannin, 
though in less quantity than tea, together with gum, sugar, caseine, 
fat, and the other ingredients also found in tea. 

Chocolate is obtained from the seeds of the cocoa-palm, native of 
Mexico, the pods of a ground-nut, a shrub native of Zanzibar, and 
other sources. The substances from which it is produced are ground 





520 


STIMULANTS AND NARCOTICS. 


to a powder, then mixed into a paste with sugar, and dried in cakes. 
Cocoa, or cocoa nibs, consists of the nuts coarsely broken. The active 
principle of cocoa, or chocolate, is theobromine, the proportion of 
which, according to the analyses of Dr Stenhouse, is five per cent. 



Fig. 177. Leaf and Fruit of Cocoa, a. Cocoa Bean. 


Theobromine is closely related, chemically, to theine, with which it is 
practically identical. The remaining constituents are chiefly fat, 
starch, sugar, coloring matter, and woody fibre. See Fig. 177. 

Matt, or Paraguay tea, and chaat, or Abyssinian tea, are the leaves 
of trees or plants which possess active principles essentially the same 
in nature and properties as theine. See Fig. 178. 











HISTORY OF TEA AND COFFEE. 


521 


History of the Use of Tea and Coffee. —Among civilized na¬ 
tions, the use of tea and coffee, as well as of the other beverages named, 
is confined to modern times. It is said that coffee has been in use in 
Arabia, its native home, a thousand years, and that tea has been used 
in China and Japan for about the same length of time. It was not 



until the middle of the sixteenth century, however, that coffee was 
first introduced into Europe by the establishment of a coffee-house in 
Constantinople, and another century passed before it was introduced 
into England. Its introduction into Constantinople was vigorously 
opposed by the priests, who asserted that its use was contrary to the 
teachings of Mahomet; but the desire for stimulation soon triumphed 
over religious scruples, and the Turks are now known as among the 
most inveterate coffee-users in the world. Its use was also opposed 
at its first introduction into more civilized lands, though far less vigor¬ 
ously than was the use of tobacco. From their full introduction to 




STIMULANTS AND NARCOTICS. 


rj22 

t/MM 

civilized nations, only about two centuries ago, these beverages have 
gradually come in more and more extensive use, especially during the 
last half-century. The annual consumption of tea and coffee, and 
their congeners, at the present day, is estimated by competent authori¬ 
ties to be as follows: Tea, 3,000,000,000 lbs.; coffee, 1,000,000,000 lbs.; 
cocoa and chocolate, 100,000,000 lbs. 

Mat^ is used by at least 40,000,000 people, being the common 
beverage of the natives of South America, where the tree from which 
it is obtained grows abundantly without cultivation. It is probable 
that fully one-half the human race, if not a larger proportion, make 
use of one or more of these beverages. In England, tea is the favorite 
drink, 100,000,000 pounds being annually imported into that country. 
It is also the favorite beverage in Russia and Holland. In Turkey, 
Sweden, France, and Germany, coffee is the favorite. In the latter 
country the amount of coffee used is fourteen pounds for each person. 

Effects of Theine upon Man anil Lower Animals. —Numerous 
experiments upon the direct effects of theine,—as also its allied sub¬ 
stances, caffeine and theobromine,—conducted by Dr. E. Smith, Dr. 
Richardson, and others, show that in small or ordinary doses it causes 
an increased action of the heart, an increased elimination of carbonic 
acid through the lungs, loss of heat, and increased activity of the kid¬ 
neys. In larger doses, it produces nausea, vertigo, and finally insensi¬ 
bility and death. Dr. Edward Smith, after drinking an infusion made 
from two ounces of coffee, which probably contained about seven 
grains of caffeine, fell to the floor unconscious. 

A prominent official in the British army, now doing service in 
Africa, recently lost his favorite horse in a manner which is both sin¬ 
gular and instructive. A cook left a few pounds of tea in the sack 
which had contained it, which was filled with corn by a Kafir groom 
who knew nothing of the presence of the tea. Upon serving out the 
corn to a troop of horses, of course the last one received the larger 
share of the tea, which was eaten greedily with the corn. The result 
is thus described :— 

“ The animal plunged and kicked, and ran backward, at intervals 
galloping madly around, finally falling into a donga, where it lay dash¬ 
ing its head on the rocks, and was dispatched by an assegai thrust 
through the heart. The post-mortem appearances indicated extreme 
cerebral congestion.” 

Coffee also lessens the action of the skin. 


EVIL EFFECTS OF TEA AND COFFEE. 


523 


Evil Effects of Using Tea and Coffee.— The evil effects of the 
use of these popular beverages has made too evident their injurious 
character to allow of room to doubt their deleterious influence, not¬ 
withstanding the apologies offered for their use by those who are 
accustomed to employ them. These evil effects we will attempt to 
point out as briefly as possible. 

1. They W aste Vital Force. —By the experiments of Dr. Smith, 
M. Gazeau, and many others, it is shown that the consumption of the 
body is greater under the influence of tea or coffee than at other times, 
since the amount of carbonic acid eliminated is greater than natural, the 
amount of carbonic acid sent out from the lun^s being: the best known 
measure of the rate of waste of the body. The amount of extra waste 
thus occasioned is shown by Dr. Smith’s experiments to be from one- 
fourth to one-tenth that of the whole waste of the body, whence Dr. 
Smith very consistently remarks that it is especially adapted to “ those 
who usually eat too much.” This is a tacit confession that at the least 
the use of tea is an expensive and wasteful habit. 

The fact that the activity of the kidneys is increased, brings to light 
another means by which force is wasted, while, as is confessed, no return 
is made for the expenditure. 

2. Tea and Coffee Injure Digestion. —When taken upon an 
empty stomach these beverages produce, as is well known, serious irri¬ 
tation of the digestive organs. When taken with the food, impairment 
of digestion is produced in several ways ; (a.) By taking into the stom¬ 
ach too large a quantity of liquid ; (6.) By relaxing the stomach by the 
use of liquids of too high a temperature, by which, also, the activity of 
the gastric juice is impaired ; (c.) By precipitating the pepsin with the 
tannin which they contain. Chocolate is further injurious to digestion 
on account of the large amount of fatty substance which it contains. 

That the use of tea and coffee is a common cause of dyspepsia is an ob¬ 
servation made by all experienced physicians. At the last meeting of 
the British Medical Association, an eminent physician from Australia 
testified that dyspepsia from the use of tea and coffee is very common in 
that country. We have seen, personally, many scores of cases of which 
the use of these fascinating beverages was one of the chief causes. 

.3. The Use of Tea and Coffee Affect Injuriously the Nervous 
System. —This statement would seem to be satisfactorily established by 


524 


STIMULANTS AND NARCOTICS. 


its well-known temporary effects. It is well known that whatever ex¬ 
cites vital action above the normal standard, without supplying an extra 
amount of force to support the extra expenditure, invariably produces, as 
a secondary result, depression of vital action below the normal standard, 
or what is known as a reaction. That this' is one of the secondary ef¬ 
fects of the use of strong tea, is well known. Tea may be used so weak 
that the reaction is not noticed, but no doubt it is still felt in some de¬ 
gree by the organic system, if not by the nerves of animal life. This 
continued alternation of excitement and reaction must certainly result 
in injury to the nervous system, increasing the liability to nervous 
diseases of a functional character, such as neuralgia (neurasthenia), hys¬ 
teria, etc. 

Moral Effects. —The long-continued use of tea has a distinct effect 
upon the character. This has been too often noticed and remarked to 
be questioned. An eminent neurologist, writing in a recent number of 
the Journal of Mental and Nervous Disease, calls attention to this 
fact in the following remarks: 

“Irritability of temper, like dyspepsia, belongs in the category of 
symptoms produced by long-continued tea-drinking. 

“There are ‘tea sots’ in every great charitable.institution,—particu¬ 
larly those for the maintenance of the aged. Their symptoms are, gen¬ 
erally, mental irritability, muscular tremors, and sleeplessness.” 

t The eminent Dr. Bock, of Leipsic, writes as follows respecting the in¬ 
fluence of tea and coffee on character :— 

“ The nervousness and peevishness of our times are chiefly attributable 
to tea and coffee ; the digestive organs of confirmed coffee-drinkers are 
in a state of chronic derangement, which reacts on the brain, producing 
fretful and lachrymose moods. Fine ladies addicted to strong coffee 
have a characteristic temper, which I might describe as a mania for 
acting the persecuted saint. Chocolate is neutral in its psychic effects, 
and is really the most harmless of our fashionable drinks. The snap¬ 
pish, petulant humor of the Chinese can certainly be ascribed to their 
immoderate fondness for tea.” 

Tea-Drinkers’ Disorder.— That there is a distinct class of symp¬ 
toms characteristic of the effects of alcohol, of tobacco, of absinthe, and 
of opium, has long been generally recognized ; it is only recently, how¬ 
ever, that the mcrbid effects of tea have been sufficiently well studied by 
eminent physicians to secure the recognition of the fact that tea and cof¬ 
fee, as well as the other poisons mentioned, produce such a distinct class 


EFFECTS OF TEA-TASTING. 


525 

of symptoms. It is now conceded, however, that the use of tea may, 
and often does, produce a morbid condition which has been appropriately 
termed, tea-drinkers’ disorder. 

Less than a year ago, Dr. J. W. Morton of New York City, a phy¬ 
sician of eminence, was led by observing the symptoms of a case which 
occurred in his practice, to believe that tea is far from being the harm¬ 
less agent by many supposed. He at once began an investigation of the 
subject, and directed his attention to a large class of persons to be found 
in most large cities, known as “ tea-tasters.” The facts which his in¬ 
vestigation elicited are so valuable in this connection that we shall quote 
quite liberally from his paper on the subject which appeared in the 
Journal of Mental and Nervous Disease, for October, 1879. We 
quote as follows:— 

“ The pernicious effects of tea-tasting upon many of its followers, 
are well recognized by all their number. It seems to be accepted 
among them, without discussion, that many break down and are obliged 
to give up the business, or else pursue it with much caution and at con¬ 
stant inconvenience to their health. And those of the public who are at 
all familiar with the facts, entertain the same view. Indeed, I may say 
that if I were now to express an opinion, based upon my present, it is 
true not yet sufficiently extensive, information upon the subject, I 
should feel inclined to say, that no one engages for several years in the 
profession of ‘ tea-tasting ’ without suffering both immediate and perma¬ 
nent harm to health.” 

“ This feeling is well illustrated in the remark of a prominent wealthy 
tea merchant, who said, ‘ I would rather give a hundred thousand dol¬ 
lars than have my son become a “ tea-taster.” ’ 

“ At first glance, to witness the operation of tasting, it would hardly 
seem possible that the very small amount of tea used at any one time 
could result in harm. This amount is only equal in weight to a five- 
cent piece, about fifteen grains. About two ounces of well-boiled water 
are turned on to this, and the infusion is allowed to ‘ draw,’ perhaps, 
fifteen minutes. Of this infusion the taster takes but a few spoonfuls 
into his mouth, and often spits it out again; he also at intervals inhales 
the steam. But the harm comes, of course, from the constant repetition 
of these acts. 

“ The cases which I propose to relate exhibit the extreme physiolog¬ 
ical action of an infusion of tea. They are cases of acknowledged ex¬ 
cess; and in this lies their interest, for by familiarity with the symptoms 


526 


STIMULANTS AND NARCOTICS. 


of excess, we shall be able to thread our way back to those of modera¬ 
tion, and to point out, it may be, that what many perhaps consider 
moderation is, in reality, abuse, and that certain symptoms put down as 
‘ nervousness,’ ‘ nervous irritability,’ and ‘ nervous exhaustion,’ as well 
as the more clearly defined ailments of dyspepsia, hypochondria and 
hyperemia, may sometimes be attributed to the misuse of a common 
domestic beverage. Indeed, I am forced to think that many people, un¬ 
consciously to themselves and to their physicians, suffer from a train of 
symptoms due to tea (or its congener, coffee). We often find people 
taking tea to relieve the very set of symptoms which its abuse, as will 
be shown later, produces ; and it is often the fact that patients date 
their recovery from a dyspepsia or nerve exhaustion from the time when 
they gave up their tea.” 

The following is an account of one of the cases observed:— 

“ The immediate effects upon him are as follows: In about ten 
minutes the face becomes flushed, the whole body feels warm or 
heated, and a sort of intellectual intoxication comes on, much the same 
in character, it would seem, as that which occurs in the rarefied air of 
a mountain. He feels elated, exhilarated, troubles and cares vanish, 
everything seems bright and cheerful, his body feels light and elastic, 
his mind clear, his ideas abundant, vivid, and flowing fluently into 
words. He has found from experience that the workings of his intel¬ 
lect are really more clear and vigorous than at any other time. This 
is not a delusion on his part, for at this time he can “ talk a man over,” 

and make a more advantageous bargain than at others. 

© © 

“ At the end of about an hour’s tasting a slight reaction begins to 
set in; some headache comes on; the face feels wrinkled and shriv¬ 
eled, particularly about the eyes, which also get dark under the lids. 

“ At the end of two hours this reaction has become fully estab¬ 
lished, the flushed, warm feeling has passed off, the hands and feet are 
cold, a nervous tremor comes on, accompanied with great mental de¬ 
pression. And he is now so excitable that every noise startles him ; 
he is in a state of complete unrest and mental exhaustion; he has no 
courage to do anything; he can neither walk nor sit down, owing to 
his mental condition, and he settles into a complete gloom. His body 
in the meanwhile does not feel weary. Copious and frequent urina¬ 
tion is always present, as also certain dyspeptic symptoms, such as 
eructations of wind, sour taste, and others. 

“ The above-described immediate effects follow a single afternoon’s 

© 


EFFECTS OF TEA-TASTING. 


527 


tea-tasting. They may be summed up briefly as, excited circulation, 
intellectual intoxication, with actual increased vigor of mind power, 
increased urination; then a period of collapse indicated by cold ex¬ 
tremities, tremulousness, mental irritability and anxiety. It will be 
several days before this condition of affairs is amended. And at this 
time the temptation to take alcoholic stimulants is very strong. 

“ The chronic effects are few and decided. Headache is frequent, 
principally frontal and vertical; a ringing and buzzing in the ears is 
ver} 7 constant; black spots often flit before the eyes, and he sees 
flashes of light. Vertigo also is very persistently present; he cannot 
look up at a clock on a steeple without staggering. Insomnia exists 
to a considerable extent; he seldom has a good night’s sleep, and he 
dreams much, but his dreams are of a pleasant character; he some¬ 
times sees visions when not sleeping. Dyspepsia is more troublesome 
than any of the foregoing three symptoms. This the patient assigns 
strictly to tea-tasting, since it is made worse by tea, and improves 
when he abstains from it, though now becoming confirmed. His ap¬ 
petite is captious, he feels heavy at the epigastrium, he has eructations 
and a sour taste, and finds that certain kinds of food distress him. He 
has a frequent gurgling, and is in the habit of ‘ working ’ his whole 
chest and abdomen to make the gas pass on. 

“ His mental condition is peculiar. He lives in a state of dread 
that some accident may happen to him ; in the omnibus, fears a collis¬ 
ion ; crossing the street, fears that he will be crushed by passing teams; 
walking on the sidewalks, fears that a sign may fall, or watches the 
eaves of the houses, thinking that a brick may fall down and kill him; 
under the apprehension that every dog he meets is going to bite the 
calves of his legs, he carries an umbrella in all weathers as a defense 
against such an attack. He often dreads entering his office for fear of 
being told that some business friend has failed; and in short, lives in 
a state of constant foreboding of some impending evil. At times his 
left leg drags and feels numb, and he is conscious of an unsteady gait. 
He has also often a twitching of the muscles of the face and eyelids. 

“ The chronic effects as above described, as distinguished from the 
immediate effects, are, in brief, vertigo, headache, insomnia, dyspepsia, 
mental depression, almost amounting to delusions, and also some slight 
subjective and objective signs of a central disturbance of both sensibil¬ 
ity and motility. 

“ I omit negative evidence indicating that otherwise than as re¬ 
lated, he is in sound health. 


528 


STIMULANTS AND NARCOTICS. 


“A certain group of his symptoms point to hyperemia of the 
brain, another to disorder of the digestive function, and still another 
to morbid alterations of intellection, sensibility, and motility; all 
taken together presenting, as I venture to suggest, a clinical picture of 
tea-poisoning.” 

Similar effects were observed in all the cases investigated. In or¬ 
der to still more conclusively establish the relation between the effects 
described and the use of tea, Dr. Morton conducted a series of exper¬ 
iments in the use of tea himself, and obtained similar effects to 
those described by the persons interviewed. Since the' publication 
and circulation of his observations, an attempt has been made to dis¬ 
credit his statements, which was undoubtedly prompted by those en¬ 
gaged in the business and who are fearful of suffering pecuniarily 
through the diminution of the use of tea. The observations of Dr. 
Morton are, however, so well confirmed by other observers that the at¬ 
tempt has proved a futile one. 

To the eminent medical testimony against tea already given, we 
may add the following from Dr. B. W. Richardson:— 

“ Some functional nervous derangements are excited by fluids com¬ 
monly consumed with, or as, foods. Tea taken in excess is one of 
these disturbing agents. Tea exerts an astringent action, and by the 
presence in it of an organic substance, theine, it exercises a special in¬ 
fluence over the nervous system, which, to say the least, is tempora¬ 
rily injurious. I believe the effects from tea are more severely felt by 
the young, and that as middle age approaches, they are less severe. 

“ The symptoms which indicate the injurious action of this article 
of food are sufficiently characteristic. They are, intensely severe head¬ 
aches, constipation of the bowels with what is usually considered to be 
deficiency of bilious secretion, flatulency, an unsteadiness and feeble¬ 
ness of muscular power, and, not infrequently, a lowness of spirits 
amounting to hypochondriacal despondency. In children under the 
influence of tea this lowmess of spirits is often very severe, so severe 
that the occurrence of the simplest natural phenomena, as the ap¬ 
proach of darkness, the cast of a large shadow, or the spreading over 
the sky of dark clouds, are sufficient to create dismay and fear. 

“ In poverty-stricken districts, amongst the women who take tea 
at every meal, this extremely nervous, semi-hysterical condition from 
the action of tea is all but universal. In London and other fashion¬ 
able centers in which the custom of tea-drinking in the afternoon has 


AEG UME NTS CONSIDERED. 


529 


lately been revived under the old name of * the clruni,’ these same nerv¬ 
ous symptoms have been developed in the richer classes of society, 
who, unfortunately, too often seek to counteract the mischief by re¬ 
sorting to alcoholic stimulants. Thus one evil breeds another that is 
worse. 

“ The flatulency induced by tea taken late in the evening has the 
effect of interfering with the processes of sleep ; it prevents or disturbs 
sleep by dreams and muscular startings, and is a common cause of that 
peculiarly painful symptom known as nightmare. 

“ The extremely injurious effects of tea are best seen in some of 
those who are charged with the commercial duty of what is called 
‘ tea-tasting.’ A professed ‘ tea-taster ’ who was so seriously affected 
by the process that he thought it proper to consult me on the symp¬ 
toms induced, defined the symptoms very clearly as follows: ‘ Defi¬ 
ciency of saliva; destruction of ta,ste for food; biliousness; nausea; 
constipation; an extreme and unclefinable nervousness ; and night¬ 
mare whenever sleep is obtained.’ 

“ The symptoms from which habitual tea-drinkers suffer are iden¬ 
tical in character, but minor in degree.” 

“ Coffee, like tea, induces dyspepsia, and perhaps, with even more 
-activity than tea, it keeps the brain awake when that wearied organ 
ought, according to nature, to be asleep.” 

ARGUMENTS IN FAVOR OF TEA AND COFFEE CONSIDERED. 

Notwithstanding the numerous facts against these beverages, so 
popular is their use that there are many who profess to find apologies 
for employing them; a few of these we will now consider. 

1. Tea and Coffee Sustain the Strength. —The same argument 
urged for tobacco and alcohol is also presented in favor of tea and coffee; 
but its value is no greater in the case of the latter than in that of the 
former. That it does not sustain either muscular or nervous strength 
is shown by scientific experiments which cannot be refuted by any num¬ 
ber of unreliable accounts of the great amount of work which can be 
performed by persons who take little else than tea. Dr. Smith remarks 
that the use of tea appears to increase muscular activity, as under its in¬ 
fluence there is greater ease in making exertion; but he immediately 
adds that if exercise be taken, “a greater sense of exhaustion follows’ 
than when tea has not been taken; which shows, most conclusively, 

34 


530 


STIMULANTS AND NARCOTICS. 


that the feeling of strength is not real, but deceptive, and that a person 
is really less fitted for exertion of any kind while under the influence of 
tea than at other times. Dr. Smith further remarks, in summing up 
the effects of tea, that exercise while under its influence is followed by 
“reaction, with a sense of exhaustion,” and this is said to be felt even 
after having had a night’s rest. No better evidence of the damaging 
influence of these drugs could be required. 

If it be argued that the amount taken by ordinary consumers of tea 
is insufficient to produce any ill effect, we have but to call attention to 
the fact that the wealthy, besides using the strongest tea, take it in doses 
even larger than those employed by Dr. Smith in his experiments. It 
is not at all uncommon for persons with whom expense is not an item 
of moment, to take at each meal a quantity of the infusion of tea of 
such strength as to contain not less than five to fourteen grains of theine, 
a smaller amount than which has been known to cause unconsciousness 
and temporary paralysis. A single teaspoonful of dry tea may contain 
seven or eight grains of theine, and this is not an uncommon allowance 
for each person at a meal. 

2. Tea and Coffee Soothe the Nerves.— How do they soothe 
the nerves ? Do they furnish the requisite material for repairing the 
worn and exhausted organs ? No. They only temporarily excite them, 
so that their real condition is for a time obscured ; but when their evan¬ 
escent effect has vanished, the nerves are in greater need than before of 
being soothed, and each application of the remedy makes the evil worse. 
This is the reason why we seldom find a confirmed tea-drinker who is 
not troubled with nervousness. It is also equally true that the great 
majority of sufferers from this disease are tea or coffee drinkers. In 
hundreds of instances these nervous tea-drinkers have fully and speedily 
recovered their health by abandoning their use of the article. This is a 
sure and simple remedy. 

3. Tea and Coffee Assist Digestion. —“ Mv stomach is so weak,” 
says a tea-drinking dyspeptic, “ that a cup of good strong tea is neces¬ 
sary to enable me to digest my meal.” Yes; this is doubtless the case; 
and if you continue the practice you will find, after a time, that two or 
three cups will be necessary to enable you to dispose of your dinner sat¬ 
isfactorily. Then if you persevere in the habit, in spite of the admoni¬ 
tions of your best medical adviser, nature, you will shortly find it quite 
impossible to swallow a sufficient quantity of the beverage to make your 
stomach perform its work. Then you will begin to realize the fact that 


AEG UMENTS CONSIDERED. 


531 


goading an organ into action is quite a different thing from encouraging 
and promoting its healthy activity by supplying it with healthful, nour¬ 
ishing food. 

Do not be deceived by momentary sensations. Consider the ulti¬ 
mate effects, and you cannot fail to be convinced that instead of pro¬ 
moting digestion, tea and coffee are most effective disturbers of that 
function. How they interfere with digestion has already been explained. 

4. Tea and Coffee Relieve Headache. —How invariably the un¬ 
suspecting lady resorts to a cup of tea to relieve the distress occasioned 
by that common malady, sick-headache ! Yes; and how invariably that 
same sick-headache returns ! Who ever heard of a person who was per¬ 
manently cured of sick-headache by tea-drinking ? Such a thing would 
be impossible. Tea and coffee are among the prime causes of sick-head¬ 
ache, although they afford temporary relief, just as tobacco and alcohol 
are prolific causes of tremors, but yet appear to steady the trembling 
nerves for a short time. 

5. Tea-and Coffee Supply the Place of Food. —Many people 
who are largely addicted to the use of the articles will prefer a cup of 
strong tea or coffee to a hearty meal of nourishing food. Indeed, it is a 
general custom with the English peasant to reduce his bread fare one- 
half that he may be able to procure a cup of tea to accompany the re¬ 
mainder. Dr. Arlidge, of England, has recently called attention to the 
fact that the women of the working-classes in that country have carried 
this practice of substituting tea for food to such an extent that they are 
beginning to manifest the most unmistakable evidence of narcotic 
poisoning. 

Tea silences the demand of the system for food, but it does not in any 
respect replace it, as may be seen by the weakened energies and the at¬ 
tenuated forms of those who use it largely. As elsewhere remarked, Dr. 
Smith has shown that tea-drinkers need more food than others instead 
of less. 

6. Tea and Coffee Increase Mental Yigor. —Those who make 
this claim, mistake mental activity for mental strength. A greater error 
could not be made ; and yet this fallacious notion is very popular. See 
the poor victim of delirium tremens trembling with fright at the fan¬ 
tastic and threatening shapes which his excited fancy portrays. His 

imagination was never so active in health. Now it makes him see 

© 

forked tongues darting at him from every corner, and converts every 


532 


STIMULANTS AND NARCOTICS. 


shadow into a monster. Who will venture the assertion that his mind 
is stronger now than when in health ? Listen to the ravings of the 
patient during the delirium of fever; the mind is certainly active, hut it 
cannot be said to be strong; for strength is only consonant with health. 

When the brain is stimulated to unnatural activity by tea, coffee, 
tobacco, alcohol, or any other stimulant, it makes violent attempts to 
accomplish whatever task may be imposed upon it. But the calm, de¬ 
liberate action of the mind is impossible. The highest efforts of genius 
can never be exhibited under such circumstances. Is it argued that 
some of our greatest mental workers, as Voltaire and Johnson, were users 
of tea or coffee, we would, in answer, call attention to the nervousness, 
irritability, and irascibility which notably characterized the last years 
of the life of each of these men. Here we see the legitimate results of 
the use of tea and coffee, and it is very probable that had these men been 
more nearly correct in their habits of life they would have achieved even 
greater success than they did. 

It was long ago decided by eminent physicians that excitement is 
not strength. It has quite as long been recognized that every unnatural 
increase of physical or mental action must be followed by a correspond¬ 
ing descent below the average standard of activity. 

Then every minister who drinks a cup of strong tea to increase the 
animation of his discourse, borrows a certain amount of vivacity and en¬ 
ergy from some future effort. So every student who goads up his 
weary brain with a cup of tea to enable him to steal time from sleep, is 
making a double draft upon his capital of mental force and ability. So, 
too, the young lady who stimulates with tea to enable her to entertain 
her visitors, is laying the foundation for future intellectual poverty and 
mental inefficiency. 

7. Tea and Coffee Correct the Injurious Effects of Poor Wa¬ 
ter.— When no other reason can be offered for the continuance of a bad 
habit, this one is frequently presented. Its absurdity makes it almost 
insusceptible of candid consideration. How strange that the addition 
of a poison to water already bad enough should improve it! The asser¬ 
tion is wholly without foundation in fact, and never would have been 
advanced as an argument by tea-drinkers, except for the lack of any 
better. Two poisons are always worse than one unless they neutralize 
each other; but no such chemical properties are claimed for tea and 
coffee. 


ARGUMENTS CONSIDERED. 


533 


8. Tea and Coffee are Necessary Condiments. —One writer 
upon dietetics tells us that the utility of tea and coffee does not depend 
upon their peculiar principle, theine, but that it is wholly the product 
of a certain aromatic oil which they contain, and which he denominates 
“ osmazome.” This gentleman argues that food cannot be digested un¬ 
less it is relished ; and that since tea and coffee, in company with other 
condiments, make the food more palatable to the taste, they must be 
essential to nutrition. 

While it is certainly true that the value of any article as a food de¬ 
pends very largely on its gustatory properties, it cannot be for a mo¬ 
ment supposed that the mere question of taste is sufficient to settle the 
nutrient quality of an aliment. In other words, an article may be ex¬ 
ceedingly pleasing to the taste, and yet be equally injurious to the health 
and quite unfit for food. If this were not the case, how would the epi¬ 
cure and the glutton rejoice; for then they might gratify their appetites 
without restraint. 

Again, an article may possess little or no gustatory property,' and 
yet be a most valuable and indispensable aliment. Such is the case with 
pure water. We do not hesitate, then, to declare this argument for the 
use of tea and coffee to be without weight. It is, indeed, a fact now 
coming to be recognized more and more fully, that all condiments are 
not only useless, but injurious, tea and coffee with the rest. 

9. Tea and Coffee are Substitutes for Food. —Tea and coffee, 
as well as alcohol and tobacco, have been called by some physiologists 
“ accessory foods,” because, as was alleged, they prevent the rapid disor¬ 
ganization of tissues, which always accompanies organic activity. It 
might be easily shown that this would be most undesirable, if it were 
really true; for vital action is not only accompanied by organic change, 
but is inseparably connected with it. Some even say that it is depend¬ 
ent upon it. But we need not enlarge upon this, for it is claimed by our 
best authorities that careful experiments demonstrate the fact that 
change is accelerated instead of impeded by the use of tea and coffee. 
While we have little confidence in the reliability of any of these experi¬ 
ments, there being many chances for error, they are very interesting on 
some accounts. 

A popular writer says, “ Science almost always finds some founda¬ 
tion in fact for popular prejudices.” In this case we have a very excel¬ 
lent illustration of this fact. Quite a number of illustrious* individuals 
have been for some time recommending the use of tea and coffee, be- 


534 


STIMULANTS AND NARCOTICS. 


cause, as they claimed, they prevented the ordinary rapidity of tissue 
change, and so lengthened life and economized food. But now we find 
Dr. Smith, the author of the latest and most popular and reliable work 
on foods, telling the people that they should use tea and coffee because 
they increase the rapidity of tissue change, and so increase the available 
force of the individual. Thus it appears that those who use tea and 
coffee need to eat more food instead of less, as heretofore claimed. 

The only conclusion to be drawn from these facts is that even scien¬ 
tific men are sometimes so blinded by the fogs of appetite that they lose 
sight of true principles and allow themselves to be guided by their prej¬ 
udices. Reason and common sense must decide from the facts in the 
case, independent of all such contradictory, and hence unreliable, testi¬ 
mony. 

10. Tea “Cheers and not Inebriates.” —Philosophers have spec¬ 
ulated, theologians have moralized, and poets have waxed eloquent, 
about “the cup that cheers and not inebriates.” Doubtless we shall 
startle such when we say that, although this is very pretty poetry, it is 
false in fact. Tea and coffee, as well as tobacco, are as truly capable of 
producing a condition of intoxication as is alcohol. Intoxication is a 
condition in which the sensibilities are paralyzed and the mind delirious. 
In more than one instance has this identical condition been induced by 
the use of tea and coffee. 

In Australia, drunkenness from the use of tea is very common. In 
South America, a person who is greatly addicted to the use of coca is 
called a coquero, which means the same as our word drunkard. The 
Mate or Paraguay tea of South America, the active principle of which 
is precisely the same as that of tea and coffee, produces not only intoxi¬ 
cation but delirium tremens. Abyssinian tea, another form of the 
same principle, used in Shoa and among the poorer classes in some parts 
of China, is said by Johnson to be very intoxicating. 

We have already referred to the fact that Dr. Edward Smith, of 
England, when conducting some experiments on the “ physiological ac¬ 
tion ” of coffee, fell to the floor insensible, in company with his assist¬ 
ant, as the effect of drinking strong coffee. 

Dr. Cole, of England, describes the cases of several individuals who 
were frequently found lying insensible as the result of tea-drinking. 
One case which he mentions was an author who was thus found two or 
three times a week. 

Indeed, the man who is so far bereft of his reason that he is wholly 


ARGUMENTS CONSIDERED. 


535 


insensible is not the only person who is drunk. Every man who takes 
into his system any kind of stimulant, be it tea, coffee, tobacco, opium, 
arsenic, or alcohol, is drunk just in proportion to the dose, and all his 
actions will be more or less unnatural. 

The word intoxicate is derived from the Latin word toxicum, poison, 
intoxicatum meaning to drug or poison. Intoxication, then, is a con¬ 
dition of poisoning ; and it is wholly immaterial whether opium, alcohol, 
tobacco, tea, or coffee, is the agent employed. 

Holding that tea and coffee are harmless beverages, many temper¬ 
ance workers have urged their introduction as substitutes for alcoholic 
drinks; and for this purpose temperance (?) coffee-houses have been 
established in many of our large cities. 

We believe, however, that in the attempt to reform drunkards and 
prevent intemperance no greater mistake can be made than to attempt 
to substitute one stimulant or narcotic for another. It is possible that 
temporary benefit may be derived from the establishment of coffee¬ 
houses in districts where a sudden and extensive temperance reform - 
has been effected, but the ultimate effects of substituting tea or coffee 
for alcoholic drinks, as a cure for intemperance, will prove it to be a 
fatal error. The great sin of intemperance is not in the use of alco¬ 
hol, per se, but in the gratification of the desire for artificial stimu¬ 
lation. We fully believe that the use of tea and coffee, especially 
when it is begun early in life or indulged to any degree of excess, is a 
by no means insignificant cause of intemperance, the use of one 
stimulant leading to another, until the grossest forms of intemperance 
are reached. The facts to which attention has already been called in 
our consideration of the subject will justify this conclusion. We 
fully agree with the sentiment expressed by an eminent New York 
physician, that “ The only consistent teetotalism is that which abstains 
from all forms of stimulants and narcotics.” We thoroughly believe 
that more harm is done at the present time by tobacco, tea, and coffee, 
than by all forms of alcoholic drinks combined; and we deem it of 
the greatest importance that the efforts of temperance workers should 
be turned in this direction. We are glad to see some omens of progress 
toward true teetotalism, one of the most promising of which is the 
recent formation of the American Health and Temperance Association, 
which, although only inaugurated on New Year’s of 1870, has already 
effected more than twenty auxiliary State societies, and more than a 
hundred local organizations, and secured a membership of more than 


53G 


STIMULANTS AND NARCOTICS. 


ten thousand. The teetotal pledge of this Association requires absti¬ 
nence from alcohol, tobacco, tea, coffee, opium, and all other narcotics 
and stimulants.* 

The work of this organization is being pushed with vigor through 
its agents in all parts of this country, and in England, Sweden, Nor¬ 
way, and Switzerland. It is to be hoped- that other temperance organ¬ 
izations will take hold of this work also. 

THE USE OF OPIUM. 

Within the last few years the consumption of this narcotic drug 
has been increasing in this country to an alarming extent. Thirty 
years ago the amount of opium imported was about 130,000 pounds 
annually. To-day, according to the report of the chief of the Bu¬ 
reau of Statistics, it is not less than 400,000 pounds. Of this amount 
not more than one-fifth is used for medicinal purposes, leaving the 
enormous amount of 320,000 pounds to be disposed of by habitual 
users of the drug. The exact number of opium consumers cannot be 
determined with any degree of accuracy, as the devotees of the drug 
usually avoid disclosing the habit as much and as long as possible. 
Careful inquiries of druggists, and others likely to be the best posted, 
have elicited facts upon which it is perfectly safe to base the estimate 
that there are not less than 100,000, and very probably as many as 
200,000, habitual opium-takers in the United States. 

Enormous Doses Taken. —The amount of opium consumed by 
an old opium-eater is sometimes enormous. We have had cases in 
which twenty grains of morphia, equivalent to 320 grains of opium, 
were taken at a single dose, with no more effect than would follow the 
administration of one-fourth of a grain to a person unaccustomed to 
its use. One of the most recent cases which have come under our care 
at the Medical and Surgical Sanitarium at Battle Creek, Michigan, 
was that of a woman who had been addicted to the drug for nine or 
ten years, and had increased the quantity from less than a grain a day 
to ninety-six grains in the twenty-four hours, equivalent to more than 
three ounces of opium, together with a pint and a half of brandy. 

Narcotic Nostrums. —In addition to this enormous consumption of 
opium by those addicted to its use, immense quantities are used in vari¬ 
ous quack nostrums and in so-called “ antidotes.” Probably the most 

* Those who desire further information respecting this organization can obtain it by 
addressing the Association at Battle Creek, Mich. 


CA USES OF THE OPIUM HABIT. 


537 


widely used nostrum containing opium is Mrs. Winslow’s Soothing 
Syrup, of which no less than 750,000 bottles, containing about one grain 
of morphia each, have been sold in a single year. This quantity is 
sufficient to destroy the lives of many thousands of infants, who are 
very susceptible to the influence of the drug, as no doubt it has done. 

Causes of the Habit. —Probably the greatest of all causes of this 
• enormous increase in the habit within the last few years is its reckless 
and uncalled-for use in medicine. It is the custom of many physicians to 
prescribe opium in some form for almost every ache or pain which they 
encounter in practice. If they find a patient suffering pain, whether 
from an acute attack of colic, a chronic neuralgia, a face-ache from a 
decayed tooth, a back-ache from some uterine disease, or a fractured 
limb, an opiate is at once prescribed, and often before ascertaining what 
may be the patient’s condition. We have treated quite a number of 
persons suffering from the opium habit, and have never met a case in 
which we were not informed by the patient that the habit began with a 
physician’s prescription. This is the general testimony of all who have 
examined this question. We have had patients who had been taught by 
their physician to take morphia by means of the hypodermic method 
(injection beneath the skin), whose bodies were so completely covered 
with scars that it was scarcely possible to find a spot within reach of 
the patient’s own hands, and not uncovered by the clothing, which had 
not been punctured by the needle of the hypodermic syringe one or more 
times. In one case, a patient was actually driven to seek relief from 
the terrible habit by sheer inability to find new places for puncturing 
the skin. The most common method of taking the drug, however, is by 
the mouth. The physician gives a prescription which the patient has 
filled and refilled, until the habit is firmly fixed. We have many times 
heard patients condemn in no stinted terms the physicians who first 
introduced them to the fascinating drug, apparently forgetting that 
they may have been themselves in a large measure to blame, since it is a 
most common thing for patients to demand of physicians medicines 
which will produce immediate palliative effects, not once thinking that 
nature must effect the cure, and that time will be required to remove the 
cause of the disturbance so as to obtain relief in a natural way. 

Effects of the Opium Habit. —The continued use of opium is 
followed by effects far more serious than those from the use of tea, 
coffee, tobacco, or alcohol. It is an evil that every physician ought 
to do his utmost to expose, warn against, and prevent. Probably 


538 


STIMULANTS AND NARCOTICS. 


physicians can do more than any or all other persons combined to cure 
the habit, by exercising care to avoid in every possible way and under 
all possible circumstances the use of opium as a medicine. There are 
numerous other measures of relieving pain, and all available means 
should be tried before resorting to this drug, so likely to make the 
sufferer whom it temporarily relieves a greater sufferer in the end. 

The government of Pekin has taken measures to check the enor¬ 
mous consumption of opium in that country by interdicting its use 
after the beginning of the present year, under a most severe penalty. 
If there is need of prohibitory legislation respecting any form of in¬ 
temperance, this certainly is the one of all others requiring it, and the 
one for which there seems to be the best chance for success. 

Tyranny of the Habit. —Of the fascinating powers of this drug 
and the extreme difficulty of overcoming the habit, so much has been 
written that we need say nothing. The confessions of the opium- 
eater, De Quincey, portray in far more graphic lines than could we, 
the terrible bondage of an opium slave. We should say a word, how¬ 
ever, with reference to its cure. The numerous antidotes for the opium 
habit advertised in the newspapers are the basest frauds imaginable. 
The examination of a large number of them by Dr. Prescott, of the 
Medical Department of the University of Michigan, a few years ago, 
showed them to be, without exception, compounds of opium. In this 
case the remedy is not worse than the disease, but identical with it. 
The habit is not incurable, however, as many suppose. With proper 
treatment all can be cured, and in a comparatively brief space of time. 
In the case mentioned, in which ninety-six grains of opium were taken 
daily, the patient, although suffering with an acutely painful disease, 
was completely cured in less than six weeks, though she had been ad¬ 
dicted to the use of the drug for many years, and in addition was ad¬ 
dicted to the use of liberal quantities of alcohol, a combination much 
more difficult of cure than either habit alone. Other patients have 
been cured in three or four weeks, or in shorter periods. The method 
of treatment is described elsewhere. 

Absinthe, Chloral, Ether, etc.— The use of absinthe, chloral, sul¬ 
phuric ether, and of other narcotics and stimulants, is followed by re¬ 
sults the most serious in character; but we have not the space to dwell 
upon these, as the evils consequent upon their use are of small impor¬ 
tance when compared with the great evils resulting from the use of the 
drugs to which we have already called attention. 


HYGIENE OF THE AIR. 


In this section we shall consider the composition of the air, the im¬ 
purities with which it is likely to he contaminated, the sources of contam¬ 
ination, disinfection, and the best modes of ventilation and heating. 

The Atmosphere. —The air is a very complex mixture of gases and 
minutely divided solids in the form of dust and minute germs. The 
chief and essential constituents of the air are nitrogen and oxygen, in the 
proportion of 79 parts of the former to 21 of the latter, ignoring the 
numerous other constituents, which are too small in quantity to be re¬ 
garded in this connection, though of immense importance in their rela¬ 
tions to health. Oxygen in the form of ozone is usually found in pure 
air in small proportions. In this state, oxygen is exceedingly active, and 
is a powerful disinfectant. Oxygen is converted into ozone by the action 
of the volatile oils of flowers and the vapor of resinous substances. It is 
abundant in pine forests on account of the slow evaporation of pitch. 
Its chief source, however, seems to be electricity, hence it is very abun¬ 
dant after a thunder storm. It is in part due to this fact that the air 
seems so much purer and fresher after such a storm. 

Carbonic acid is naturally found present in the air in the proportion of 
4 parts in 10,000, or .04 per cent. Another essential ingredient is watery 
vapor, which is found in varying proportion according to the location, 
season of the year, temperature, and other varying conditions. 

It has been found by numerous experiments that the proportions in 
which oxygen and nitrogen are found in the air cannot be greatly 
changed without injury to health, although the nitrogen seems to be 
useful chiefly to dilute the oxygen, and may be replaced, temporarily at 
least, by such a neutral gas as hydrogen. If the oxygen is diminished, 
even so little as two or three parts in a hundred, respiration becomes very 
difficult, and a lighted candle burns very dimly. A slightly lower per¬ 
centage of oxygen is insufficient to support combustion. 

As air expands with the elevation of temperature, the equivalent 
amount of oxygen decreases. Thus, air at 90° F. contains an amount 
of oxygen equivalent to only about nineteen-twentieths of the usual 

539 



540 


HYGIENE OF THE AIR. 


amount at 60° F.; while air at 32° F., on account of condensation of 
volume, contains an amount of oxygen equivalent to one-twentieth more 
than the usual amount at 60° F. It is this which causes the lassitude 
consequent upon a great rise in temperature, as also the habitual and 
characteristic inertness of the natives of hot climates. The fact also 
accounts for the tonic and invigorating effects of cold air. These obser¬ 
vations agree entirely with the results of experiments which show that 
the inhalation of an increased proportion of oxygen increases vital ac¬ 
tion, while the opposite effect is produced by a diminished quantity. 

An increase of altitude has an effect upon the atmosphere similar to 
that of increased temperature. The air rapidly diminishes in density, or 
grows thinner, as the altitude increases, so that at a height of a little less 
than three and one-half miles its density is only one-half of that at the 
surface of the earth. At an elevation of less than 9,000 feet the density 
of the air is decreased to such an extent that a given volume contains 
oxygen equivalent to only about three-fourths of that contained in an 
equal volume at the surface. An effect exactly the same in kind but 
less in degree is produced by the changes in barometric pressure which 
are constantly taking place. When the barometer falls, the air is thin¬ 
ner, and less oxygen is respired. When it rises, the opposite effect is 
produced. These facts account for the feeling of oppression and want 
of air experienced by those who ascend to great heights on mountains 
or by means of balloons. This we experienced in a very unpleasant de¬ 
gree in the Rocky Mountains at an altitude of less than 14,000 feet, upon 
attempting to exercise even in a very gentle manner. Persons who have 
ascended to greater heights have found the difficulty to increase propor¬ 
tionately with the altitude. The same facts also account for the enerva¬ 
tion and oppression often felt just prior to and during a storm, when 
the barometer usually falls, owing to the decrease in the density of the 
atmosphere. It will be readily understood that a sudden rise in temper¬ 
ature accompanied by a fall of the barometer would produce a double 
degree of interference with respiration, by decreasing the amount of 
oxygen inhaled at each breath. The amount of oxygen taken in at a 
single respiration with the thermometer at 80° and the barometer an 
inch and a half lower than usual, would be equivalent to only nine-tenths 
of the amount of oxygen taken in with the barometer at its usual height 
and the temperature at G0°. This very readily accounts for the extreme 
degree of enervation, and often prostration, felt, especially by nervous 
people and invalids, just prior to a storm in very hot weather. 


IMPURITIES OF THE AIR. 


541 


Persons living in an elevated atmosphere in some degree compen¬ 
sate for the diminished amount of oxygen in the air by increasing the 
amount taken in at each respiration. This is said to result in increas¬ 
ing the lung capacity of people residing in such localities. It is also 
supposed that the necessity for increased action of the lungs and the 
breathing of a larger amount of air is the means by which persons 
suffering with some forms of pulmonary disease are apparently ben¬ 
efited by residence in elevated districts. 

As before remarked, the amount of watery vapor in the air varies 
greatly with the locality, season, and other conditions. The air of 
countries located near the sea, or other large bodies of water, contains 
a large proportion of watery vapor when the wind is in the direction 
of the water. When the wind is blowing in the opposite direction, 
the air is apt to be quite dry. Just before a storm the air is usually 
nearly saturated with vapor. In the warm season of the year the de¬ 
gree of saturation of out-door air and that within doors is about the 

o 

same. In the winter season, however, owing to the higher tempera¬ 
ture of in-door air, it is very much drier unless watery vapor is added 
by artificial means. This is owing to the fact that air acquires by 
increase of temperature a greater capacity for absorbing moisture. 
This point need not be dwelt upon further, as it has been fully ex¬ 
plained in connection with the hygiene of respiration. 

Impurities of the Air. —The principal impurities of the air to 
which we shall call particular attention are as follows:— 

First, various gases, comprising carbon-dioxide or carbonic acid, 
carbonic oxide, ammonia, sulphureted hydrogen, and various noxious 
gases arising from the decomposition of organic matter, from render¬ 
ing establishments, chemical works, and other sources. 

Second, germs and other minute living bodies consisting of spores, 
animalcules, etc. 

Th ird, dust, consisting of minute particles of earthy matter, frag¬ 
ments of hair, fibres from clothing, minute portions of small insects, 
particles of decomposing matter, and a great variety of substances too 
numerous to mention. 

We will now notice more in detail some of the more important of 
these impurities and their sources. 

Carbonic Acid. —Of the various poisons which contaminate the 
air, carbonic acid, or, more properly, carbon dioxide, is the most abun¬ 
dant. While not the most dangerous, it may be considered as the 


542 


HYGIENE OF THE A IE, 


chief impurity of the air. It is produced by the burning of wood, 
coal, and all ordinary combustibles, by the respiratory processes of 
animals and plants, and by the decay or decomposition of organic sub¬ 
stances. It is also produced by various chemical processes, as the burn¬ 
ing of lime in lime-kilns. Carbonic acid is an invisible, odorless gas, 
a fact which adds to its dangerous character, since it makes it impos¬ 
sible to detect its presence by the senses. It is heavier than air, and 
hence has a tendency to accumulate in low places, as in unused wells, 
deep valleys, caves, and similar places. Some of the properties of 



Candle Extinguished by Carbonic Acid Gas. Fig-. iQO. Pouring Carbonic Acid Gan. 

this gas may be easily observed by making the following experiment:— 
Place in a deep glass jar—a two-quart fruit can will answer the 
purpose admirably—two heaping teaspoonfuls of bi-carbonate of soda 
or saleratus. Add a teaspoonful of water and allow the soda to 
dissolve. Now add a teaspoonful of strong vinegar. Immediately 
upon the addition of the vinegar a vigorous chemical action will occur, 
accompanied by great effervescence, the result of the liberation of car¬ 
bonic acid gas. In a few minutes the action will cease. Now, if a bit 
of candle be lighted and let down into the jar, by means of a wire, it 
will be extinguished almost as soon as it enters the mouth of the jar. 
(See Fig. 179.) This shows that the carbonic acid gas will not support 
combustion. Indeed, it is one of the best means of extinguishing fires, 
being employed for this purpose in the Babcock and other forms of ex- 








































SOURCES OF CARBONIC ACID GAS. 


543 


tinguishers. That the gas is heavier than air is shown by the fact 
that it can be poured from one vessel to another, as also by the fact 
that when generated in the manner described it will remain for some 
time in the jar in which it is produced. While the jar is still full of 
gas, or before very much has been allowed to escape, raise it carefully 
to the mouth of another empty jar and perform the act of pouring 
exactly as though it were filled with water, as shown in Fig. 180. 
The fact that the carbonic acid has been poured into the jar may be 
shown by letting down into it a lighted candle as represented in the 
figure inferred to. 

The presence of carbonic acid may also be demonstrated in another 
manner. It is well known that chalk is a chemical compound of lime 
with carbonic acid. By pouring into the jar half a teaspoonful of 
clear lime and slaking thoroughly after placing a cover over the jar, 
the carbonic acid will combine with the lime, producing chalk, which 
will give to the water a milky or cloudy appearance. Lime-water is 
easily made by slaking freshly burned lime in water and allowing it 
to settle until clear. The clear solution may be turned off into another 
bottle, boiled, corked,- and preserved for use at any time required. 

The most important sources of carbonic acid in the air of dwelling- 
houses or other confined spaces occupied by human beings, where 
alone there is much danger from this gas, are respiration and the com - 
bustion of gas, oil, candles, and other illuminating substances. The 
presence of carbonic acid in the breath may be easily shown by a 
slight modification of the experiment described in the preceding par¬ 
agraph. Take a clean glass jar, and cover the mouth closely with 
writing-paper. Make two holes in the paper cover large enough to 
admit the end of the little finger. In one of these insert a glass tube 
or a large straw of sufficient length to reach to the bottom of the jar. 
Place the mouth at the other end and breathe into the jar for one or 
two minutes, taking care not to draw into the lungs any air from the 
jar. If a short piece of lighted candle be now let down into the jar 
as before immediately after removing the cover, it will be extinguished 
at once. The presence of carbonic acid in the jar may also be detected 
as in the previous experiment by putting into the jar a small quantity 
of lime-water, and shaking it for a few seconds. The production of 
chalk is indicated by the cloudy appearance, proving the presence of 
carbonic acid as before stated. 

The amount of carbonic acid produced by each adult person is 


544 


HYGIENE OF THE AIR. 


about one cubic inch at each breath, which would amount to twenty 
cubic inches, or about two-thirds of a pound, in a minute, or two-thirds 
of a cubic foot in. an hour. The ordinary oil-lamp produces about the 
same quantity of carbonic acid as a person. A good candle produces 
from five to ten times as much. Immense quantities of carbonic acid 
are produced in stoves, fire-places, and furnaces, but these we do not 
need to take into account, as it is conducted away with the smoke 
through the chimney. 

Carbonic acid is not so active a poison as many other gases with 
which the air is sometimes contaminated, but numerous experiments 
performed upon birds, mice, and other small animals, as well as upon 
human beings, have shown beyond the possibility of a doubt that it is 
directly poisonous to all forms of animal life even in small quantities. 
In the quantity in which it naturally exists in the atmosphere,—3 to 
4 parts in 10,000,—it is not injurious to animal life and is of great 
service as gaseous food to plants and all forms of vegetable life. If, 
however, its proportion be increased to G or 7 parts in 10,000, it be¬ 
comes decidedly prejudicial to health. This is true, however, only 
when it is produced by the respiration of animals or human beings, 
and is generally considered to be due more directly to the organic poi¬ 
son with which carbonic acid from these sources is always associated 
than from the carbonic acid itself. It has been shown to be true, 
however, that if pure carbonic acid from any source be added to the 
air in such quantity as to reduce the proportion of oxygen even as lit¬ 
tle as one-tenth per cent, or one part in a thousand, serious results will 
follow. 

Test for Carbonic Acid .—The most reliable authorities all ao;ree 
that the proportion of carbonic acid should never be allowed to be¬ 
come greater than 6 parts in 10,000; hence, it is important to be able 
to detect the presence of this gas, especially since, as before remarked, 
it cannot be readily detected by any of the senses. Fortunately, this 
may be accomplished by very simple means, the use of which requires 
only ordinary care. The materials required to perform the test are, a 
supply of perfectly clear, saturated lime-water, and four bottles or jars 
of different sizes, the sizes required being the following: one jar or 
bottle capable of holding exactly 16 ounces, or one pint; a second 
holding 10| ounces; a third holding 8 ounces, or one-half pint; and a 
fourth capable of holding 64 ounces. The jars should have necks large 
enough to admit of perfect cleaning of the whole inside, and the great- 


CARBONIC OXIDE. 


545 


est pains should be taken to remove every particle of dirt or dust from 
the inside as well as the outside, with water. To apply the test, till 
the jar with the air to be tested. This may be done either by draw¬ 
ing the air out of the bottle through a straw or tube, or by filling it with 
pure water and letting the water escape. Great care should be taken 
in sucking the air out of the bottle that the breath be not allowed to 
enter. To determine the amount of carbonic acid present, use the 
smallest jar first. After filling it in the manner described, pour in a 
large table-spoonful of clear lime-water. Close the mouth with a clean 
stopper and shake vigorously for a minute or two. If the lime-water 
becomes cloudy, carbonic acid is present in the air in the proportion 
of 10 parts to 10,000. If it does not become cloudy, repeat the ex¬ 
periment with the next sized jar or the half-pint jar. If the lime- 
water becomes cloudy in this, the proportion of carbonic acid is 8 
parts in 10,000. This proportion may often be found in the rooms of 
dwelling-houses, and sometimes in crowded streets and narrow alleys. 
If the lime-water does not become cloudy in the jar of this size, the 
next size should be used in the same manner. The cloudiness appear¬ 
ing in this jar indicates the presence of 6 parts in 10,000. This is the 
largest proportion which may exist without actual danger to life. If 
no cloudiness appears without the employment of the largest jar, the 
proportion is only 4 parts of carbonic acid to 10,000 of pure air. 

Carbonic oxide, or more properly, carbon mon-oxide, is a gas closely 
allied to carbonic acid in its chemical composition, though very much 
more dangerous. This gas is produced only by incomplete oxidation. 
It is always found in the burning of coal in grates and stoves, but as 
it is a combustible gas, it is usually consumed, and so gives rise to no 
evil consequences. It is the burning of this gas which produces the 
blue flame characteristic of coal-fires. When the draft of a stove or 
range is seriously obstructed, this gas often finds its way into the air 
breathed by human beings. By its penetrating character it readily 
passes out of stoves seemingly air-tight through the minute cracks be¬ 
tween the different pieces of iron of which the stove is composed. It 
has been shown by experiment, also, that it passes with great facility 
through cast-iron when heated red-hot. This does not take place, 
however, so long as there is a sufficient draft, as that portion of the 
gas which escapes combustion is carried away with the smoke. When¬ 
ever the draft is obstructed, however, there is danger that this ex¬ 
ceedingly poisonous gas may find its way into the air and be taken 

35 


54G 


HYGIENE OF THE AIR. 


into the lungs. Carbonic oxide is also produced by gas-jets and lamps 
when turned down so low that incomplete combustion of the escaping 
gases takes place. The amount of gas which may be produced in 
this way is so great that serious consequences may result where 
ventilation is defective, as in sleeping in a close bed-room where the 
gas-jet or lamp is turned down very low, since it requires but an ex¬ 
ceedingly small proportion of this gas to produce serious effects. Or¬ 
dinary burning gas usually contains quite a large proportion of car¬ 
bonic oxide and it is undoubtedly the presence of this gas which causes 
the inhalation of coal-gas to produce such fatal results. Death is pro¬ 
duced by carbonic oxide by its paralyzing effect upon the blood-cor¬ 
puscles. It renders them incapable of absorbing oxygen, so that a 
person poisoned by it really dies of suffocation. 

To avoid danger of poisoning from carbonic oxide, the following 
suggestions should always be observed: First, avoid the use of close 
dampers in stoves or stove-pipes, and always secure a good draft from 
coal-grates; second, never allow the fire-box of a heating furnace to 
become red-hot; third, never allow gas-jets or lamps to burn when 
turned down so low that combustion is incomplete. The indication 
of the incomplete combustion of gas or oil is the presence of odors by 
which they are characterized and which may always be observed when 
a room is entered where a gas-jet or lamp turned low has been burn¬ 
ing for some time. Of the other poisonous gases which find their way 
into our rooms, the most injurious is sulphureted hydrogen, a gas 
which is always produced in the decomposition of animal matter. It 
has a very strong odor,—that of rotten eggs, and is very poisonous in 
character. It is present in sewer-gas, in the gas escaping from vaults, 
cesspools, barn-yards, and all emanations from decomposing animal 
excreta as well as from decaying animal bodies. The odor of car¬ 
rion is strongly laden with sulphureted hydrogen, and this is one of the 
most common sources of the gas, since small animals not infrequently 
secrete themselves in the open spaces underneath dwellings, when 
about to die. Chickens, cats, dogs, and other animals often die and 
undergo decomposition in such places. It is on this account very un¬ 
wise to use poison of any kind for the purpose of getting rid of rats 
and mice or other small animals. We have known instances to occur 
in which dwellings became almost uninhabitable from the eras arisino- 
from the decayed rats which had been poisoned and died between the 
walls and partitions, and in other inaccessible places. In the gutters, 


SULPHURIC ACID. 


547 


back streets, and alleys of large cities, this gas is sometimes produced 
in such enormous quantities that its chemical properties become per¬ 
ceptible, as well illustrated by the following anecdote which we heard 
related by a professor of chemistry in one of our State Universities:— 

“ A young lady who was entirely innocent of any knowledge of 
chemistry or chemical facts, emerged from an elegant mansion in New 
York City, fully equipped for an afternoon promenade, with face ar¬ 
tistically painted a la mode. Pier course, unfortunately, lay for a lit¬ 
tle distance through a portion of the city where the drainage was im¬ 
perfect, and the air was consequently redolent with that wonderfully 
pungent and active gas which is so characteristic of rotten eggs,—sul- 
phureted hydrogen. Of course the lady could not be unconscious of 
the presence of some noxious element in the atmosphere; but she was, 
nevertheless, wholly ignorant of its chemical properties. Her igno¬ 
rance did not, however, deter the gas from manifesting its most vig¬ 
orous affinities for the lead paint upon her cheeks, of which she had 
abundant evidence as she stood before a mirror, upon her return home, 
and viewed the swarthy appearance of her countenance, which would 
have been very becoming to a representative member of the African 
race.” 

Ammonia is often present in the air arising from animal decompo¬ 
sition, its chief source being cesspools, vaults, and particularly stables 
and barn-yards. It is exceedingly disagreeable, but is not actively 
poisonous in such a degree as the other gases mentioned. 

Sulphuric acid is not infrequently present in the air, sometimes 
in considerable quantities in consequence of the combustion of coal, 
which always contains more or less sulphur, as well as from the burn¬ 
ing of coal-gas. The quantity of this acid produced in large cities 
where much coal is burned occasions the crumbling of brick and stone 
buildings, and in libraries it has often been known to destroy the 
leather binding of books exposed to its action, it being found not in¬ 
frequently that the binding of all the books on the higher shelves of 
the library become so brittle that rebinding is necessary. 

Complaint has also been made by wholesale dry-goods merchants 
in London that cotton goods and other fabrics stored on the upper 
shelves of high rooms and the upper stories of buildings, when kept on 
hand for some time, are injured to such an extent by the sulphuric acid 
produced by the burning gas as to become rotten and unsalable. 

There is no doubt but that the poisonous and irritating effects of 


548 


HYGIENE OF THE AIR. 


sulphuric acid produced in this way is a common cause of disease, af¬ 
fecting the air-passages. The evils arising from the vapors of this 
acid are now so well recognized that in large hospitals there is placed 
over each gas-burner a pipe for the purpose of conveying away the 
poisonous products of combustion. The evil is also remedied in some 
places by the use of gas produced by a mixture of gasoline vapor with 
air, a method which involves some inconvenience, but is recommended 
by its cheapness, its safety, the quality of the light produced by it, the 
absence of actively poisonous properties in the gas, and the entire ab¬ 
sence of active poisons in the products of combustion. This method 
of lighting has now been in use for more than two years at the Med¬ 
ical and Surgical Sanitarium, Battle Creek, Mich. 

Other noxious gases arising from chemical works, dye-houses, etc., 
are so seldom met with, or are so obviously injurious in character, 
that we do not need to mention them in detail. 



Fig-. 181. Atmospheric Germs Greatly Maguilied. 


Disease Germs. —Modern science has demonstrated through the 
aid of that wonderful little instrument, the microscope, that the most 
powerful of all the enemies to human life are those which are most 
insignificant in size. Through the researches of Pasteur, Tyndall, and 
other eminent workers in this field, it has been shown beyond a chance 
for question that the air which we breathe always contains in greater 
or lesser numbers minute living bodies known as germs. In Fig. 181 
may be seen some of these minute organisms greatly magnified. As 
seen in the cut, they are simply roundish bodies, mixed with other 
bodies of various shapes, which are particles of dust as seen when 
greatly magnified. Wherever decay of either animal or vegetable 
matter has taken place, germs are developed and given off in 
great numbers. Mold from moldy bread, when placed under the 
microscope, may be seen to throw off into the air an immense number 
of minute particles termed spores, which are capable not only of giv- 


DISEASE GERMS. 


519 


ing rise to growths of mold, but is thought by scientists to be active 
in producing some forms of disease. Some so-called germs are ani¬ 
malcules, while others are germs of vegetable life. It is the presence 
of certain varieties of these little germs which occasions the fermenta¬ 
tion of beer, the “ rising ” of bread, the “ working ” of cider, and the 
“spoiling” of canned fruit and other preserved products, the “sour¬ 
ing” of milk, and all kinds of decay and decomposition. The condi¬ 
tions required for the growth and development of these minute organ¬ 
isms are warmth and moisture. In winter they are paralyzed by the 
cold, but as soon as the vernal sun appears, they spring quickly into 
life and activity. They are not affected by a very low temperature, 
and have even been known to withstand for hours a temperature con¬ 
siderably above that of boiling water. In the vicinity of cesspools, 
vaults, barn-yards, and other places where decomposition is going on, 
the air is heavily laden with these disease-producing agencies. 

Their office in the economy of nature seems to be to destroy bodies 
possessing higher forms of life, or, at any rate, to assist higher forms 
of organization to return to the inorganic or unorganized state. When 
the body is kept in a healthy condition, all its tissues possessing a 
high degree of vitality, it is unaffected by these agents of decay and 
death; but so soon as the standard of vitality is lowered in any de¬ 
gree, or when the system is attacked by germs in great numbers, pos¬ 
sessing unusually active properties, we become a prey to their ravages 
and subject to a variety of maladies of the most fatal character. There 
seems to be at present little room for doubt that typhus and diph¬ 
theria, cerebro-spinal meningitis, malarial fevers, all of the contagious 
diseases, and perhaps a large number of others, the cause of which has 
not been so carefully studied, are produced by these agents. The 
presence of germs in the air cannot be very readily detected by any 
test which relates directly to them, but it may be safely considered 
that whenever and wherever foul odors are present, germs are also to 
be found, since these two sources of disease are almost invariably as¬ 
sociated together, having the same origin. 

It should be remembered, however, that germs may be present 
when foul odors are not, since they may be formed and given off be¬ 
fore a sufficient degree of decomposition has taken place to give rise 
to offensive gases. This fact should lead to the prompt removal of 
anything which is known to be a source of germs, since these minute 
and invisible bodies are far more serious in their effects upon the hu- 


550 


HYGIENE OF THE AIK. 


man system than any foul gas with which the air is ordinarily con¬ 
taminated. The mold upon the wall should be regarded with the 
gravest suspicion, and measures should be promptly taken for a re¬ 
moval of its cause. A musty odor is evidence of the presence in the 
air of spores thrown off by mold which may become the cause of seri¬ 
ous disease. 

Dust. —It is next to impossible to obtain air wholly free from dust. 
Its constant motion lifts and holds suspended little particles of various 
substances which are more or less injurious to health, unless the quan¬ 
tity is very small indeed. Some trades, as stone-cutting, coal-heaving, 
rag-picking, cotton and wool spinning and weaving, and other voca¬ 
tions which involve the production of considerable quantities of dust, 
expose the workmen to an atmosphere loaded with fine particles which 
are drawn into the lungs with every breath, and, finding lodgment 
there, may induce irritation and still more serious disease of those or¬ 
gans. By a w r onderful provision of nature, as elsewhere explained, 
the finer particles of dust, if in small quantity, may be wholly re¬ 
moved so that they will not pass down into the more delicate air-cells 
of the lungs; but if the quantity of dust is great, this provision fails 
to afford protection. 

The inhalation of dust is one of the causes of consumption. Post¬ 
mortem examination of the lungs of persons who had died from this 
cause showed the lungs to have acquired the color of the particles in¬ 
haled ; and, in some cases, they contained so large a quantity of sand 
that they felt gritty to the touch. 

Great care should always be taken to avoid dust as much as possi¬ 
ble. In sweeping carpets and dirty floors, a person is exposed to in¬ 
jury unless some precaution, such as sprinkling the floor or moisten¬ 
ing the broom, is taken to prevent filling the air with dirt. There 
are very few people who would not turn with disgust from food which 
was filled with particles of coal or sand, covered with dust, and gritty 
to the teeth. Yet the same persons will take their gaseous food in 
precisely the same condition without remonstrance. 

If necessarily exposed to dust for a time, danger from its inhala¬ 
tion may be avoided by applying over the mouth and nostrils a cotton¬ 
wool respirator, by means of which the air will be strained. A pocket- 
handkerchief will answer a very good purpose in the absence of a res¬ 
pirator. 

Organic Poison. —Gases, germs, and dust are most prolific sources 
of disease and death which attack man from the air; but there is vet 


ORGANIC POISON. 


551 


another enemy of life more potent still, which lurks, too often unsus¬ 
pected, in the air we breathe. Very little, indeed, is known of the real 
nature of this poison, since it has, in considerable degree, eluded the 
efforts of the chemist to submit it to analysis; but it is of organic ori¬ 
gin, and hence is known by the term organic poison. This poisonous 
element is introduced into the air chiefly by means of respiration, to¬ 
gether with exhalations from the skin. It is one of the most noxious 
poisons ever present in air. It will produce death much sooner than 
most other impurities found in the air. Experiments have shown 
that mice and other small animals will die in a few minutes when 
confined in air heavily charged with this poison. The moisture 
which condenses on the inside of the windows of an occupied 
room in a cold day contains the poison in solution. If a little is 
collected in a vial and set away, it will soon become intensely fetid 
and offensive ; and when examined with the microscope it is found to 
be alive with vegetable growths and various animal forms. This poi¬ 
son also condenses on the walls and furniture of close, unventilated 
rooms, and a characteristic odor frequently emanates from them, 
and often clings to the clothing and bodies of persons living in them. 
This poison undergoes decomposition very rapidly, becoming foul and 
offensive in a few minutes. It is this which gives to an unventilated 
room the close, fusty odor with which every one is familiar. One who 
has been long in the room will not observe it; but it is very distinct 
to a person coming in directly from the pure air outside. 

The amount of matter which is thus condensed upon and absorbed 
by plaster walls is much greater than is ordinarily supposed. Two 
causes operate to concentrate these fatally poisonous substances in the 
porous plaster walls of living-rooms of dwelling houses : first, the con¬ 
densation of the moisture of the breath on the walls, which are usually 
cooler than the atmosphere of the room ; second, the process which 
takes place through all porous walls, the inside air passing outward 
while the outside air is passing in. By these two processes such a 
large quantity is deposited that in the course of time the walls of the 
room may become highly charged with it. It is said that an ingenious 
Chinaman has discovered this fact, and that he finds it profitable to re¬ 
move all the plaster from his dwelling once in ten or fifteen years, re¬ 
placing it with new, using the old plaster to fertilize the soil. It is 
certainly well worth while to inquire whether it would not be wise 
for sanitarians to advocate the general adoption of this ( hinese cus- 


HYGIENE OF THE AIR. 


tom. We have no doubt it would be the means of saving a large 
amount of disease. The sovereign remedy for all evils resulting from 
the accumulation of the waste products of respiration, is, of course, 
thorough and efficient ventilation, the means for which will be pointed 
out under that head. 

Various Sources of Dangerous Gases and Disease Germs.— 

Under this head we shall notice various sources of air contamination 
which we have not yet referred to, or have barely mentioned, many of 
which are often the unsuspected causes of wide-spread and fatal dis¬ 
ease. 

Cellars. —Many families who wonder “ why some of the children 
are sick all the time ” can find the cause underneath the floor. Nearly 
all houses have cellars. Here are stored all sorts of things for winter 
use—dead things and live things, articles to eat and fuel to burn, old 
boxes and barrels, heaps of coal, bins of vegetables, etc., etc. The coal 
and wood are continually sending up foul gases. Many of the vegeta¬ 
bles undergo decay, and add greatly to the formation of disease-pro¬ 
ducing elements. Besides the cellar, there is usually an open space un¬ 
der the other portions of the house, between the foundation walls. 
In the country this space is often large enough to admit dogs, cats, 
pigs, and Other small animals, but not sufficiently large to allow room 
for cleaning it. Here various small animals find a hiding-place, and 
often die. Being out of sight and reach, they are not discovered even 
when the stench of their decaying bodies becomes distinctly manifest. 

All the foul gases engendered in these various ways pass upward 
into the house, filling every room, condensing in fetid moisture upon 
the walls, and poisoning all who breathe in the house. 

Cellars under houses are rather prejudicial to health, even at best. 
As they are commonly used, they are very greatly so. If there must 
be cellars beneath the house, they should be large, light, and well ven¬ 
tilated. Every week, at least, the cellar windows should be opened 
wide to allow free change of air. A good way to ventilate a cellar is 
to extend from it a pipe to the kitchen chimney. The draft in the 
chimney will carry away the gases which would otherwise find their 
way into the rooms above. 

Cellars should be kept clear of decaying vegetables, wood, wet 
coal, and mold. The walls should be frequently whitewashed, or 
washed with a strong solution of copperas. The importance of some 
of these simple measures cannot well be overestimated. 


MOLDY WALLS. 


553 


Houses should be built so high above the ground that the space 
beneath can be easily cleaned every few months. 

Moldy W.alls. —Many people who do not appreciate the impor¬ 
tance of sunshine as they should, allow mold and mildew to accumu¬ 
late upon their walls in damp weather, especially in nooks and corners 
that will be unobserved, never thinking that any harm will' come from 
so doing. Such are ignorant of the fact that each patch of mold is a 
forest of millions of little plants which are constantly throwing off 
into the air myriads of germs to be inhaled by the occupants of the 
house. There is good evidence for believing that the forms of leprosy 
described in the Jewish law as affecting the house were nothing less 
than certain forms of mold or fungoid growths which are especially 
liable to occur in warm countries like the land of Palestine. The de¬ 
scription of the so-called “ leprosy in the house,” together with the 
proper means to be adopted to remove the difficulty, may be found in 
Lev. 14 : 36-48 as follows :— 

“ Then the priest shall command that they empty the house, before 
the priest go into it to see the plague, that all that is in the house be 
not made unclean; and afterward the priest shall go in to sec the 
house ; and he shall look on the plague, and, behold, if the plague be 
in the walls of the house with hollow streaks, greenish or reddish, 
which in sight are low^er than the wall, then the priest shall go out of 
the house to the door of the house, and shut up the house seven days; 
and the priest shall come again the seventh day, and shall look; and, 
behold, if the plague be spread in the "walls of the house, then the 
priest shall command that they take away the stones in which the 
plague is, and they shall cast them into an unclean place without the 
city ; and he shall cause the house to be scraped within round about, 
and they shall pour out the dust that they scrape off without the city 
into an unclean place; and they shall take other stones, and put them 
in the place of those stones ; and he shall take other mortar, and shall 
plaster the house. 

“ And if the plague come again, and break out in the house, after 
that he hath taken away the stones, and after he hath scraped the 
house, and after it is plastered, then the priest shall come and look, 
and, behold, if the plague be spread in the house, it is a fretting 
leprosy in the house; it is unclean. And he shall break down the 
house, the stones of it, and the timber thereof, and all the mortar of 
the house; and he shall carry them forth out of the city into an un- 


554 


HYGIENE OF TI1E AIR. 


clean place. Moreover, he that goeth into the house all the while that 
it is shut up shall be unclean until the even. And he that lieth in the 
house shall wash his clothes; and he that eateth in the house shall 
wash his clothes. And if the priest shall come in and look upon it, 
and, behold, the plague hath not spread in the house, after the house 
was plastered, then the priest shall pronounce the house clean, because 
the plague is healed.” 

Many have puzzled themselves much respecting the nature of the 
leprosy above described; but when we consider the description given, 
in the light of modern sanitary science, the meaning is plain. The 
description answers exactly to certain species of mold which are apt 
to form on damp walls, being sometimes greenish and sometimes red¬ 
dish in color. The mold itself is not communicable to human beings, 
but as it grows it throws off into the air myriads of germs which give 
rise to fermentation and putrefaction, and when taken into the human 
system, to serious disease. The directions given for removing the evil 
are most excellent. If scraping off the mold and the plaster of the 
house and replastering did not exterminate it, the house ought to be 
torn down, for the recurrence of the mold would indicate that the 
conditions connected with the location of the house were such as to 
render it unfit to live in. 

How many leprous houses may be found now-a-days ! The green 
spots on the wall, the musty odor, and the damp, germ-laden air to be 
found in many a palatial residence as well as in the spare bedroom 
and dark parlors of the less pretentious cottages of people of more 
limited means, are symptoms of house leprosy which, three thousand 
years ago, would have consigned the infected dwellings to demolition. 
Are we thirty centuries behind Moses in our knowledge of, and obedi¬ 
ence to, sanitary law ? 

Privies. —As ordinarily constructed and managed, these necessary 
institutions are most prolific sources of disease. The animal excre¬ 
tions which are left to accumulate in them undergo still further putre¬ 
factive changes, which result in the development of the most pestilen¬ 
tial germs and gases. Here is where the terrible typhoid poison 
originates. Deep vaults should never be allowed under any circum¬ 
stances. The best way to manage a privy is this : Early in the spring 
fill up the old vault, if there is one, even with the surface. Raise the * 
building a little. Have made at the tin-shop a sufficient number of 
pails of galvanized iron. The pails should be of the form and size 


DRY-EARTH SYSTEM. 


odd 



Fig. 182. Pail for use with 
Dry-Earth System. 


indicated in Fig. 182. Each should be furnished with a long hail, 
and a strong handle at one side. In using these pails fill each half 
full of fine, dry dirt (not sand) or ashes, and 
shove it into position, as shown in Fig. 183. 

By the addition of a little dry dirt two or 
three times a day, all foul odors will be pre 
vented. The contents of the pails ought to 
be removed every night in the warmest 
weather of summer, the pails being replaced 
with a fresh supply of dry earth. During 
cooler weather, if little used, the pails will 
require emptying but once a week, if they 
are kept well supplied with dry earth. The 

contents of the pails may be buried or removed to a proper place at a 
distance from any dwelling or well. 

For convenience, it is found 
to be an excellent plan to hire a 
scavenger to attend to the pails 
at regular, stated times. Fifteen 
or twenty in a community can 
unite on the same plan, and 
thus make the expense very 
slight for each. 

We introduced this plan at 
the Battle Creek College, a 
large educational institution, 
as well as at the Sanitarium, 
w T here we have employed it for 
several years, and it has given 
perfect satisfaction from its 
first introduction. The same 
plan has, at our suggestion, 
been recently adopted by the 
trustees of another large edu¬ 
cational institution in this 
State. It has also been largely 
adopted in this city for the 
warm season of the year, with 
excellent results. 





























556 


HYGIENE OF THE AIR. 


About the first of December, the pails may be removed and a 
shallow vault dug. The vault should not exceed two feet in depth 
and it should not be tightly inclosed. This will allow the contents of 
the vault to freeze. They may be removed several times during the 
winter, and should be kept covered with dry dirt, which should be 
procured in sufficient quantitylin the fall. 

Persons living in houses connected with sewers, as is customary in 
cities, incur great danger of injury from an exceedingly active agent 
of disease known as sewer-gas. Sewers are often unventilated, and 
become blocked up so that the confined gases find exit through the 
sinks, wash-bowls, bath-tubs, and water-closets of the houses with 
which they are connected. It is of the greatest importance that all 
connections with the sewers should be made air-tight, and should be 
guarded with traps of the most improved form, so as to make the en¬ 
trance of sewer-gas impossible. The sewer-pipes connected with the 
water-closets should be carried directly upward through the roof, and 
surmounted by a ventilating cap of the most improved form. This 
plan would ordinarily prevent any great danger from this source. 
Water-closets should be placed in a part of the building where they 
will not be likely to contaminate other rooms in the house, should 
they become foul. They should be thoroughly ventilated. 

Barn-yards, Hen-coops, etc. —The close proximity of barn-yards, 
hen-coops, and hog-pens to human dwellings is a frequent cause of 
serious and fatal disease. The germs which are developed in the filth 
abounding in those places, together with the noxious gases constantly 
arising from the decomposing excreta, are productive of disease when 
received into the system. Often, indeed, the well from which the 
family supply of water is obtained will be located only a few feet 
from a reeking barn-yard, or, as we have more than once seen, the well 
will, for convenience, be located within the yard itself. In consequence 
of the proximity, the water of the well will be contaminated by the 
soluble filth which percolates down through the porous earth and finds 
its way into the underground veins of water by which the well 
is fed. See Plate XVI. 

A few years ago a man came under our care at the Sanitarium 
suffering with what he supposed to be ague. Upon examination of 
his case, we very soon became convinced that his disease was typhoid 
fever instead, a view which was confirmed by the further history of 
the case. In less than a week, the son, a boy twelve or fourteen years 





Showing a not infrequent condition of affairs. The cesspool in close proximity to the 
cistern, contaminates it by the drainage of its foul contents through the porous soil, so 
that both become sources of disease and death. The well, located in the barn-yard for 
convenience, and near the privy vault, receives the foul drainage from both; while from 
the same foul source poisonous gases constantly arise and carry disease and death to the 
unsuspecting inmates of the house close by. 



Fig. 3. 

A condition very similar to that shown in Fig. 1, except that in this case the chief 
source of danger is the foul emanations from the cellar, vault, hog pen. and hen house. 


Plate XVI — INSANITARY CONDITIONS. 


% 


















































BARN-YARDS, HEN-COOPS, ETC. 


557 


of age, who was troubled with “ fits,” arrived, and his case also proved 
to be typhoid fever. In less than another week, the wife and mother 
joined the other members of the family, suffering, as she said, with 
the chills, hut, as we speedily found, with typhoid fever also. We 
placed the afflicted family in a cottage, with nurses, and in due time 
they were all convalescent, although they suffered very severely and 
were each exceedingly ill for several days. When the father, who first 
became convalescent, was just beginning to recover, we one day called 
upon him, when he began to reproach himself in the most bitter 
terms for his sickness and that of the other members of his family. 
He remarked that he cared less for the suffering he had endured and 
the expense he had incurred than he otherwise should but for the bit¬ 
ter consciousness that he was wholly to blame for it all, and ought to 
have known better than to allow the conditions to occur which occa¬ 
sioned the suffering. He then recited to us how, a year previous, 
thinking to increase his income somewhat, his wife proposed 
to raise a flock of chickens, and for her convenience a hen¬ 
house had been moved to within a few feet of the back-door 
During the few months previous to their sickness, three hundred 
chickens had been hatched and brought up in close proximity to the 
house, and the natural consequence was that the door-yard was in a 
condition little less repulsive than the most filthy pig-st} r . Foul gases 
were constantly arising and being carried into the house, together 
with countless numbers of germs. The process continued until the 
whole family were thoroughly poisoned, and much-abused nature 
finally manifested her resentment in a manner which was in the highest 
degree unpleasant and expensive, in more ways than one. We have 
no doubt that hundreds of cases of typhoid fever have been produced 
in a similar manner, and that people often look a long way from home 
for causes of disease which exist within the limits of their own 
premises. 

Notwithstanding all these dangers, there are people who, incredi¬ 
ble as it may seem, still hold to the absurd idea generated in the Dark 
Ages, when the streets of every city were one immense reeking cess¬ 
pool, that foul smells originating in the filthy ordure of horses and 
cows possess some healing properties. Not long ago, when we appealed 
to a man to clear his barn-yard, which had become a positive nuisance, 
being not more than half a dozen feet from the threshold of a dwell- 
ing-house, he retorted that he had always been informed, and as he 


558 


HYGIENE OF THE AIR. 


thought by good authority, that a barn-yard smell was the “ healthiest 
kind of a smell,” and was “ especially good for consumptives.” If 
there is such an absurd error prevalent, it ought certainly to be cor¬ 
rected. No foul, noxious odor can be of any possible advantage to 
the health. Barn-yards should be located at least forty or fifty rods 
away from the dwelling, and farther if possible. 

Brains and Cesspools. —Drains, sewers, and cesspools, connected 
with a house are often sources of serious disease. The kitchen sink is 
not infrequently the door through which the germs of disease silently 
creep into a household and develop into disease and death, the cause of 
which remains a mystery and is attributed to the inscrutable dealings of 
Providence. 

In the summer, draughts are produced in the room, which suck up 
the filthy gases which are formed in the cesspool' or sewer, through the 
drain pipe,—unless it is furnished with an efficient water-trap, which is 
not usually the case. In the winter, the gases of the cesspool are nat¬ 
urally warmer than the air above, and so they rise and find their way 
into the house, filling it with invisible poison, which is breathed, and 
thus taken into the blood, by every occupant of the dwelling. Thou¬ 
sands of valuable lives are annually sacrificed in this way. 

How shall this evil be remedied ? In cities, the problem is a difficult 
one, unless sewers can be replaced by the dry-earth system. In the 
country and in small towns, it is easily cured thus:— 

Make the cesspool some little distance from 
the house. Place in communication with it 
a ventilating flue sixteen or eighteen feet in 
height, and four to six inches in diameter, and 
surmounted by a ventilator. This will carry 
off’ the foul gases under ordinary circumstances, 
but it will sometimes be found inefficient; hence, 
a water-trap should be formed in the drain-pipe, 
just beneath the sink, by bending the pipe so that it will retain con¬ 
stantly three or four inches of water. S^e Plate XV, and Fig. 184 . 

Another good way is to connect the drain-pipe with the chimney or 
stove-pipedby means of a pipe of suitable size. This will secure ventila¬ 
tion of the drain, except when there is no heat in the chimney 

Another valuable precaution is this: Pour into the sink two or three 
times a week a gallon of water in which a pound of copperas has been 
dissolved. A few crystals of copperas kept constantly in the sink could 




















Fig. l. 

The above cut is an illustration of a very common source of disease. At the left hand 
is shown a house, the inmates of which are being poisoned bv destructive gases (shown in 
blue) laden with disease germs which emanate from the cellar in which may be seen bins 
and barrels of decomposing vegetables, and the cesspool, tilled with the accumulations of 
years. The foul gases and germs from the cellar find ready access to the rooms above 
through the open cellar door, and from the seething cesspool they ascend to the house 
through the untrapped drain pipe which communicates with the sink. At the right hand 
may be 6een a house which is protected from cesspool contamination by means of a trap 
in the drain pipe. As will be seen, the foul gases, represented by the blue color, pass up 
through the ventilating pipe into the open air, instead of being drawn up into the house 
through the kitchen sink. 


Fig- *<J. 

This cut illustrates a condition of things not infrequently found in country villages, 
and even in cities, lhe house is situated in a hollow. The well, close bv, is seen to pass 
through a stratum of rock which follows the contour of the surface of the ground, a few 
feet below. Part-way up the hill at the right is a vault filled with the filthy accumu¬ 
lations of years. At the top of the hill is a barn with an accumulation of manure near. 
Upon the top of the hill at the left, is situated a cemetery. From these several sources 
there is a constant drainage, shown in the cut in blue, which is conducted by the rocky 
stratum directly to the well, which really becomes a cesspool, receiving the abominable 
filth from all the sources mentioned. This is a true picture of a state of things which has 
been proven by careful sanitary surveys to exist in numerous instances. 



Plate XV. 





































































DANGER FROM DECAYING WOOD. 


oof) 


do no harm. It is very cheap when bought by the quantity. A new 
cesspool should be made at least once a year or the old one thoroughly 
cleaned. 

Decaying Wood. —While it is now pretty generally understood 
that decaying substances emit dangerous gases and other causes of dis¬ 
ease to which human beings cannot be exposed without danger, it is not 
so generally known that the same danger accompanies the decay of 
wood as of other forms of vegetable decomposition. 

At the Nashville meeting of the American Public Health Associa¬ 
tion, 1879, Dr. Brewer, President of the Connecticut State Board of 
Health and professor of Agriculture in Harvard University, read a 
highly interesting paper describing a series of experiments on the sub¬ 
ject, by which he had found that this is a matter of much greater im¬ 
portance than has been heretofore supposed. He found that green wood 
placed in pure water, even when the water is many times greater in 
bulk than the wood, very soon gives rise to the most active evidences of 
decomposition. Within two or three days the liquid in which such wood 
has been placed becomes very foul smelling, and upon examination with 
the microscope is found to contain myriads of microscopic organisms, 
just such as are always found present where decomposition is going on. 
In a very short time the liquid becomes dark colored and very foul, con¬ 
tinuing thus for years. The Doctor found that this occurs with all va¬ 
rieties of wood, the hardest woods as well as the soft varieties readily in¬ 
ducing decay when placed in water. 

In view of these facts it is very evident that there is great need of 
reform on the part of many who consider themselves models of obedi¬ 
ence to sanitary law. It appears that wood-piles, heaps of chips about 
the door-yard, rotten plank walks, decaying sawdust and shavings in 
the vicinity of saw-mills and other wood-working establishments, are 
about as much to be feared as heaps of garbage or manure, cesspools, 
neglected privy vaults, and similar nuisances. These facts also afford a 
strong argument against the use of wood for piles, well-curbing, or for 
any other purpose that will bring it in contact with moisture, and sug¬ 
gest that danger may exist in the neglected wood-box behind the 
kitchen fire, as well as from sewer-gas emanating from an untrapped 
water-closet. 

The practice which exists in many lumbering districts of discharging 
great quantities of sawdust into streams, the water of which is in many 
cases afterward used for drinking purposes, is a very pernicious one in- 


560 


HYGIENE OF THE AIE. 


deed. If the water contains a large amount of clay in suspension, the 
earthy matter may combine with the substances dissolved out of the 
wood and thus prevent the decomposition which would otherwise occur. 
As an evidence that this is not a mere theoretical difficulty, we may 
mention the fact that a complaint was entered to the Michigan State 
Board of Health not long since, by persons living in the lumbering re • 
gions, against the very practice last referred to, on the ground that it 
was injurious to health; and the health officer of one of the lumbering 
cities of the State says, in his annual report for 1879, that the principal 
source of danger to life and health is the accumulations of sawdust 
about the mills in the vicinity. A bill providing for the prevention of 
the practice of putting sawdust into streams has recently been intro¬ 
duced into Congress, and, it is to be hoped, will be passed. 

Dr. Coleman, member of the Richmond Academy of Medicine, in a 
paper read before that body and reported in the Virginia Medical 
Monthly, Yol. 8, No. 9, page 721, takes the ground that emanations 
from decaying wood are among the active causes of typhoid fever. In 
illustration, he said that the inmates of a house in Richmond, built over a 
pile of decaying shavings, had suffered from typhoid fever for four suc¬ 
cessive years. After the shavings were removed, no more cases of fever 
occurred. As another illustration, he stated that during the war his briof : 
ade occupied for some time, during the Virginia campaign, a field where 
the trees had been girdled and many had fallen down from decay. Next to 
his command another brigade encamped in a grove of living trees. Out 
of 850 men encamped in the belted woods, 600 had the so-called camp- 
fever—really typhoid—whereas only five persons of those camping in 
the other brigade had the disease. He also called attention to a fact 
well remembered by the older physicians of the city,—that cases of 
typhoid fever were very numerous in the city immediately after the 
war, which he attributed to the fact that material and labor being 
scarce and expensive it was next to impossible to make proper repairs 
in the houses, many of which, in the wooden parts, were considerably 
advanced in decay, especially in the basement floors. He had no doubt 
that the unusual prevalence of fever was due to the emanations from the 
decaying timbers. The Doctor instanced a number of cases which came 
under his notice in support of his views. 

Feather-beds and Soiled Clothing.— The use of feather-beds may 

be shown to be detrimental to health in several ways; but we wish to 
call attention to the fact that they may be a source of contamination of 


FEATHER-BEDS AND SOILED CLOTHING. 


5(31 


the air immediately surrounding a person during sleep. They not only 
themselves undergo a slow decomposition evolving foul and poisonous 
gases, but on account of their remarkable hygroscopic properties, in 
which they are equaled by few other substances, they absorb fetid ex¬ 
halations from the body which are thrown off from the skin during 
sleep. As this continues often for a long time, the accumulation may 
become very great and the feather-bed be converted into a hot-bed of 
disease germs. As feathers sutler little loss by use, the feather-bed often 
becomes an heir-loom and is passed down from one generation to another. 
The older it becomes, the worse it is. It is somewhat alarming to reflect 
upon the amount of disease germs which may be stowed away in a sack 
of feathers which has done service during a hundred years or more. 
Subject to all the accidents and emergencies of domestic life, it has, per¬ 
haps, carried half a dozen persons through typhoid fever and pillowed 
the last months of the gradual dissolution of a consumptive, besides 
being in constant use the balance of the time. We have on several oc¬ 
casions been so unfortunate as to be obliged to sleep upon feather-beds 
from which odors arose so intense and disgusting as to be almost unen¬ 
durable. More than once we have, as a last resort, been obliged to pull 
our bed to pieces and remove the offensive portion of it before being able 
to go to sleep. Hair, cotton, straw, and husk mattresses are greatly 
superior to feathers from a hygienic stand-point. By means of a recent 
invention, felt mattresses are now made which are luxurious enough for 
any one and entirely wholesome. From the opportunity we have had 
of inspecting the use of this kind of mattress we believe it to be the best 
for the purpose of anything in use. 

The custom, more common in the old country than in this, of allow¬ 
ing soiled clothes to accumulate in closets, or other places, for several 
weeks often becomes a serious injury to health. This is especially the 
case in the summer season when under-clothing frequently becomes satu¬ 
rated with perspiration. The odor arising from soiled underclothing Is 
essentially the same as that which comes from the organic matter escap¬ 
ing from the lungs, and is almost equally poisonous in character. If 
clothing can not be washed within a week or two after it is has been 
worn, it should be thoroughly exposed to the sun and air for at least 
twenty-four hours, by which means it will become sufficiently disinfected 
to obviate all danger from keeping it a longer time. 

Arsenical Papers.— Many cases of poisoning, some fatal, have been 
traced to the use of wall-papers the colors of which contained arsenic. 

36 


562 


HYGIENE OF THE AIR. 


Window-curtains, paper boxes, and even articles of clothing have be¬ 
come sources of poisoning in the same way. The color of wall-paper 
which most frequently contains arsenic is green, although many other 
colors have been found to be contaminated in the same manner. It is 
almost impossible to find a green enameled paper which does not con¬ 
tain arsenic. The arsenical poison is dispersed through the air in the 
form of fine dust which is separated from the paper by the rubbing of 
garments, swinging of picture-frames, and in various other ways. 
Green window-curtains containing arsenic are particularly dangerous, 
as the frequent rolling and unrolling of the curtain communicates a 
large quantity of the poison to the air. It is believed also that the 
poison of wall-paper may be communicated to the air through the fer¬ 
mentation of the material used in attaching the paper to the wall, which 
decomposes the arsenical compound in the paint producing sulphureted 
hydrogen, one of the most deadly of all gases. This is especially likely 
to occur when new paper is put on without removing the old, a practice 
which can not be too severely condemned. We have seen walls upon 
which there were from four to eight layers of this arsenical wall-paper. 
In one case in which the wall already bore five layers of poisonous paper 
another was being added. Green wrapping paper, even that used in 
wrapping candies, has also been found to contain arsenic. It may be 
said that, in general, it is wise to avoid green colors altogether. Although 
all are not in a high degree poisonous, all are likely to be contaminated 
and may safely be avoided. It is very easy to test wall-paper before 
buying, and it would be wise to take the precaution to do so in all cases. 
The following is the most simple manner of testing it: Place a small 
piece of the paper—say two or three square inches—in a saucer, and 
pour over it strong ammonia water. If arsenic is present, it will be dis¬ 
solved by the ammonia. After leaving it to stand five or ten minutes, 
turn off the ammonia a little to one side, and drop into it one or two 
crystals of nitrate of silver. If arsenic is present, little yellow particles 
of arsenite of silver will soon make their appearance on the crystals 
of nitrate of silver. Green arsenical papers, when soaked in am¬ 
monia water, usually lose their color, or turn blue. 


IMPORTANCE OF VENTILATION 


503 


VENTILATION, 

Ventilation is rendered necessary chiefly by the contamination of 
the air by the foul and poisonous products of respiration and perspira¬ 
tion, and by the combustion incident to illumination, in the burning 
of gas, oil, and candles. It consists, essentially, not in absolute re¬ 
moval of all impurities from the air, but in diluting it to an extent suf¬ 
ficient to render it tolerable without producing disease. The amount 
of air needed for this purpose will of course depend upon the degree 
or rapidity of contamination. It will be useful for us to consider in 
this connection the rapidity with which the air becomes impure under 
ordinary circumstances. 

As already stated, a person produces or exhales at each breath one 
cubic inch of carbonic acid. Since the ordinary proportion of the gas 
is four parts to 10,000 of air, or two parts to 5,000, and the greatest 
amount consistent with health is three parts to 5,000 of air, it is ev¬ 
ident that a single cubic inch of carbonic acid gas renders unfit for 
respiration 5,000 cubic inches of air, or at least increases its propor¬ 
tion of impurities to such a degree that it may be breathed but once 
more without being injurious to the system. As in singing, speaking, 
when engaged in exercise, even when standing, although not actively 
exercising, there is a considerable increase in the depth of respiration, 
or the amount of air respired, so that considerably more than one 
cubic inch of carbonic acid is exhaled with each breath, while a con¬ 
siderable amount of contamination of the air occurs through the skin, 
which is not taken into the account, we may safely say that each 
breath renders unfit for breathing again, three cubic feet of air. With 
this fact as a practical basis, it is very easy to ascertain how long the 
air in an unventilated room of any given size will remain fit for res¬ 
piration. Let us take as an example a bedroom 9x10 and 10 feet 
high, with no means provided for ventilation. There are plenty such 
to be found. The capacity of such a room would be 900 cubic feet of 
air, which would all be rendered absolutely unfit to breathe, and in 
fact poisonous, by a single person breathing it at the rate of twenty 
respirations a minute for fifteen minutes. Two persons would re¬ 
quire but half the time. Two adults and a lamp, or two grown per¬ 
sons, a small child, and a candle, would produce the highest degree of 
contamination admissible in five minutes. These calculations are of 
course based upon the supposition that the room under consideration 


561 


HYGIENE OF THE AIR. 


is air-tight. Fortunately, however, this is not the case, no matter how 
studiously the architect or builder and the occupants may have en¬ 
deavored to guard against the possible entrance of a whiff of pure air. 
The life-giving element will find its way in, even through brick walls 
and solid masonry, and around the sides of the window-sash, through 
keyholes, and in every other possible way, though in quantities wholly 
inadequate to dilute the products of respiration to the point of safety. 
Examination of the air in crowded theaters has shown that the 
amount of carbonic acid present is often five to ten times as great as 
is consistent with safety to health. 

A little computation based on these facts will show that each per¬ 
son requires at least 3,000 cubic feet of fresh, pure air per hour to 
wash away and dilute the poisons poured forth from his own lungs 
and skin. Any system of ventilation is inadequate which does not 
supply this amount of air to each occupant of a dwelling, lecture- 
room, sitting-room, or sleeping apartment. Sick-rooms and hospitals 
require two or three times as much air as this, on account of the 
greatly increased amount of contamination. 

Plans of Ventilation. —In considering plans of ventilation it 
must be recollected that this quantity of air must be supplied with¬ 
out exposing persons to drafts of cold air. It is easy enough to get 
plenty of air, but to get it without drafts is often a problem of no little 
difficulty, especially in crowded assembly rooms, where a very rapid 
change of air is often necessary. 

Numerous plans for supplying pure air have been proposed and 
experimented with, and numerous ingenious devices have been adopted 
for use in special cases; but we have not space to enter into the con¬ 
sideration of these systems, as most of them are especially adapted to 
the ventilation of large buildings. Our object is merely to point out 
simple methods by which common dwelling-houses may be ventilated 
in accordance with the demands of hygiene. 

How to secure this 3,000 cubic feet, or more than two hundred 
hogsheads of pure air each hour, day and night, at all seasons of the 
year, is the problem which we wish especially to consider. The prin¬ 
ciples of correct ventilation are very simple, and yet they are so lit¬ 
tle understood that we have had the accompanying diagrams made, 
so that by illustration we may make the subject so clear that it can 
be easily comprehended by all. 

Fig. 185 represents a tall glass jar. A short piece of a lighted candle 


PLANS OF VENTILATION. 


5G5 


has been lowered into it by means of a wire with a shallow cup at 
the end. \\ hen the candle was first lowered it burned very brightly, 
but in a few seconds it began to grow dim, and in less than half a 
minute it ceased to burn, sending up smoke, as is seen in the figure, 
like a candle which has been blown out. 



The cause of the extinguishment of the candle is the accumulation 
in the bottom of the jar of carbonic acid. As this gas is incapable of 
supporting combustion, as well as respiration, the candle is put out by 
the poison generated by its own combustion. In a similar way, thou¬ 
sands of human beings annually die from the results of their own 
breathing, self-poisoned. The gas, being heavier than air, settles in 
the bottom of the jar. By repeating the experiment, and taking a lit- 


















































5G6 


HYGIENE OF THE AIE. 


tie pains, it is possible to obtain the jar quite full of this invisi¬ 
ble gaseous poison, which not only extinguishes candles in experiments 
such as the one described, but puts out the lives of more infants every 
year than are killed by cholera, the plague, small-pox and yellow fever 
combined. 

Fig. 186 shows the candle burning brightly in the glass jar. If 
watched closely, it will be seen that it flickers as though it were being 
blown with considerable violence, which evidently indicates that there 
is a strong draft, even in the bottom of the tall jar. What makes the 
difference ? The change in the behavior of the candle is wholly due to 
the fact that we have passed down into the jar, to within a few inches 
of the candle, a strip of card-board the width of which is nearly equal * 
to the diameter of the jar. By this means two openings are made, one 
of which allows the heated and impure air to pass up on one side of 
the card-board, while pure air passes down on the other side. Thus a 
circulation is made. This is still more clearly seen in Fig. 187, in which 
a smoking taper is held at the mouth of the jar. It will be observed 
that the smoke, instead of rising, as it usually does, is drawn down 
into the tube upon one side of the card-board septum, or partition, be¬ 
ing drawn up on the other, showing to the eye that quite a strong- 
draft exists. 

The lesson to be learned from these illustrations is that at least two 
openings are necessary in order that there shall be a draft or change 
of air. In Fig. 185 it is seen that the candle was extinguished, owing 
to the accumulation of carbonic acid, there being no draft to carry it 
away, so long as there was but one opening at the mouth of the jar; 
but as soon as the partition was introduced, the candle burned brightly 
and flickered in the draft created. This simple plan is often used in 
the ventilation of deep mines, a tight partition being built in the mid¬ 
dle of the descending shaft. It has happened that the partition in 
such mines has been destroyed by accident or fire, when the workmen 
in the mine have either suffered death from suffocation, or barely es¬ 
caped with their lives. A person shut up in a room with a single 
opening, as by a window lowered or raised a few inches, is exactly in 
the condition, so far as his supply of fresh air is concerned, of the can¬ 
dle in the bottom of the jar, or the miner at the bottom of a shaft 
without a partition. Instead of smothering at once, however, he will 
suffocate by degrees. The length of time required will depend upon 
the tightness of the room and the toughness of the individual. 


WINDOW VENTILATION. 


r 

■)b( 

It being clearly shown that there cannot be a change of air with¬ 
out at least two openings,—unless, of course, the single opening be a 
very large one, through which both an outward and an inward cur¬ 
rent can be established,—it may properly be inquired, How shall these 
openings be supplied or arranged ? This question may be answered 
in several ways, a few of which we will now consider. 

Window Ventilation. —The conditions required can be rudely se¬ 
cured in any ordinary building by opening two windows, preferably on 
opposite sides of a room, or by opening a window and a door, or even 
with one window, in case of necessity, by lowering the upper sash and 
raising the lower one. A practical question often asked is, How much 
must a window be raised or lowered in order to secure the proper 
amount of air ? Since each person requires at least 3,000 cubic feet 
of fresh air each hour, it is evident that each of the two openings must 
be of sufficient size to allow the passage of that amount of air in the 
time specified. Allowance must also be made for gas-lights, lamps, 
candles, etc. A candle should be counted as about half equal to a per¬ 
son, a lamp as equal to one person, and a gas-light as equivalent to six 
to ten persons. Careful experiments have shown that in order to se¬ 
cure the proper amount of air under ordinary circumstances, without 
producing unpleasant and dangerous drafts, it is necessary to raise or 
lower a window of ordinary width one inch for each person. Hence, 
if the occupants of a room consisted of three persons and a lamp, it 
would be necessary that the window on one side of the room should 
be lowered five inches, and on the other side raised five inches. 

When a strong wind is blowing, and in very cold weather, the 
opening may be decreased in proportion to the force of the wind or 
the degree of coldness. It must be acknowledged, however, that this 
is a very poor mode of ventilation, at the best. The only reason why 
we have given it any attention is that it is the only mode that many 
persons can be induced to adopt, and it is better that a poor method 
should be used rationally than that those who employ it should be left 
to go to such extremes as do many persons. We have known people 
who prided themselves in sleeping in a room in which, in the coldest 
weather, the wind was allowed to blow a hurricane through windows 
lowered a foot or two on all sides of the room, when a half-inch open¬ 
ing in two windows would have furnished them with all the air they 
could possibly make any use of. We have also known many people, 
—and we are sorry to say that this class of persons much exceeds in 


568 


HYGIENE OF THE AIR. 



numbers the other class referred to,—who imagined that all the fresh 
air their systems required could find its way in through the keyhole of 
the outside door, around the carefully listed window-casings, or 
through solid brick walls. Fortunately for the latter class, a little air 

does find entrance through 
the narrow channels men¬ 
tioned, else the cases of 
chronic smothering would 
be much more frequent than 
they are. Let us now notice 
a few of the most common 
errors in attempts at venti¬ 
lation ; and first we will call 
attention to some of the evils 
of window ventilation, the 
method just described. 


Evils of Window Yen- 
tilation. —The accompany¬ 
ing diagram, Fig. 188, almost 
explains itself, so that few 
words are necessary. It rep¬ 
resents a section of a room in 
which is shown a stove, one 
window, and a man seated 
between. The space repre¬ 
sented by straight lines is 
occupied by warm air, which 
is seen to be passing out at 
the upper opening of the 
the window cold air, repre¬ 
sented by the dotted space, is seen to be entering and filling the lower 
part of the room. The cool air flows along the floor to the stove, by 
which it is warmed and thus caused to ascend, filling the upper part of 
the room and passing out at the upper opening in the window, as before 
noticed. This plan undoubtedly secures to the gentleman who is sitting 
in the chair an abundant supply of fresh air ; but, as is readily seen, it 
seriously disturbs the distribution of heat in the room, causing an accu¬ 
mulation of the heated air in the upper part of the room, about the gen¬ 
tleman’s head, while his feet are surrounded with cold air direct from 



Fig-. 189. 


window. Through the lower opening in 







































CHIMNEY VENTILATION. 


509 


out of doors, which is the reverse of what is desirable for health. If the 
gentleman could reverse his position, without inconvenience otherwise, 
he would .secure good conditions regarding both heat and ventilation. 

Chimney Ventilation. —The value of the chimney as a ventilator 
is much greater than is always appreciated. The old-fashioned fire¬ 
place was a most thorough means of ventilation; and even the modern 

stove, which requires a 
much smaller quantity 
of air, is by no means 
worthless as a ventilator 
as well as a means of 
heating. It Is possible, 
however, to utilize the 
chimney in other and 
more efficient ways. 
There are several methods 
of accomplishing this: 
one is to carry the smoke- 
pipe up the whole length 
of the chimney. By this 
means the hot smoke and 
gases in the pipe will heat 
the surrounding air in 
the chimney, and create 
a draft which may be 
utilized very readily by connecting the chimney with the room to be 
ventilated. This is probably the best and most economical means of 
ventilating a small building. By placing the chimney in the center of 
the house and leading all the smoke-pipes of the house into one central 
pipe running through the center of the chimney, a good draft may be 
produced; and by connecting each room with the chimney by means of 
proper ducts, the most thorough ventilation of the whole house may be 
secured. A good idea of this method of ventilation may be obtained 
from Fig. 190. 

Another means of accomplishing the same thing is to have another 
opening into the chimney besides that for the stove-pipe, through which 
foul air may be allowed to enter. The objections to this plan are chiefly 
two: 1. It detracts from the draft of the stove and sometimes causes it 
to smoke, and hence can only be employed in stoves which have a draft 



Tig - . 190. Best Ventilation, a and b. Air Registers to let 
out foul air; c. Ventilating-Shaft; d. Air Inlet. 


































570 


HYGIENE OF THE AIR. 



Fig 


191. Stove-pipe 
V entilator. 


much stronger than is necessary to carry away the smoke. 2. As down¬ 
ward drafts sometimes occur in the chimney, smoke is liable to enter the 
room through the ventilator. The latter difficulty can be effectually rem¬ 
edied by placing at the ventilator opening a valve which will allow air to 
enter the chimney, but closes tightly as soon as there is any movement 
in the opposite direction. We have arranged a very convenient form of 
ventilator to operate on this principle which may be attached to the 
stove-pipe, and thus save the trouble of making an extra opening into 

the chimney. The construction of this ventilator 
may be seen in the accompanying diagram, Fig- 
191. This ventilator can be attached to any stove 
which has a strong draft, and it works very well. 
We have tried it for more than a year, and with 
perfect satisfaction. It should be mentioned, how¬ 
ever, that it is necessary to close the damper in the 
ventilator before opening the stove door to replen¬ 
ish the supply of fuel, in order to prevent the smoke from escaping into 
the room from the stove. 

Like all other modes of ventilation dependent on the draft of 
a chimney or shaft, this mode is good only when the chimney is 
heated, as while the fire is burning. Hence a constant fire should be 
maintained wherever it is in use, night and day. While there are some 
objections to this plan of ventilation, its simplicity and ready applicabil¬ 
ity to houses in which the common stove is used, as a means of securing 
good ventilation, are so great as to recommend it most strongly to the. 
common-people. In order to increase the efficiency of the ventilator de¬ 
scribed, and to complement its action in the removal of foul air by the 
ready introduction of pure air in such a manner as to secure immunity 
from drafts with an abundant supply of pure air, a simple plan is the 
following: Have constructed a box about six inches deep, three inches 
wide, and of a length exactly equal to the width of the window casing 
inside. Instead of making the box with a tight bottom, make the 
bottom consist of wire cloth with rather coarse meshes.’ Put on the top 
a hinged lid, with some simple arrangement at the side by which the lid 
may be raised or lowered at pleasure, and fastened at any point. The 
apparatus is now complete; and all that is needed to secure the admis¬ 
sion of air without drafts, even in very cold weather, is to place this box 
in the top of the window-opening, lowering the upper sash a little for 
the purpose. The box should be placed with the bottom outward, being 







VENTILA TING-SHAFTS. 


571 


allowed to project a little beyond the sash, and with the opening of the 
lid directed toward the ceiling. By this means the current of air which 
enters the room will be so modified as to prevent unpleasant and harm¬ 
ful drafts. The wire screen will break its force and divide it into a great 
number of small currents. The hinged cover will direct the air upward 
toward the ceiling, whence it will be directed toward the floor; and as 
it settles it will be warmed by the air of the room which is always 
warmer near the ceiling than elsewhere in the room. This will bring 
the cool air about the head, where it is needed, and will prevent the ac¬ 
cumulation of cold air around the feet, which most need extra warmth 
on account of their remoteness from the center of the body. By opening 
or closing the cover, the size of the opening may be regulated to suit all 
sorts of weather. When the weather is extremely cold or a very strong 
wind is blowing, a mere crack may be sufficient to give entrance to all 
the air needed. When possible, one or more windows should be provided 
with such openings on different sides of the room, by which means dis¬ 
turbances caused by changes in the wind could be easily corrected. The 
box can be readily adapted to windows of different sizes by making it 
shorter than the width of the casing and placing in each end a movable 
piece which can be slid out to close any space left at the ends. The 
opening made between the two sashes by the lowering of the upper sash 

may be closed by listing or cotton, or by 
a long strip of pasteboard covered with 
felt and fitted to the sash. This will not 

be needed except in the very coldest 
Fig:. 192. Air-Inlet Box. \ J ., , 

weather, as the air which enters through 

the sash will be given an upward direction, and so will not be likely to 

be felt. For cut of inlet box see Fig. 192. 



Ventilating-Shafts .—Large houses heated by furnaces, or by 
steam or water pipes, must be provided with ventilating-shafts extend¬ 
ing: from the basement to above the roof, and connected with each 
room of the house by ducts with openings of sufficient size to secure 
thorough renewal of the air as often as necessary to answer the re¬ 
quirements of hygiene. As already suggested, the most economical 
way of ventilating by means of a shaft, is to convey the smoke from 
stoves or furnaces by means of a smoke-stack, and to place this in the 
center of a large shaft, the air of which will thus be heated and a 
draft produced. The almost universal fault in constructing ventilating- 
shafts is to make them too small, or to make the openings into them 







572 


HYGIENE OF THE AIR. 



Fig - . 193. Ventilation Working Wrong Way. 



Fig - . 194. Diagram showing Defective System of 
Ventilation. 


insufficiently large. Ample 
ventilating space should be 
provided. Better have too 
much space than too little. 
It is also important that every 
room in the house should be 
connected with the ventilat¬ 
ing-shaft or chimney. Cel¬ 
lars, pantries, clothes-rooms, 
closets, and halls, though usu¬ 
ally neglected, should receive 
first attention with regard to 
ventilation. 

A very common error is the 
supposition that nothing is re¬ 
quired to secure a draft but 
an upright shaft. A cold 
shaft will “ draw ” when a 
strong -wind is passing over 
its top, but the current will 
vary with the wind, and is 
likely to be downward as well 
as upward, a$ is shown by the 
accompanying diagram, Fig. 
193. We have even known 
cases in which the ventilating- 
shaft, instead of passing- 
through the roof and thus 
communicating with the open 
air, ended in the garret, as 
shown in Fig. 194. 

A ventilating-shaft, in order 
to draw well, must be heated 
to a temperature of 50° to 75° 
F. above that of the room to 
be ventilated, and should be 
surmounted by some device 
to prevent interference with 
the draft from downward cur- 

































































HE A TING. 


573 


rents of wind. Two openings into the flue should be made from 
each room. The lower one should be used constantly, and so need 
not be made to close; but as the upper one is to be used only to clear 
the room of air quickly when it has been over-heated, it should be 
made to close, and should be opened only when necessary for the 
purpose named. 

Heating. —The tendency of Americans is to keep their living- 
rooms at too high a temperature. In England the usual temperature 
is 58° to G0° F., rarely more; but in this country it is more common 
to find the rooms of dwellings heated to from 70° to 80° F. It is prob¬ 
able that the drier atmosphere of this country makes a higher temper¬ 
ature necessary; but the usual temperature maintained is quite too 
warm. The effect of so high a temperature is to render the skin deli¬ 
cate and the system very susceptible to injury from the numerous 
changes to which our climate is subject. The proper temperature is 
60° to 65°. A few old people may require 70°; but the temperature 
should not be allowed to exceed that degree. The greater the heat to 
which the body is accustomed, the less the power of resisting cold, and 
vice versa. We have often found invalids who had been confined for 
some time in an atmosphere in which the thermometer stood at 90° F., 
as we found upon testing it, and yet they complained of chilliness, 
insisted on having every window tightly closed, and shivered when¬ 
ever the door was opened or a breath of fresh air admitted from any 
source. If a temperature of G5° is uncomfortably cool at first, the 
difficulty may be relieved by the addition of more clothing, or by tak¬ 
ing more exercise. Abundant exercise in the open air is the best 
means of hardening the body to a low temperature. 

It is important that the heating and the ventilating apparatus 
should be so arranged as to assist each other. Hence, the best heating 
apparatus is the one which will maintain an equable temperature the 
most easily and with the smallest expense, while at the same time 
helping the ventilation. The old-fashioned fire-place was a splendid 
ventilator, but as it utilized only about one-tenth of the heat produced 
by the combustion of coal or wood, wasting the balance, economy forbids 
its use in cities, by any except the wealthy, though it may be used 
where fuel is cheap, and is employed to some extent. It is also open to 
the objection that it requires much labor to take care of it, to furnish 
fuel and to keep free from dust and ashes the apartments heated 
by it. The improved forms of grates economize heat very greatly, but 


574 


HYGIENE OF THE AIR. 


lose much more heat than the most improved forms of stoves. They 
are to be recommended as excellent means of heating. The objection 
sometimes made that radiant heat is not healthful, is without founda¬ 
tion. Radiant heat is the kind furnished by the sun, which is un¬ 
doubtedly the best of all means of heating. There is no reason why it 
should not be healthful; and the fact that it will warm a person sit¬ 
ting before a fire-place while he is breathing cool air, is a recommenda¬ 
tion well worthy of consideration. The most serious objection against 
the fire-place as a heater is that it is inadequate to warm comfortably 
very large rooms in extremely cold weather. This may be in part, but 
not always wholly, remedied by using several fire-places in one room, 
but this is not always convenient, and increases the ventilation out of 
proportion to the heating of the room, so that it is very expensive. 
A most excellent plan is to combine the stove and tire-place in large 
rooms. Let the fire-place be placed in the inside wall, and the stove 
at the outer side of the room. The stove will thus supply the addi¬ 
tional heat necessary, while the fire-place acts as a ventilator as well as 
a heater. For almost any room usually found in dwelling houses, the 
plan last suggested, combined with the plan proposed for admitting 
fresh air through a box placed at the upper part of the window, will 
be found sufficient to secure the proper degree of heat and an abun¬ 
dant supply of pure air. 

The porcelain stoves of Germany certainly secure an equable tem¬ 
perature, but they in no way assist ventilation. Indeed, in the efforts 
to retain their heat as long as possible, the windows and doors are 
carefully guarded in cold weather, so that as little cold air as possible 
shall find entrance. The air-tight stoves of America and some other 
countries are not so good as heat retainers, but they are usually no 
better as ventilators, though excellent heaters. It is possible, how¬ 
ever, to convert almost any ordinary stove into a most efficient means 
of helping ventilation, by connecting with it a pipe bringing fresh air 
directly from out of doors. The inner end of the pipe should com¬ 
municate with a chamber attached to the stove body in such a way 
that the fresh air may be warmed as it enters. This plan may be un¬ 
derstood at a glance by referring to Fig. 195. By combining with this 
plan the stove-pipe ventilator elsewhere described, all the requisites 
for good ventilation may be obtained. Care should be observed to 
locate the ventilator so that the fresh air may not pass immediately to 
it and be carried away before being used. As in the case of furnaces, 


NIGHT-AIR. 


575 




Li 




great care should be taken that the outer end of the fresh-air duct 
terminates where pure air can be obtained. Fresh-air inlets should 
often be examined, as dead rats and other nuisances often contaminate 
the air at its entrance through these channels. 

Moistening of the Air.— 

Although there has been 
much discussion upon the 
subject, there is good evi¬ 
dence for believing that the 
addition of moisture to air 
which is unusually dry is a 
matter of great importance 
to persons in health, as also 
to those suffering with cer¬ 
tain forms of disease, par¬ 
ticularly pulmonary difficul¬ 
ties. The air should not 
be saturated, but should contain sufficient moisture so that it will 
not cause unpleasant dryness of the throat, eyes, and skin. The 
requisite amount of moisture may be obtained by evaporation of 
moisture in open vessels upon the stove, in a pan provided for it in 
the furnace, by means of moistened linen cloths or sponges placed be¬ 
fore registers, and in a variety of other ways. Attention to this point 
is particularly necessary in winter, when out-of-door air, on account 
of its low temperature, contains a much smaller proportion of moist¬ 
ure than at most other times. 



Fig. 195. 


Stove-pipe Ventilation, a. Stove-pipe Ven¬ 
tilator; b. Inlet for Pure Air. 


Night-Air. —In conclusion, we must say one word respecting the 
popular dread of night-air. The notion that night-air is not always 
as pure as day-air, has been ridiculed by some writers on health, but 
we think without just cause, as there seerqs to be evidence for believ¬ 
ing that there is some foundation for the popular fear of night-air. 
During the day, the layer of air nearest the earth is heated by con¬ 
tact with the soil warmed by the solar beams, and rising, it carries 
upward with it the noxious vapors and germs which are chiefly gen¬ 
erated near the surface of the ground. When the sun sets and the 
earth cools by radiation of its heat into space, the poison-laden air 
sinks down near the surface again, along with fogs and heavy vapors. 
Hence, a person is more likely to contract malarial disease by inhal¬ 
ing night-air in the vicinity of swamps or other malarious localities. 




























































HYGIENE OF THE AIR. 


576 

This fact must be borne in mind, however, that night-air is all the air 
we have at night, and must be breathed, if we breathe at all. The 
air in dwellings is night-air, as well as that which is out of doors, at 
least, the small quantity of air contained in dwellings at sunset must 
be through doors and windows and other openings speedily changed 
so as to be precisely like outside air in character. The recommenda¬ 
tion of the late Dr. Hall to shut up sleeping-rooms as closely as possi¬ 
ble several hours before sunset, and to keep them closed during the 
night, so as to have a supply of day-air for use during sleep, was most 
harmful and pernicious. He argued that as a person takes in at each 
breath but twenty cubic inches of air, a single small roomful of air 
would easily last during the seven or eight hours of sleep. This he 
demonstrated to his satisfaction by a simple mathematical proposition. 
The doctor, like many others, evidently overlooked the fact that one 
respiration renders air unfit to breathe, not by using up its oxygen, 
but by poisoning it so that it becomes unfit to breathe. As already 
explained, each breath, though consisting of but twenty cubic inches 
of air, and containing but one cubic inch of carbonic acid, on account 
of the organic poison contained in it, poisons three cubic feet of air; 
so that a single person would really consume, or render unfit for 
respiratory food, as much air in thirty minutes as would fifteen per¬ 
sons in eight hours according to Dr. Hall’s erroneous calculation. 
The best that can be done in the night is to secure as good air as there 
is, which will be found in the upper rooms of the house, since they 
are farther from the ground. The fear of night-air should deter no 
one from ventilating sleeping-rooms during the night, as during sleep 
more air is needed than at any other time, on account of the increased 
quantities of poisonous products given off from the skin and lungs 
during repose. It is this fact which makes it especially necessary that 
beds and bedding should be thoroughly ventilated every morning. If 
possible, they should be exposed to the rays of the sun and fresh air 
for two or three hours, at least, daily. The windows of a sleeping 
apartment should always be widely opened every morning, and the 
disinfecting air and sunshine allowed to perform their sanitary labors 
unrestricted by blinds and curtains. 


DISINFECTANTS. 


577 


DISINFECTION. 

As air contamination is often the result of causes which cannot be 
remedied by ventilation alone, disinfection becomes necessary as an 
auxilliary, though no amount of disinfection can take the place of an 
abundant supply of fresh air. Substances liable to produce contam¬ 
ination by undergoing putrefactive decomposition should be removed 
to so great a distance from human habitations as to obviate all possi¬ 
bility of danger. In case this cannot be readily done, and often when 
it can be done, in order to prevent contamination during transit, the 
dangerous substance should be rendered innocuous by the use of dis¬ 
infectants. Disinfectants are of two classes: those which simply 
destroy the offensive odors of putrescent substances, or deodorants, 
and those which not only destroy the odors, but the substances them¬ 
selves, or check or prevent putrescent changes. The most of these 
are known as antiseptics. We will call attention to some of the best 
and most easily used disinfectants, and the conditions to which they are 
especially adapted. 

Dry Earth. —This is one of the best of all disinfectants for solid 
and semi-solid matters. It is a most excellent agent for deodorizing- 
excreta. It operates by absorbing fluids and foul gases. It must be 
very dry, and the finer the better. Sand is not good. Earth, if wet, 
is worthless. Dry powdered clay is best. Coal ashes act mainly 
on the same principle, and are good. Dust from the road is a very 
good material. It should be gathered and preserved in boxes under 
cover, in readiness for use in wet weather. Dry earth must be used 
very freely to be effective. 

Lime.— Freshly burned lime is another very efficient disinfectant 
for some purposes. It is useful chiefly as an absorbent. In damp 
rooms having a musty odor and moldy walls, place several large, shal¬ 
low vessels with a liberal supply of fresh lime broken into pieces the 
size of a walnut. 

Pulverized Charcoal. —This is excellent to absorb and destroy foul 
gases. It must be applied freely, and often renewed. Should be bro¬ 
ken into small pieces. It is so cheap that it ought to be used very ex¬ 
tensively. 

When cistern or well water acquires a foul, sour, or sulphurous 
smell, it is very impure, and should not be used without filtering 
37 ’ 


578 


HYGIENE OF THE AIR 


through, charcoal. Very frequently the evil can be corrected by 
putting down into the well or cistern a large sack containing a bushel 
or two of powdered charcoal. The sack should be moved about in 
the water several times a day for a few days. 

■A 

Chloride of Lime, —Excellent to destroy putrid substances, foul 
gases, and disease germs. Its efficiency is due to the chlorine gas 
which escapes from it when moistened. 

Into a gallon of water, put a pound of fresh chloride of lime. (Be 
sure it is fresh. It is about worthless when old.) Stir well. Filter, 
or turn off after settling. Use freely. 

This is an excellent preparation for cleansing clothing that has 
been soiled by the discharges of patients. For this purpose, use one 
quart of the solution described to half a pailful of water. It is also 
very useful for cleansing the hands of nurses who may be employed 
in cases of loathsome or infectious disease. After preparation, the so¬ 
lution must be used at once or kept tightly stoppered. 

Chlorine Gas.—This is one of the most effective of disinfectants. 
It may be prepared in several ways. The following are simple and 
practical methods:— 

1. With one and a half pounds of fresh chloride of lime mix one 
pound of powdered alum. This is excellent to use in a sick-room 
where foul odors are present, as the chlorine is given off gradually. 

2. Mix equal parts of chloride of lime and muriatic or sulphuric 
acid. Mix in an earthen vessel with water equal to the acid by 
measure. 

3. Mix together in an earthen vessel equal parts of salt and black 
oxide of manganese, and pour on two parts by weight of sulphuric 
acid. 

About a pound and a half of chloride of lime, or of the mixture of 
salt and oxide of manganese, with the proper amount of acid, will be 
required for each one hundred cubic feet of air to be disinfected. In 
using chlorine to disinfect rooms which have been occupied by fever 
patients, all colored fabrics, picture-frames, and other articles likely to 
be injured, should be removed, and the room tightly closed for twenty- 
four hours, after which it should be aired for two or three days. In 
disinfection after scarlet fever and diphtheria, everything used about 
the patient should be left in the room. 

As the irritating fumes of this gas may be inhaled by accident, it 


DISINFECTANTS. 


579 


"will be useful to know that they may be antidoted by the inhalation 
of ammonia, or better, by breathing the vapor of alcohol. 

Sulphurous Acid. —This well-known bleaching agent is also a very 
good disinfectant. It is even preferable to chlorine gas for disinfect¬ 
ing rooms and clothing, if used thoroughly. It may be used for dis¬ 
infection in the same manner as for bleaching purposes. After re¬ 
moving from the room everything that may be discolored by a bleacli- 
ing agent, as all kinds of colored cotton fabrics, and getting all in 
readiness to close the room quickly and tightly, place in an old iron 
kettle some live coals, upon which throw the sulphur or powdered 
brimstone, setting the kettle on bricks. 

Another convenient method is to place in the middle of the room, 
nil a piece of sheet-iron or boards, a few shovelfuls of wet sand. Place 
in the sand several bricks near together, and on the bricks two or three 
hot stove-covers, bottom upward. Put the sulphur on these, and there 
will be no danger of fire. A hot iron kettle answers equally well. 
Use two ounces of sulphur to each one hundred cubic feet of air to be 
disinfected. Close the room tightly for twenty-four hours, then ven¬ 
tilate for two days and scrub and repaper the walls. 

Copperas. —Also known as sulphate of iron. For disinfecting 
drains, sewers, cesspools, privies, and vessels containing the discharges 
of the sick. It must be used liberally, and is, fortunately, very cheap. 

To use, dissolve in water in proportion of one pound to the gallon 
of hot water. Add for each gallon two ounces of commercial carbolic 
acid. Pour into sink-drains a pint every day. One or two quarts daily 
will keep a water-closet in a wholesome condition if the trap does not 
leak. A gallon every two or three days will be sufficient to keep a 
privy measurably sanitary after its contents have once been sufficiently 
flooded to remove all foul odor. This solution is excellent for disin¬ 
fecting stables and places where horses or other animals stand. 

Permanganate of Potash. —A most excellent disinfectant, though 
more expensive than the others mentioned. Its best use is for disin¬ 
fecting the discharges of the sick. A quantity of the solution should 
be constantly kept in the chamber vessel. Delicate fabrics should not 
come in contact with the solution, as it leaves a stain. It may also be 
well used for purifying a cistern, the water of which has become foul. 
The water should be stirred from the bottom when it is poured in. 

For use, dissolve one ounce in three gallons of water. For cisterns. 


580 


HYGIENE OF THE A IE. 


use one ounce to the gallon, and add until the pink color fails to dis¬ 
appear in half an hour. 

As is the case with copperas, sulphate of zinc, and similar disin¬ 
fectants, permanganate of potash is not volatile, hence it does little if 
any good to keep vessels filled with the solution standing in sick¬ 
rooms unless it is otherwise used. 

Ozone. —This most active disinfecting agent may be easily pro¬ 
duced in two ways, as follows: 1. It may be produced gradually by 
means of fragments of phosphorus partially covered with water in a 
saucer, or by wetting a bunch of phosphorus matches and suspend¬ 
ing in the room. The ends of the matches must be kept moist by fre¬ 
quent wetting. 2. By mixing with a solution of one part of perman¬ 
ganate of potash in ten of water an equal measure of sulphuric 
acid. This is an admirable disinfectant for use in the sick-room, as it 
is very powerful and has not a very disagreeable smell in quantities in 
which it is useful. Either method of producing it may be employed. 

Ozone is nature’s great disinfectant. It is produced by various 
natural agents, such as electrical discharges, the gums of certain forest 
trees, the perfumes of flowers, and a great number of other means 
which are in constant activity, keeping good the supply which is ex¬ 
hausted by the destruction of the noxious vapors, germs, and various 
other agents destructive to human life which teem the air. The value 
of this wonderful agent as a disinfectant is but just coming to be ap¬ 
preciated in some small degree. It is to be hoped that ere long some 
means will be devised by which it can be cheaply manufactured in 
great quantities, when it may be made the means of doing an incalcu¬ 
lable amount of good ; as, for instance, in destroying the poisonous em¬ 
anations from swamps, marshes, and other sources of atmospheric 
poisons. 


RATIONAL REMEDIES FOR DISEASE. 


In this portion of this work we shall consider such methods and 
means of medical treatment as may be safely trusted in the hands of 
unprofessional persons, and such as all should be familiar with, not only 
to enable them to apply efficient remedies in the absence of a physician, 
but to render them capable of using under the direction of a wise phy¬ 
sician those remedies which are generally conceded to be in the great 
majority of cases the most efficient of all remedial measures when in¬ 
telligently and thoroughly applied. 

Before entering upon the consideration of remedies, we must become 
acquainted with the nature of disease, and the relation of remedies to 
the system. For ages, the true principles relating to these two im¬ 
portant subjects have been buried beneath the rubbish of empiricism, 
dogmatism, ignorance, and superstition ; but the wonderful advances in 
all departments of science during the present century, and particularly 
in medicine and its collateral sciences, have thrown a flood of light upon 
the subject, and made clear much that was once dark and mysterious. 
The microscope, in its wonderful revelations regarding the lower forms 
of life and the structure of the human body and the changes which it 
may undergo in disease, has contributed not a little to this result. 

What Is Disease I —This question has been variously answered at 
different times in the history of the science of medicine. Among the 
ancients the prevailing notion was that disease was the result of the di¬ 
rect influence of evil spirits who took possession of human beings and 
inflicted upon them various sufferings. They observed that when a 
man was sick his temperament and disposition were wholly different 
from what they were in health. The hale, hearty, jovial man became 
not only emaciated and pale, but morose, fretful, and sad. They also 
observed the violent contortions which were sometimes manifested under 
the influence of severe pain. Men were far more superstitious then 
than now. They attributed the most trivial occurrences, which were 
mysterious to their untutored minds, to some supernatural agency, just 

581 



5S2 


RATIONAL REMEDIES FOIl DISEASE. 


as many people do in modern times. Their conclusion was that disease 
was the work of demons, who were allowed tp harass and persecute men 
by possessing their bodies and subjecting them to all manner of tortures. 

Entirely consistent with their opinion of the nature of disease was 
the mode of treating disease in voirue with the ancients. If the cause 
of a man’s sickness was an incarcerated demon,—which they supposed 
was the case,—the proper remedy would evidently be to get the Sa¬ 
tanic lodger out in some manner, if possible. To effect this very de¬ 
sirable end, various methods were used, all of vv hich were more or less 
connected with certain mysterious religious rites, the secret of which was 
confided to a few individuals, usually the priests. In this way the 
priests became physicians—quacks, we would say now-a-days—and the 
professions of theology and medicine became mingled, the early supersti¬ 
tions of the former being permanently grafted upon the latter. One 
very approved method of getting rid of a demon was to draw him out 
through the nose of the patient after applying a certain root to the 
nostrils. A method much more severe for the patient was flagellation, 
which either ended in the departure of the devil or the death of the vic¬ 
tim. Bathing in certain waters, inhaling the air of particular caves, 
and similar measures, were also regarded as efficient remedies. 

These ancient notions of disease are still preserved with all their 
original superstitions in some of the dark corners of the earth, as is well 
illustrated in Dr. Richardson’s interesting description of the physician 
of Thibet. We quote the following from his interesting essay, “The 
World of Physic” :— 

“ In the month of September, when the day breaks over his mag¬ 
nificent mountains, watch this man leaving his Lamasery to collect his 
remedies. A leathern bag and a tea-kettle carry all his wants. Armed 
with a pointed iron-capped staff and hook, like a Druid of our own old 
time, he marches forth with his train of pupils, and roaming the mount¬ 
ains, picks out of the laboratory of nature his medicinal stores, from 
branch, from shrub, from root. With the declining sun he returns, 
laden with his spoils, next day culls them, dries them in the air, packs 
them, labels them, stores them in some safe garner of the quiet Lam¬ 
asery, and, in his honest soul, believes that the wealth of the whole med¬ 
ical world is in his safe keeping. Called to the couch of the sick or the 
dying, he is content to hear of pain, to read off’ signs of oppression, and, 
striking his fingers across the pulse of each wrist, as a musician doth the 
strings of his instrument, he is satisfied. The phenomena he sees are 


MEDIC A L S UP ERST [ TI ONS. 


583 

with him easily understood ; they are the assaults of a demon who must 
be expelled. So many diseases, so many demons, and, let it not he 
doubted, so many remedies. From the wonderful pouch by the side of 
that physician, come forth those dried plants he gathered on the mount¬ 
ain side, and down the throat of the afflicted certain of them go, in 
nauseous powder. Or, should the remedy not be in the pouch, this 
wonderful Lama physician, with more than homoeopathic skill, writes 
the name of the remedy on a scrap of paper, moistens the paper with 
his lips, rolls it into a pill, and administers it to the faithful, who, 
straightway swallowing, with the earnest belief that the name is as 
good as the thing when it comes through proper hands, believes and 
lives, or believes and dies, as the case may be. 

“ But before the last event shall happen, be the patient rich enough 
to bear the operation, our good Lama has one or two other resources at 
hand, belonging to the imaginative, which resources are bold, and, in 
proportion as they are bold, effective. By that most convenient of the¬ 
ories, that every disease is a demon within the man, the good Lama has 
a power to which we civilized have no claim. Between the actual ex¬ 
istence of a thing, and firm faith in that existence, whether it be or not, 
the gulf is narrow in all minds, absent in most ; and so, the Tartar pa¬ 
tient is, to his physician, as good as a man who should have veritably of 
veritably a demon within him. Well, I put to you here, to all, what 
would you wish for most if you believed as firmly that you had a de¬ 
mon in your tooth, making it ache, as that you had a tooth to be made 
to ache ? I suspect you would like to have the demon cleared out. 
Further, if you were a Lama physician, and knew the quality of the 
demon, and his best mode of exit, you would, I think, attempt to re¬ 
move him. Our Lama sympathizes. He says to his patient, ‘ 1 can get 
rid of this demon by certain magical prayers, but you, being a wealthy 
man, are afflicted with a very proud demon, in fact, quite a swell de¬ 
mon, and he will not go away unless you find him a thorough good 
horse to carry him off' And so the horse is brought out, properly ac¬ 
coutered, the prayers are recited, and then, the demon getting inside the 
horse, and the physician outside, they go away together, and unless the 
demon leaves the horse, or the physician disposes of both, demon and 
physician remain as intimate as is proper so long as the horse lives. 
Where the demon goes afterward I cannot say : I suppose, to his native 
place.” 

To Hippocrates, a physician who flourished several centuries before 
the Christian era, more than to any other physician of ancient times Ik*- 


584 


RATIONAL REMEDIES FOR DISEASE . 


longs the honor of discovering that climate, food, and personal habits 
have far more to do with diseases than any Satanic or other supernat¬ 
ural agency. His notion of the exact nature of disease, was, however, 
quite too absurd for credence, although it involved a true principle. He 
believed that there were certain humors in the body which play an im¬ 
portant part in the functions of the body. According to his views, 
when those humors are in just the right proportion, health is the result; 
if any one of the humors is in excess, disease follows. It will be noted 
that the primary idea in this theory is that disease results from disar¬ 
rangement of the body. 

But although this noble old physician labored very zealously to up¬ 
root the superstitious notions of disease, he was successful only with a 
few of his most intimate disciples. The unlearned masses still clung to 
their old fallacies ; and notwithstanding the great advancement which 
civilization and enlightenment have made since then, we find the same 
erroneous dogmas in the world at the present day, though in a some¬ 
what modified form. People no longer regard a sick man as one pos¬ 
sessed with a devil, but the prevalent opinion would seem to be that it 
is an evil entity of some kind which settles down upon or into a man 
and works all manner of mischief. In descriptions of fever we are 
often told that the patient was “attacked,” “ carried through,” etc. ; or 
that the doctor “combated the disease,” until the “fever left him.” 

As before remarked, the microscope has done much to solve the 
mystery connected with this subject. This wonderful little instrument 
has shown the human body to be made up of minute elements, each of 
which has a life of its own more or less independent of the lives of other 
elements with which it is surrounded. 

Although it would be presumptuous to assert that the whole mys¬ 
tery of life is yet revealed, it is now well known to all scientists that 
what is usually termed life, that is, the phenomena of animal existence, 
is merely the combined result of the individual lives of the microscopic 
cells of which all living bodies are composed. That these cells have an 
independent life is proven by the fact that they will retain their life and 
vitality for hours after the death of the individual. 

In the human body these cells are separated into groups, forming 
organs, each of which has a certain definite and peculiar function to 
perform. Thus, one set of cells form the muscles, and by their united 
action produce all the movements of the body. Another set form the 
liver, and have the function of removing certain impurities from the 


HEALTH AND DISEASE. 


585 


Mood. Still another collection of cells make up the brain and by their 
action produce thought, while other cells form the nerves, which serve 
the purpose of conveying impressions to and fro between the brain and 
the external world. 

When all of these cells are acting harmoniously, each performing 
properly the work belonging to it, the whole body is in a state of health. 
Hence we say, It is not only the business of the cell structures of the 
body to do all the work of life, but they are also required to keep them¬ 
selves and the body in repair. Every thought of the brain, every 
transmission of an impression by a nerve, every contraction of a muscle, 
occasions the destruction of millions of the delicate constituents of brain, 
nerve, and muscle. If they were allowed to go unrepaired, those organs 
would soon lose their power of action, and death would result. 

Health is that condition of the body in which each organ performs 
its proper function. It is the harmonious action of all the bodily 
organs. 

Through the influence of various disturbing causes, the harmonious 
action of the organs of the bodv is sometimes interfered with. The 

O 

action of some may be accelerated, while that of others is impeded or 
wholly interrupted ; and even the structure of organs may be impaired. 
This disturbance or derangement is accompanied by discomfort and un¬ 
pleasant sensations. 

This condition of the body is disease ; which may be defined, in 
brief, as a derangement of the bodily functions or structures. 

Disease is the exact opposite of health. The one is normal, the other 
abnormal. The one is harmonious action, the other is discordant action. 
The one is physiological, the other pathological. There may be all 
grades of departure from normal or healthy action, as well as all degrees 
of impairment of structure, short of actual destruction, which is death. 
It has been asserted that disease may be either purely functional or 
purely organic ; but there is good reason to question whether there can 
be any disturbance of function without some degree of structural de¬ 
rangement ; and it is certainly impossible that there should be injury of 
.structure without impairment of function. 

The abnormal action of an organ, occasioned by a disturbing cause, 
is in most cases an effort on the part of the organ to recover its normal 
condition by removing, if possible, the cause of the disturbance. 
Viewed in this light, disease may be called remedial effort, since it is an 
effort to remedy an existing evil. For example, snufl taken into the nose 


58(3 


RATIONAL REMEDIES FOR DISEASE. 


occasions sneezing; and how? Snuff is an acrid, irritating poison. 
AVhen it touches the delicate membrane of the nose, it is at once recog¬ 
nized as something which ought to be ejected. By means of the nervous 
connection between the mucous membrane of the nose and the muscles 
of respiration, the latter are induced to act in such a way as to forcibly 
eject the offending substance by a gust of air from the lungs. Thus the 
evil is removed; and the effort of removal was a remedial effort. Since 
it was an abnormal action, or one not performed in the regular and 
healthy action of the organs involved, it was disease. 

If some offensive substance, as tobacco, ipecac, or sulphate of zinc, is 
introduced into the stomach, that organ speedily recognizes its obnox¬ 
ious character, and, acting with the abdominal muscles, expels it by a 
strong, spasmodic effort, called vomiting. This action is a remedial one, 
and is really disease. 

A person inhales the virus of small-pox, by which means his blood 
becomes filled with poisonous germs. In a few days he begins to suffer 
numerous disturbances, has a high fever, and presently a characteristic 
eruption of the skin. All this disturbance is an effort of nature to expel 
from the body the poisonous virus which was originally taken into the 
system, and which was generated therein by propagation. 

From the fact that disease is so often remedial effort, some have 
taken extreme grounds respecting its nature, claiming that disease is al¬ 
ways remedial effort. The fallacy of this theory is at once apparent when 
the attempt is made to apply it to a large class of diseases known as 
organic, such as the various degenerations of muscular, nervous, and 
other tissues, tumors, cancerous formations, and other morbid growths. 
In no sense can these forms of disease be called remedial. 

The Medical Pathies .—From the earliest periods in the history of 
medicine down to the present, there have always been sects in medicine 
as well as in theology. Practitioners have differed in their modes of 
treating disease in accordance with their varying ideas of the nature of 
disease and the relation of remedies to the human system. In modern 
times, the agitation incident to the overthrow of many cherished dog¬ 
mas in medicine held from the remotest ages, has developed a greater 
degree of diversity of opinion on medical subjects than has ever existed 
at any previous period. We have not time to notice at length all the 
various medical doctrines of the age, nor to point out in detail what we 
consider the fundamental errors upon which they are severally based. 
Neither would we desire to do so, as our object in this work is not to 


THE ARTIFICIAL METHOD. 


587 


make a belligerent attack upon any class of people, professional or non- 
professional, but rather to inculcate true principles in relation to health 
and disease, the soundness of which must be admitted by all classes alike. 
In pointing out, however, what we believe to be the true relation of 
remedies to disease, and the best modes of applying remedial measures, it 
will be necessary for us to notice in a very general way some of the 
principal modes of practice in modern times. The different modes of 
practice which have existed in modern times and are still in vogue to a 
greater or lesser extent, for convenience of consideration may be divided 
into four general classes; namely, 1. The Artificial; 2. The Exclusive; 3. 
The Expectant; 4. The Rational. 

The Artificial Method. —What has been termed the Artificial 
Method of treating disease consists in the application of means—chiefly 
drugs—with the idea that they possess a direct controlling influence 
upon various maladies by means of which the same may be expelled 
from the body. Acting under the belief that disease was something 
within the body to be expelled, the votaries of this method naturally 
considered it necessary to attack the morbid entity with an energy in 
proportion to its gravity. It was this belief which led the leading 
practitioners, in fact the greater share of all medical practitioners, of the 
last generation, to employ in their practice remedies, or rather measures 
supposed to be remedies, of a character so depressing to the vitality and 
so dangerous to health that they have been at the present time almost 
wholly and universally discarded. This mode of treatment is undoubt¬ 
edly a modern relic of the ancient notion, to which attention has al¬ 
ready been called, which supposed disease to consist of a malign entity 
which must be expelled from the body by measures proportionate in 
violence to the malignity of the incarcerated demon. The notion of de¬ 
moniacal possession has, of course, disappeared in the light of the rev¬ 
elations of modern science, but the method of practice originated and 
perpetuated by this ancient and now exploded notion of disease still sur¬ 
vives. This method has been termed, though incorrectly, by the disciples 
of Hahnemann, the Allopathic method in contradistinction from their own 
or the Homeopathic method. Fortunately for the world, this method of 
practice is rapidly disappearing, and there is every reason to hope that, 
like the ancient notion which gave birth to it, it will soon be buried in 
the oblivion of the past. That such a result would not be undesirable is 
openly admitted by the leading members of the medical profession in all 
parts of the world. The men who stand in the front rank of scientific 


RATIONAL REMEDIES FOR DISEASE. 


">88 


medicine everywhere teach at the present day doctrines quite opposed to 
those held by their predecessors. The artificial method is thus described 
by Prof. Jacob Bigelow, M. D., of Harvard University: “The destruc¬ 
tive tendencies of disease and the supposed proneness to deterioration of 
nature herself were opposed by copious and exhausting depletion fol¬ 
lowed by a shadowy array of alteratives, deobstruents, and tonics. The 
confinement by disease which might have been terminated in a few days 
was protracted to weeks and months; because the importance of the case 
required, as it was thought, that the patient should be ‘ taken down ’ 
mid then artificially ‘ built up.’ 

“ Artificial medicine undermined the strength, elicited new morbid 
manifestations, and left more disease than it took away. The question 
raised was not how much the patient had profited under his active 
treatment, but how much more of the same he could bear. Large doses 
of violent and deleterious drugs were given as long as the patient evinced 
* tolerance ’ of them, that is, did not sink under them. The results in 
such cases, if favorable, like the escapes of desperate surgery, were chron¬ 
icled as professional triumphs, while the press was silent on the disas¬ 
trous results subsequently incurred in like cases by deluded imitators. 
If diseases proved fatal, or even if they were not jugulated or cut short 
at the outset, the misfortune was attributed to the circumstance of the 
remedies not being sufficiently active, or of the physician not being 
called in season. A considerable amount of violent practice is still 
maintained by routine physicians who, without going deeply into the 
true nature or exigencies of the case before them, assume the general 
ground that nothing is dangerous but neglect. Edge-tools are used as 
though they could never be anything more than harmless playthings. 
It is thought allowable to . harass the patient with daily and opposite 
prescriptions; to try, to abandon, to re-inforce, or reverse; to blow hot 
and cold on successive days; but never to let the patient alone nor in¬ 
trust his case to the quiet guidance of nature. Consulting physicians 
frequently and painfully witness the gratuitous suffering and continued 
nausea, the prostration of strength and prevention of appetite, the stupefac¬ 
tion of the senses and the wearisome days and nights which would never 
have occurred had there been no such thing as officious medication. 
What practitioner has not seen infants screaming in the pangs of hun¬ 
ger, or of stimulants remorselessly applied to their tender skins, and 
Avhose only chance for relief was in the continued routine of unnecessary 
calomel and ipecacuanha.” 


EXCLUSIVE METHOD. 


58D 


The same author further states that blisters, antimonial ointments, 
insalivation, etc., may continue to afflict the patient long after the dis¬ 
ease is gone. The effects of powerful depletion are felt for months, and 
sometimes for years. “ The enormous polypharmacopoeia of modern 
times is an excrescence on science, unsupported by any evidence of ne¬ 
cessity or fitness.” 

A few more extracts from eminent members of the profession may 
not be uninteresting. Prof. Gilman, M. D., of the New York College of 
Physicians and Surgeons, says, “ A mild mercurial course and mildly 
cutting a man’s throat are synonymous terms.” 

John Mason Goode, M. D., F. R. S., author of “ Goode’s Study of Med¬ 
icine,” says, “ The effects of our medicines on the human system are in the 
highest degree uncertain, except, indeed, that they have destroyed more 
lives than war, pestilence, and famine, combined.” 

Exclusive Method. —Under this head are, included all of the vari¬ 
ous medical sects which have claimed to be able to cure all diseases by 
a single method or by the employment of one or a few remedies. The 
method comprises Homeopathy, Hydropathy, Eclecticism (in the usual 
application of the term), Physio-medicalism, and many others too numer¬ 
ous to mention. Many patent nostrums and secret remedies are in¬ 
cluded under this class, claiming, as they do, to be panaceas for all the 
ills which flesh is hen- to. 

Each one of the exclusive systems undoubtedly contains elements of 
truth, some presenting much truth and little error, others much error and 
very little truth. All, however, embody the fundamental error that dis¬ 
eases may be cured by the application of some one principle or a few rem¬ 
edies. Homeopathy has, undoubtedly, acomplished a great amount of 
good in demonstrating that in a large share of cases, at least, extremely 
minute or infinitesimal doses of medicine are as efficient if not more use¬ 
ful in the treatment of disease than the huge doses and “ heroic ” prac¬ 
tices almost universally in vogue at the time when homeopathy came 
into existence. It is not remarkable that the wide contrast between its 
small doses and palatable medicaments and the vile, nauseating mixtures 
employed in the artificial method should have won for it a large follow¬ 
ing and increased popularity, even at the present time when it is well 
known that not more than one in a hundred of the so-called homeopathic 
physicians believe or attempt to practice the principles enunciated by the 
founder of the system. So, also, hydropathy has accomplished a work 
for which the world has not yet learned to be sufficiently grateful, al- 


590 


RATIONAL REMEDIES FOR DISEASE. 


though the present indications are that the whole system, stripped of its 
exclusive character, will be grafted upon all other systems of practice 
alike. In its exclusive form, hydropathy has doubtless done much harm. 
We cannot believe, however, that, notwithstanding all the ignorance 
and fanaticism of some of the earlier advocates of the “ cold-water cure,” 
one-tenth as much harm has been done by this exclusive method of prac¬ 
tice as by the artificial methods of treatment before described, which, 
according to Dr. Coggswell, of Boston, have been “ productive of vastly 
more evil than good,” and which, according to the eminent Dr. Rush, of 
Philadelphia, have not only “ assisted in multiplying diseases,” but also 
“ increased their fatality.” Electro-therapy, like hydropathy, originated 
with men whose views of medical science were limited and inaccurate ; 
and its failure to accomplish what was claimed for it as an exclusive 
remedy, brought it, like hydropathy and all other exclusive remedies, 
into disrepute with the more enlightened part of the profession. Through 
scientific investigation, however, both electro-therapy and hydro-therapy, 
or hydriatics, have been placed upon a rational basis, and have thus been 
shown to contain a large proportion of truth in spite of the many 
erroneous notions and properties connected with them by their earlier 
advocates. 

The Expectant Method. —The unfavorable results of the artificial 
method of treatment, and the uncertain and often disappointing results 
of the exclusive methods, have given rise to a great amount of skepticism 
on the part of many observing people respecting the merits of all modes 
of treatment, out of which has grown what may be termed the Expectant 
Method of treatment, which consists in simply giving to the patient good 
care and nursing, withholding all active measures of treatment in the be¬ 
lief that every case of disease is either incurable or has a direct tendency 
toward recovery ; and that all remedies are clearly useless in averting 
death or shortening the duration of human maladies. This method has 
never attained to any very great popularity, and never can secure a large 
number of followers, since it is directly opposed to the popular notion of 
disease and the almost universal belief in the efficacy of remedies. Even 
those who have been when in health its warmest supporters, when them¬ 
selves suffering with serious disease, have nearly always deserted then- 
favorite theory and resorted for relief to the same measures as those of 
less skeptical tendencies. The expectant method of treatment has, how¬ 
ever, in the cases in which it has been employed, demonstrated beyond 
room for question that certain diseases at least have a natural tendency 


THE EXPECTANT METHOD. 


591 


to recovery, and are influenced by remedial measures in a much smaller 
degree than has been almost universally supposed. Numerous experi¬ 
ments in the expectant treatment of various maladies have been made in 
various European countries and also in this country, and in not a few 
instances experimenters have declared that the results obtained when no 
active remedial measures were employed were equally good with those ob¬ 
tained from the most active medication. It is to be said, however, with 
reference to those experiments, that the expectant method has usually 
been compared with a mode of treatment closely allied to, if not identical 
with, that described as the artificial method; and hence it is not surpris¬ 
ing that the patient when left to himself with no attention except proper 
care and nursing has suffered less, and made a more rapid recovery, than 
when tormented by various irritating and depressing agents applied with 
an idea of combating the morbid entity at work in his organism. Al¬ 
though this method of treatment has sometimes been described as “a 
meditation on death,” yet it must be said in its favor that if the choice 
were between it and the old-fashioned artificial method of practice be¬ 
lieved in by our forefathers and still to some extent in vogue, the prefer¬ 
ence would be decidedly in favor of the expectant method. On this point 
Dr. Jacob Bigelow, president of the American Academy of Arts and Sci¬ 
ences, and professor in the medical department of Harvard University, hi 
a work published a few' years ago, stated as his sincere belief that “ the 
unbiased opinion of most medical men of sound judgment and long ex¬ 
perience is made up that the amount of death and disaster in the world 
would be less if all diseases w r ere left to themselves than it now is under 
the multiform, reckless, and contradictory modes of practice, good and 
bad, with which practitioners of diverse denominations carry on their 
differences, at the expense of their patients.” 

Said Sir. John Forbes, M. D., F. It. S., “ Some patients get well with 
the aid of medicine, more without it, and still more in spite of it.” 

Says the Dublin Medical Journal, “Assuredly the uncertain and 
most unsatisfactory art that v T e call medical science is no science at all, 
but a jumble of inconsistent opinions, of conclusions hastily and often in¬ 
correctly drawn, of facts misunderstood or perverted, of comparisons 
without analogy, of hypotheses without reason, and of theories not 
only useless but dangerous.” 

Said Dr.Bostwick, author of the “ History of Medicine,” “Every dose 
of medicine given is a blind experiment on the vitality of the patient/' 

Said James Johnson, M. D., F. R. S., editor of The Medico-chirurgical 


592 


RATIONAL REMEDIES FOR DISEASE. 


Review, “ I declare as my conscientious conviction founded on long ex¬ 
perience and reflection, that if there was not a single physician, surgeon,, 
inan-midwife, chemist, apothecary, druggist, nor drug, on the face of the 
earth, there would be less sickness and less mortality than now prevail.” 

Prof. J. W. Carson, of the New York College of Physicians and 
Surgeons, says, “We do not know whether our patients recover because 
we give them medicine or because nature cures them. Perhaps bread- 
pills would cure as many as medicine.” The eminent Dr. Alonzo Clark 
a professor in the same medical college, states that “ in their zeal to do,, 
good, physicians have done much harm; they have hurried many to 
the crave who would have recovered if left to natureand that “ all of 
our curative agents are poisons, and, as a consequence, every dose dimin¬ 
ishes the patient’s vitality.” 

Prof. Martin Paine, of the New York University Medical College, 
asserts that “drug medicines do but cure one disease by producing 
another,” a sentiment which is also sustained by the testimony of the 
late Prof. Liebig, the well-known German chemist. 

Prof. Samuel G. Armor, of the Long Island Hospital, in a lecture 
before the Association of Physicians, in Brooklyn, said, “ Drugs are ad¬ 
ministered, patients recover, and we suppose that we have cured them, 
whereas our remedies have had little or nothing to do with recovery; 
very likely it took place in spite of our drugs.” 

Dr. Oliver Wendell Holmes, the well-known “ Autocrat of the break¬ 
fast table,” has asserted that mankind would be infinitely better off if 
all drugs were cast into the sea, but adds that such a procedure would 
be “bad for the fishes.” 

Rational Medicine. —The outgrowth of scientific investigation of 
the nature and causes of disease and the relations to the human body 
of the various external agents which may be brought in contact with 
it, has been the development, out of the chaos and confusion of the 
“ war of the pathies,” of a method of dealing with the human system 
when subject to disease known as the Rational Method. This system 
recognizes no universal remedy for disease and no universal law of 
cure. It confines itself to no one order or class of remedies or meth¬ 
ods. It includes and recognizes all useful remedial agents, no matter 
when, how, or by whom discovered, which have been by experience 
proven to be of real value in the treatment of disease. It avoids ex¬ 
clusive systems and ideas, but accepts all that is really valuable in all. 
It is in the fullest and truest sense eclectic in character. Its princi¬ 
ples may be concisely stated as follows:— 


RATIONAL MEDICINE. 


593 


1. Nature alone possesses the power to heal. 

2. Any agent which will assist nature in effecting a cure is a re¬ 
medial agent, and may, under proper circumstances, be used as such. 

3. Remedial agents affect the system beneficially, not through their 
own operations upon it, but through the reactions of the living tissues 
upon them. 

4. All remedial agents involve in their application the expenditure 
of the vitality of the patient, some more, some less. 

5. The best remedies are those which will render the most reme¬ 
dial aid with the least expense to the vitality of the patient. 

6. Patients, not diseases, are to be treated. 

7. There is in nature no antidote for the results of the transires- 
sion of physical laws. 

Upon these few principles all true medical philosophy and prac¬ 
tice are based; and the success or want of success of any particular 
method of treatment wholly depends upon the degree to which these 
principles are recognized and applied. In order to render them more 
intelligible to non-professional readers, for whom principally we write, 
we will consider each of these principles more at length. 

1. Nature alone possesses the power to heal. —That the true heal¬ 
ing power resides in nature is established by a great number of facts, 
many of which are admirably presented in a work by Sir John Forbes, 
editor of the British and Foreign Medical Review, entitled, “Nature 
and Art in Disease.” The author clearly proves that nature is the real 
healing power by the following facts, which he ably presents:—• 

(1) Wild animals- suffer the most serious injuries and are fre¬ 
quently affected by epidemic diseases, and yet recover without artifi¬ 
cial aid. The same is true of domestic animals in a somewhat less de¬ 
gree, since they are sometimes subject to medical treatment. It is 
suggested, however, that such treatment as is usually employed has no 
effect whatever, or is detrimental rather than beneficial. Such treat¬ 
ment as placing in the stall of the sick animal branches of the wych- 
elm, tying to its tail colored threads, or making a slit in the sick creat¬ 
ure’s ear with a pair of rusty scissors, could certainly have very little 
curative effect. 

(2) Among savages and semi-civilized nations, medical treatment 
is either not employed, or consists of such absurd procedures as could 
not possibly be of any benefit, consisting in many cases of charms, in¬ 
cantations, and other measures equally harmless to produce any appre¬ 
ciable effects. 

38 


594 


RATIONAL REMEDIES FOR DISEASE. 


(3) Many cases have occurred in which persons have suffered with 
serious maladies, such as fevers and other acute diseases, when isolated 
or otherwise unable to obtain medical advice, and yet have made excel¬ 
lent recoveries. 

(4) Many experiments have been made by physicians in different 
countries in the treatment of diseases by inert remedies for the pur¬ 
pose of studying the natural history of disease. In many cases, re¬ 
sults have been so favorable as to give rise to the gravest skepticism 
as to the efficacy of remedial measures. The writer mentions the case 
of a celebrated professor, who, on being told that a new sect had 
sprung up—the homeopathists—which cured diseases by infinitesimal 
doses of medicine, replied that he had long been in the habit of doing 
more than this ; namely, curing diseases by none. At the present time 
there are very few eminent physicians who do not hold to this view, 
and it is probable that there can scarcely be found anywhere an intel¬ 
ligent physician who would attempt to defend the strange and absurd 
views of Cumming on this point, who is said to have exclaimed in his 
lecture-room, “ As for nature, I would treat it in the sick-room as I 
would a squalling cat,—open the door and drive it outbut it is not 
doubted that the following of such pernicious teaching has given rise 
to a large share of the erroneous, unscientific, and unsuccessful med¬ 
ical practice of the last century. 

2. Any agent which will assist nature in effecting a cure is a reme¬ 
dial agent, and may, under proper circumstances, he used as such .— 
As before remarked, the rational method is wholly opposed to exclu¬ 
sive treatment. It accepts any remedy which experience has shown 
to be of real value in the treatment of the various maladies to which 
mankind is subject. The proper test for any method or plan of treat¬ 
ment proposed is, “ Will it aid nature in restoring a sick person to 
health ? ” If this question can be answered in the affirmative, this 
remedy may be employed, no matter how when or where it was orig¬ 
inated or discovered. 

3. Remedial agents affect the system beneficially, not through their 
operations upon it, but through the reactions of the living tissue upon 
them .—This proposition, although directly opposed to the notions 
generally entertained by non-professional people, is abundantly sus¬ 
tained by scientific evidence. The contrary view, namely, that reme¬ 
dies operate directly upon the system, originated in the erroneous 
view’s of the nature of disease, which supposed it to be an entity of 


RATIONAL MEDICINE. 


595 


some sort to be attacked and driven out by energetic measures. This 
fallacious view, having been entertained at a time when many of the 
current expressions relating to disease and its treatment were being 
formulated, has been perpetuated by them; and it is probably due to 
this fact that it is so extremely difficult to uproot from the popular 
mind, and even from the average professional mind, the absurd doc¬ 
trines which were long since exploded by scientific investigation. A 
thorough understanding and ready acceptance of this proposition is 
insured by a knowledge of the properties of vital or organized tissues 
and the relations of inert or inorganic matter to organization. A few 
illustrations may be necessary to make this point perfectly clear to 
the ordinary reader. We will begin with examples of the simplest 
kind and proceed from them to more complex examples. 

Food is said to nourish the body. The expression with reference 
to it apparently supposes that the food is the active agent and that 
the body is acted upon by it; yet the most superficial study of the 
process of nutrition clearly demonstrates that the body alone, with its 
organs, is the active agent, the food being wholly passive. When re¬ 
ceived into the body, the food is subject to processes of digestion, in 
which it does not act, but is acted upon by the teeth, stomach, intes¬ 
tines, and various digestive juices which come in contact with it. 
After being reduced to a fluid condition it is still further acted upon, 
beinor absorbed and thus received into the blood, from which it is taken 
up by the various vessels, carried into various parts of the body and 
converted into tissue, and thus utilized. Through the whole process 
the food is acted upon, not in a single instance appearing otherwise 
than as a wdiolly passive substance. Water, one of the most impor¬ 
tant elements of nutrition as well as a powerful remedial agent, when 
taken into the system is acted upon by the blood-vessels, tissues, and 
various other parts of the body, and thus made to subserve useful 
ends, but in no instance does it act upon living parts. The same may 
be said respecting air. It is received, absorbed, assimilated, and 
finally expelled from the body in connection with carbon, a waste 
product. It, too, is wholly passive. 

Now let us observe that the same relation exists between the liv¬ 
ing tissues and remedial agents which may be applied to them. Let 
us suppose, for instance, that a person swallows some substance which 
is said to act as an emetic. When received into the stomach it is 
recognized as something which cannot be utilized, and as obnoxious to 


598 


RATIONAL REMEDIES FOR DISEASE. 


the tissues. The inherent tendency of the body to maintain itself in 
a normal condition by keeping its various parts free from obstructions 
and irritating elements, occasions the action of the stomach and acces¬ 
sory parts upon the foreign substance received, which results in its 
expulsion. The feeling of nausea which precedes the expulsory act 
is an expression of the repugnance of the system for the obnoxious 
substance received, and the expulsory act known as vomiting, which 
is said to be the effect of the emetic, is evidently nothing more nor 
less than a vigorous effort on the part of the system to rid itself of 
the irritating and unusable substance. Any substance which is thus 
treated by the stomach is called an emetic. The substances rejected 
in this manner by the system are said to possess emetic properties, 
although it is evident from the facts to which we have just called 
attention that the emetic properties, so-called, are due to the manner 
in which the substance is recognized by the system, rather than to 
any action upon the system by the emetic substance. In like man¬ 
ner, we may easily see that substances called diuretic are simply those 
which occasion an increased action on the part of the kidneys by 
being expelled by them. Scientific physicians understand this fact 
perfectly well, though for convenience in referring to diuretics, they 
speak of the drug as though it acted on the kidneys. Many persons 
undoubtedly believe that sweet spirits of nitre, juniper, and other 
well-known diuretics, act upon the kidneys, but scientific physicians 
entertain no such idea. 

A cathartic is a drug which is expelled by the intestines. Any 
substance which occasions an increased activity of the skin, or per¬ 
spiration, is called a diaphoretic. If we should consider each one of 
the properties of different medicines or remedial agents, we should 
find that in each case the medicinal property, so-called, is expressive of 
the manner in which the system acts toward the remedy rather than 
any action of the remedy itself. The remedy which occasions only one 
kind of action has one property, while a remedy which occasions numer¬ 
ous actions or disturbances in the body possesses many properties. 

It is important that this point should be clearly understood and al¬ 
ways kept in mind in the application of remedies in the treatment of 
disease, as many serious errors in practice may thus be prevented. 

4. All remedial agents involve in their action an expenditure of 
the vitality of the patient, some more, some less .—This proposition fol¬ 
lows as a natural result from the preceding. While a person receives 


RATIONAL MEDICINE. 


597 


strength and nourishment from the digestion of food, it is nevertheless 
true that vitality is expended in the process of digestion. So with all of 
the other nutritive processes. In the circulation of the blood, in respira¬ 
tion, and all other vital actions, vitality is being constantly used up or 
expended. An agent which increases any of these actions necessarily 
increases vital expenditure. 

5. The best remedies are those which ivill furnish the most re¬ 
medied aid with the least expense to the vitality of the patient .—It 
would need no argument to convince a merchant that he would derive 
the most profit from the sale of goods for which he could obtain the 
highest price and which he could purchase at the lowest figures; or the 
farmer that he would derive the greatest gain by raising crops for 
which he could obtain the largest pecuniary returns with the least out¬ 
lay of money and labor in raising. It is equally evident that the best 
remedies to use in the treatment of the sick are those which will secure 
the desired results with the least expenditure of vitality on the part of 
the patient. What these remedies are we shall point out in another con¬ 
nection. 

6. Patients, not diseases, are to be treated .—To some, this propo¬ 
sition will appear absurd, while to others it will appear equally unnec¬ 
essary. That the proposition is neither absurd nor superfluous is 
abundantly proved by the most casual examination of the many modes 
of treatment which have been in vogue during the past, as well as some 
of those still employed to a greater or less extent at the present time. 
Not a small proportion of the average practitioners, when called to see 
a patient, in considering the symptoms of the case and the indications 
for treatment, consider less the patient himself than the name and nat¬ 
ure of the disease with which he is suffering. It is a common custom 
with many non-progressive phj^sicians, and with the laity almost alto¬ 
gether, to treat diseases by their names. If a person is suffering from 
any given disease, he is at once advised to take some remedy which is 
said to cure that disease. The particular remedy prescribed will depend 
largely on the prevailing fashion at that particular time or place, fft is, in 
fact, the disregard of the principle above stated which has led to what are 
termed fashions in medicine, the existence and evil results of which are 
fully recognized by the more intelligent physicians everywhere. It has not 
infrequently happened—indeed, we believe occurrences of the sort to be 
more common than we would dare to suggest—that some acute or 
chronic diseases have been treated with the result of successfully curing 


598 


RATIONAL REMEDIES FOR DISEASE. 


tke disease, but with equal success in destroying the patient. “ Cured 
to death,” might justly be written upon many a tombstone placed over 
graves whose occupants were said to have died of various maladies which 
were far less responsible for their death than was the “ heroic ” treatment 
to which they were subjected. Nothing can be more unscientific, or 
more unsatisfactory in its results, than the ordinary routine of “ treat¬ 
ing ” diseases. Any plan of treatment, to be successful in aiding nature 
in the relief of human suffering and the prolongation of human life, 
must regard the conditions and interests of the patient, rather than the 
name or nature of the disease from which he is suffering. We need not 
delay longer upon this point as it will be reverted to at greater length 
elsewhere. 

7. There is in nature no antidote for the results of the transgres¬ 
sion of physical laws. —This proposition, too, will doubtless be warmly 
disputed, especially by those who imagine that all existing things were 
made for the special benefit or advantage of man, and that everything 
may, by proper investigation, be made subservient to his interests. We 
believe, however, as was remarked to us by the learned editor of one of 
the leading medical journals of the West, that “ there is no more danger¬ 
ous popular error than that it is possible for a person to violate ad libi¬ 
tum the laws which relate to his physical well-being, and then avert the 
natural penalty of his transgression by swallowing a few doses of med¬ 
icine, or by resorting to any other remedial measure.” Remedies may 
postpone, for a time, the results of physical transgression, and may even 
seem to prevent them altogether, but careful observation will show that 
the escape from punishment is only apparent. Its form may be mod¬ 
ified, but it cannot be averted entirely. A person who squanders his 
vital force will certainly die prematurely. If his career is not cut short 
by some acute malady, he will be worn out by some chronic disorder. 

Rational medicine teaches that every physical transgression must 
be visited by commensurate punishment, and that the proper work for 
the physician is to instruct people how to escape the penalty of trans¬ 
gression, not only by averting the penalty after the liability to it has 
been incurred, but by giving warning, by proper instruction, of the cer¬ 
tainty with which suffering and possibly death result from a disregard of 
nature’s laws, and thus preventing transgression. 


HYGIENIC AGENTS. 


599 


THERAPEUTIC AGENTS OR REMEDIES FOR DISEASE. 

We are now prepared to enter upon the consideration of the differ¬ 
ent classes of therapeutic agents which are or may be employed in the 
treatment of disease. In considering this subject we shall endeavor to 
point out the excellences or disadvantages of each class, and shall give 
special preference and prominence to those remedies which are partic¬ 
ularly adapted to the use of non-professional persons, touching very 
lightly those agents which should be employed, if at all, only by the 
trained physician. 

In this consideration we shall divide all remedies into two classes, 
under the respective heads, “ Hygienic Agents ” and “ Medicinal 
Agents.” 

HYGIENIC AGENTS. 

Under this head we shall consider the remedial properties and ap¬ 
plications of water, air, light, heat, electricity, exercise, food, and mental 
influences. These agencies are termed hygienic, because they are not 
only useful in disease in aiding in the restoration of health, but are 
also essential to the maintenance of life and health at all times. Of 
all the remedies employed in the treatment of disease these are the 
most important, and will receive first attention for the following 
reasons :— 

1. Because a great share of the maladies to which human beings 
are subject arise from disturbances in the relations of these agents to 
the human system, which only need to be regulated to effect a cure of 
the disease. 

2. Because they sustain to the vital organs friendly rather than 
hostile relations, and harmonize with its processes in a most admirable 
manner. 

3. In consequence of these facts the remedies comprised in this 
class are those which are least expensive to the system, since they will 
accomplish the results desired with the least expenditure of vitality. 
On this account they are to be recommended above all others, and 
should be employed to the exclusion of all others when accessible, and 
when they are capable of meeting the requirements of the case in 
hand. That we are not alone in this view of the merits of hygienic 
remedial agents, or hygeio-therapeutics, we might show by numerous 


600 


RATIONAL REMEDIES FOR DISEASE. 


references to the teachings of eminent medical instructors, were it nec¬ 
essary ; but so general has the admission of this truth become, that we 
need not weary either ourselves or our readers with quotations upon 
the subject. One or two references will suffice as illustrations of many. 

“ It is the duty of the physician to restore health by the simplest 
means in his power.”— Prof. S. G. Armor, M. D., of the Long Island 
Medical College. 

“ Hygiene is of far more value in the treatment of disease than 
drugs.”— Prof. Willard Parker, of the New York College of Physicians 
and Surgeons. 

Let us now consider in detail the merits and modes of application 
of each one of these agents. 

WATER. 

In order to understand the relations of water to the system as a 
remedial agent we must become acquainted, in some degree at least, 
with its physical properties. Water exists in three states; viz., as a 
solid, in the form of ice; as a liquid, its most common form; and as a 
vapor, in the form of steam. When in the last condition, the gaseous, 
it is invisible. That to which the term steam is very commonly ap¬ 
plied, is not steam, but water in a state of fine division, or mist. 

Below 32° F., pure water exists in the form of ice. Between 32° 
and 212°, it is a liquid. At 212° it is converted into vapor. Water 
slowly evaporates at all temperatures below 212°, being absorbed and 
held in solution by the air. 

Water possesses the greatest specific heat of any substance. By 
specific heat is meant the actual amount of heat required to elevate 
its temperature a given number of degrees. For example, it requires 
ten times as much heat to raise a pound of water 1° in temperature 
as to elevate a pound of copper 1° in temperature. To raise the tem¬ 
perature of a pound of lead 1°, requires only one-thirtieth as much 
heat as to produce the same effect upon a pound of water. Water ab¬ 
sorbs more heat by elevation of temperature than any other substance. 
In passing from the solid to the liquid state, it absorbs a vast amount 
of heat without any elevation of temperature. The same thing occurs 
in the conversion of water into steam or vapor by evaporation. In 
the evaporation of one pound of water, as much heat is absorbed, or 
rendered latent, as would suffice to raise nearly a thousand pounds of 
water one degree in temperature. This heat is abstracted from sur- 


PHYSIOLOGICAL EFFECTS OF WATER. 


601 


rounding objects; and, hence, evaporation is one of the most powerful 
means of producing cold. The effect is the same, no matter what the 
temperature at which evaporation occurs. 

Water is not the best conductor of heat, but it conducts much 
more readily than air, and readily communicates its heat to bodies 
with which it comes in contact, also abstracting heat when of a lower 
temperature, when changing from a solid to a liquid state, or from the 
liquid to the gaseous condition. 

One of the most useful properties of water is its power to dissolve 
numerous substances, its solvent properties being nearly universal. 
To this property it owes its value as a cleansing agent, as also its 
value as a means of aiding nutrition by dissolving and circulating the 
nutritive elements required for the sustenance of the body, and wash¬ 
ing away from the tissues the waste products resulting from their activ¬ 
ity. It is also through its solvent properties, as we shall show, that 
some of its most important remedial applications are attributable. 

The Physiological Effects of Water. —The effects of water 
upon the human system are the results of the operation of its phys¬ 
ical properties in conjunction with the vital forces. As with all other 
agents, its effects may be either local or general, according to the mode 
of application. Different effects are also produced, according as the 
administration is internal or external. Many other modifying circum¬ 
stances, as age, sex, and physical condition, affect the results in a 
greater or lesser degree. 

Water affects the system through three different means; viz:— 

1. As a diluent. 

2. By its solvent properties. 

3. By modifying the general or local temperature of the body. 

1. Water as a Diluent. —Water is received into the system by 
absorption, either through a mucous membrane, or through the skin. 
It usually enters through the medium of the stomach and intestinal 
canal. When received into the blood, it of course increases its volume, 
and produces an increased fullness of the circulatory vessels, which 
are never distended to their fullest extent, and hence allow room for 
change in the volume of their contents. The blood is necessarily ren¬ 
dered more fluid, and if previously in any degree viscid its circulation 
is quickened by its dilution. Hence it is of great importance that care 
should be taken to supply the blood with a sufficient quantity of fluid. 
This is especially necessary during the hot season of the year, when 


602 


RATIONAL REMEDIES FOR DISEASE. 


the blood loses its watery portion quite rapidly through profuse per¬ 
spiration. It is also important to be remembered by those who are 
exposed to extreme artificial heat, as is .the case with glass-blowers 
furnace-men, stokers, etc. 

2. The Effects of the Solvent Properties of Water. — With 

the exception of air, water is the most transient of all the elements re¬ 
ceived into the body. It is eliminated by the skin, the lungs, the kid¬ 
neys, and the intestines. By its solvent action, it dissolves the various 
poisonous products of the disintegration of the tissues. The volume of 
the blood being increased, more water comes in contact with the debris 
contained in any part, and, in consequence, the same undesirable prod 
ucts are more perfectly removed. The increased amount of excremen- 
titious matter in solution is brought in contact with the various depu¬ 
rating organs, producing, notably, the following results:— 

a. An increase of the urinary excretion. It is an important fact 
that this increase does not consist in the addition of water merely, or di¬ 
lution, but that there is also an increased amount of urea, the chief ex- 
crementitious principle removed from the blood by the kidneys. 

b. An increase in the cutaneous excretion. Water-drinking is one 
of the most efficient means of producing copious perspiration; which, as 
with the urinary excretion, is not a mere elimination of water, but is a 
real depurating process. 

c. An increase in the action of the liver. Experiments made with 
every care to avoid the possibility of error, by the most eminent 
scientists and physiologists, show that the drinking of water is one 
of the most efficient means of increasing the activity of the liver, increas¬ 
ing not only the quantity of bile formed, but the amount of solid mat¬ 
ter secreted and excreted. 

d. Increased action of the intestinal mucous membrane. Elimi¬ 
nation from the mucous membrane of the intestinal canal, which Is an 
important organ of excretion, is also increased by drinking freely of pure 
water. The result of this increased action is not only to remove from 
the blood some of its foulest constituents, but to render more fluid the 
contents of the intestines, and thus tend to obviate that almost universal 
accompaniment of sedentary habits, constipation. 

The removal of clogging matters from the system in this manner al¬ 
lows greater freedom of vital action, so that the activities of the body 
are quickened, and both waste and repair, disintegration and assimila¬ 
tion, are accelerated. 


EFFECTS OF MODIFICATION OF TEMPERATURE. 


603 


I he use of water thus hastens all the vital processes by increasing 
the change of tissue. This result is, of course, chiefly obtained by em¬ 
ploying it as a drink. The experiments of Liebig fully confirm this 
view. He expressly mentions the free use of water as one of the means 
of accelerating vital change. Prof. John B. Biddle, M. D., hi his “ Ma¬ 
teria Medica,” states that “ it promotes both the metamorphosis and con¬ 
struction of tissue,” from which fact he attributes to it valuable curative 
properties as an alterative, when the removal of a morbid taint is de¬ 
sired, as in certain venereal diseases. Numerous other observers and 
experimenters attribute to water the same effects. It has also been 
noted that not only eliminative but assimilative processes are facilitated 
by the free use of water internally, and even in greater degree, so that 
those who drink water freely as a therapeutic means, usually increase in 
weight. The greater purity of the blood and the more perfect removal of 
obstructions, facilitates tissue formation and repair. 

3. Effects Resulting from the Modification of Temperature.— 

Perhaps the most important, certainly the most common, effects of water 
upon the living organism are those which result from its modifications 
of the temperature of the body in its various modes of application. 
These effects vary greatly, according to the temperature and the dura¬ 
tion of the application. General and local applications also differ in their 
results. All of the effects of water are chiefly the results of the vital re¬ 
sistance of the system in its attempts to remove abnormal or unusual 
conditions, or to accommodate itself to new circumstances. 

Baths are divided into six classes, according to their temperature, as 
follows:— 

1. Cold,.33° to 60° F. 

2. Cool,.60° “ 70° “ 

3. Temperate, .... 70° “ 85° “ 

4. Tepid,.85° “ 92° “ 

5. Warm,.92° “ 98° “ 

6. Hot,.98° “112° “ 

For the sake of simplicity, we will consider the effects of water ap¬ 
plications under three heads, viz., cold, warm, and hot. 

The Cold Bath .—Under this head we will consider applications of all 
temperatures below 85° F. Cold or cool water, applied to any portion 
of the body, causes instant contraction of the small arteries of the part, 
through its influence upon the sympathetic or vaso-motor system of 
nerves. So long as the application of the unusual temperature is con- 






G04 


RATIONAL REMEDIES FOR DISEASE. 


tinued, the vascular contraction is maintained, and the part seems nearly 
bloodless. If the cold is below 33° F., and is long continued, destruction 
of the tissues by freezing will rasult. 

If a moderately cool or cold temperature is maintained for some 
time, the blood-vessels of the part are more or less permanently con¬ 
tracted, and the blood supply thus lessened. If, on the other hand, the 
application is very brief, the contraction of the vessels is only moment¬ 
ary, and is followed by a proportionate degree of relaxation, and a cor¬ 
responding increase in the supply of blood to the part. 

A very cold bath applied to any considerable portion of the body, 
and continued more than a very brief time, produces headache, dullness, 
sometimes nausea and vomiting, loss of sensibility, and other unpleasant 
and painful symptoms. 

It is thus seen that the effects of cold are quite different—exactly 
opposite, in fact—as the application is a prolonged or a brief one. The 
long application produces effects in some degree permanently sedative, 
while the brief application is followed by a momentary condition which 
may be termed shock, and which is usually followed ver} 7 quickly by a 
reaction analogous to stimulation when produced in any other manner. 

Effect of Cold upon tlie Pulse .—The experiments of Drs. Currie, 
Bell, and others, show conclusively that the cold bath has the uniform 
effect of diminishing the frequency of the heart’s action from ten to 
twenty beats in a minute below the usual standard. Upon the first ap¬ 
plication of cold, there is a slight increase in the rate of pulsation; but 
this soon subsides, and is succeeded by a marked diminution. The ulti¬ 
mate effect is the same, whether the application is made at its maximum 
degree of severity or not; but if the application is first warm, being 
gradually reduced in temperature, the result is reached without the oc¬ 
currence of the unpleasant shock, or feeling of chilliness, which attends 
the sudden application of cold, especially in persons of delicate nervous 
sensibilities. The amount and after-duration of the diminished rate of 
pulsation depends upon the temperature and duration of the bath. In 
health, it does not commonly extend beyond a few hours at most. 

Effect of Cold upon Temperature .—It was also shown by the 
same experimenters that the temperature of the body is reduced pro¬ 
portionately with the action of the heart. The natural temperature, as 
shown by a thermometer placed in the axilla, is 98° F. During and 
after a cold bath, the thermometer applied to the same part, indicates 
from one-half a degree to five or six, or even more degrees, diminution 
of temperature. In some cases the temperature continues to fall after 


EFFECTS OF COLD BATH. 


605 


the bath. The real temperature is lessened, even though the skin may 
glow, and even seem to possess increased warmth. Cold and heat are, 
within certain limits, wholly relative terms to the nerves of sensibility. 
What is warm at one time may be cold at another, though the temper¬ 
ature remains the same. The same temperature may be warm to one 
hand and cool to the other. Temperature can only be accurately de¬ 
termined by the thermometer. 

Rationale of Effects of the Cold Bath .—The manner in which the 
cold bath produces the sedative effects noted, is apparently simple. 
\\ hen applied locally, to a single organ or part, it diminishes the cir¬ 
culation in the part by occasioning contraction of the muscular coats 
of the arterioles, or small arteries. Their caliber being thus lessened, 
they of course allow the passage of less blood, and the circulation in 
the part is diminished. There are three causes for the decrease of 
heat; viz.,— 

1. A portion of the heat of any part is brought to it by the blood; 
the supply of blood being lessened, the heat is diminished. 

2. Heat is produced by vital changes which occur in the capilla¬ 
ries'or their immediate vicinity. These depend chiefly upon the sup¬ 
ply of oxygen, which, again, is largely regulated by the blood supply ; 
and it being lessened with the blood, the amount of heat ■produced is 
diminished. 

Again, it has long been known that all the vital activities of the 
body, which result in its growth, repair, and development, as well as 
all the functions peculiar to animal life, including animal heat, are 
due to the action of the protoplasmic elements of the body. It has 
also been long known that cold will restrain these activities. Every 
microscopist is familiar with the fact that in studying the movements 
of white blood corpuscles, or of other protoplasmic elements, it is neces¬ 
sary to maintain a temperature at least equal to that of the body. 
When the temperature falls, the amoeboid movements cease; as the 
temperature is raised, they begin again. If the temperature is raised 
above that of the body, there is a wonderful and unnatural increase in 
the activity of the protoplasmic masses. In view of these well-known 
facts, are we not justified in the conclusion that the application of cold 
to the body, either locally or generally, may lessen the production of 
heat by lessening the vital activities, or protoplasmic movements by 
which animal heat is largely, if not wholly, maintained ? It may be 
suggested in answer to this argument, that animal heat may be pro- 


606 


RATIONAL REMEDIES FOR DISEASE. 


duced by chemical changes within the body analogous to combustion. 
To this we may rejoin that while the renowned Dr. Priestly, originally, 
and afterward Dr. Currie, and still later, the great chemist of Ger¬ 
many, Prof. Liebig, attributed the production of animal heat to the 
union of oxygen with hydrogen and carbon within the body, by a proc¬ 
ess of real combustion, later investigators have unanimously dis¬ 
carded the idea as unsupported by facts. The present view on this 
subject is that oxygen does not combine directly with the carbon, hy¬ 
drogen, or any other of the elements of the tissues or of the blood, but 
that it is assimilated like other forms of food, while carbon di-oxide is 
excreted, like urea, cholesterine, and others of the effete matters of the 
body. Animal heat is one of the results of the various metamorphoses 
of the tissues by which these waste matters are produced. 

3. The water in contact with the part, being of a lower tempera¬ 
ture, abstracts heat from it as it would from any other body of a 
higher temperature than itself. 

When the application of cold water is more general, being made to 
the whole body or to a considerable portion of it, the same .effects are 
produced on a larger scale. A large proportion of the small arteries 
of the body, being brought under the influence of cold, are made to 
contract, thus directly lessening the circulation, and so diminishing, 
also, the production of heat. Through the sympathetic system, the 
same effect produced upon the small arteries is produced also upon the 
heart, lessening the rapidity of its contractions. Again, it has been 
satisfactorily shown that the action of the heart is largely controlled 
by the action of the small arteries; so that we have abundant expla¬ 
nation of the decrease in the rate of pulsation. Finally we have a 
cold fluid in contact with a large portion of the body, abstracting heat 
by conduction, as Veil as lessening its production. 

The rationale of the effects of a cold bath of very short duration is 
equally simple. The sudden impression of cold excites to vigorous 
action the nerve centers which have control of the circulatory and 
heat-producing functions, and thus, through the vital reaction of the 
system, effects contrary to those of a prolonged application are ob¬ 
tained. 

Thus we see that water may be applied in such a manner as to 
produce either most powerful stimulating effects, or to depress the 
vital activities of the body, diminishing circulation and animal heat in 
a most remarkable manner. 


THE EOT BATH. 


607 


The effects of local applications of cold water are less marked upon 
the general system, though essentially the same effects are observed in 
the stimulation of the circulation and vital activities by short and the 
opposite by prolonged applications. The pulse and general tempera¬ 
ture of the body are affected in proportion to the extent of the appli¬ 
cation. 

The Hot Bath .—We shall include under this head applications of 
a temperature above 98° F., the mean temperature of the body. As 
with the cold bath, the effects differ greatly, according as the applica¬ 
tion is brief or prolonged. Local and general applications also differ 
in their effects. 

A brief local application causes an increase in the circulation of a 
part which very closely resembles, perhaps is identical with, active 
congestion. The small artei’ies are distended, and the vital activities 
and heat of the part are increased. The several effects seem to be lit¬ 
tle different from those resulting from the application of a mild sin¬ 
apism. The action of the vital instincts is defensive in both cases. 

When applied to special organs, special effects are produced. For 
instance, a hot fomentation applied to the head for a few minutes will 
usually produce drowsiness by diversion of a portion of the blood sup¬ 
ply of the brain to the skull and scalp. Prolonged applications pro¬ 
duce a more or less permanent relaxation of the blood-vessels, and con¬ 
sequent congestion. 

A hot bath applied to the whole body, or a large portion of it, pro¬ 
duces an acceleration of the pulse and an increase of animal heat pro¬ 
portionate to the temperature of the bath. A bath at 106° to 108° F. 
will increase the pulse from the normal standard to one hundred or 
one hundred and twenty beats in a minute, in a short time. A bath 
four or five degrees hotter has been known to increase the pulse to 
more than one hundred and fifty beats in a minute. 

When a hot bath is prolonged, the face becomes flushed, and the 
whole skin very red; the head aches; sight is sometimes dimmed; 
ringing in the ears, faintness, a stinging pain in the skin, and intense 
desire to urinate, are symptoms which are often present. Copious 
perspiration and intense congestion of the skin are constant effects. 
The cutaneous congestion, from relaxation of the blood-vessels, is apt 
to continue to exist after the bath, if it is greatly prolonged, to the se¬ 
rious injury of the subject. 

The effects of the vapor bath are essentially the same as those de- 


608 


RATIONAL REMEDIES FOR DISEASE. 


scribed, though a somewhat higher degree of heat is tolerated without 
injury. In the hot-air bath a still higher heat is borne with impu¬ 
nity. 

When local applications are made at a temperature of 108° to 
120° F., the first effect seems to be contraction of the small vessels. 
At any rate, such an application is the best known means of checking 
capillary hemorrhage. 

Rationale of Effects of the Hot Bath .—It scarcely need be repeated 
that all of the effects noticed, as well as those of all other baths, are 
chiefly the results of modifications of vital action occasioned by the 
agent employed. The application of heat to the body occasions relax¬ 
ation of the muscular coats of the small arteries, and increased action 
of those vessels. No doubt this is for the purpose of bringing moist¬ 
ure to the surface to protect the tissues against the unnatural heat. 
As is the case with cold baths, the causes which modify the heat are 
three; viz.,— 

1. The increased quantity of blood circulating through the part 
brings to it an increased amount of heat. 

2. Increased vital and chemical action increases the production of 
heat. 

3. The body absorbs heat from the surrounding medium as any 
other colder object would do. 

In the general application of hot water or vapor, effects similar to 
its local effects are produced upon the whole surface of the body, in¬ 
volving, also, to a considerable extent, the deeper structures. The 
pulse is accelerated because the small arteries are distended and more 
active, creating a demand for a greater quantity of blood, requiring an 
increase in the heart’s action. It is also quite probable that the action 
of the heart is somewhat quickened as the result of the influence of 
heat upon the pneumogastric nerve which controls it. 

The cerebral symptoms, faintness, etc., which occur when heat is 
applied in excess, are the result of the diversion of so large a propor¬ 
tion of the blood into the superficial vessels. A prolonged hot foot 
bath or leg bath will often produce faintness. 

There are few agents which will so rapidly produce such powerfully 
excitant and stimulant effects as the hot bath. The painful and unde¬ 
sirable results occasioned by its incautious use are evidences of its 
power. 

The Harm Bath .—In this connection we apply the term warm to 


THE WARM BATH. 


009 


baths of a temperature between 85° and 98° F., though baths of a 
temperature between 85° and 92° would be more accurately termed 
tepid, which term is applied to baths of that temperature elsewhere 
than in this immediate connection. 

The warm bath never exceeds the temperature of the body, and is 
usually below it. Its effect is uniformly to diminish the frequency of 
the pulse and of respiration, and to decrease animal heat. Its effects 
are the same, though less in degree, as those of the cool or cold bath, 
in this respect, but they differ in sevei’al other particulars. Unlike 
the cold bath, the warm bath is not accompanied by an unpleasant 
shock, or chill, and hence is not followed by reaction. It promotes 
the action of the skin in a very marked degree, increasing both per¬ 
spiration and absorption. When continued for an hour or two, the 
weight is appreciably increased by the absorption of water. Its gen¬ 
eral effects are very mild and soothing, often inclining the patient to 
sleep. 

This bath seems to produce its effects not so much by exciting the 
vital energies to abnormal action or resistance as by supplying the 
most favorable conditions for the performance of the natural and usual 
functions. This is doubtless on account of its close approximation to 
the temperature of the body. In this respect, if this supposition be 
true, it differs from baths of a temperature either much above or 
greatly below the normal temperature of the body. 

Hebra, the eminent dematologist of Vienna, has shown by actual 
tests that human beings may exist in the warm bath not only many 
hours, but days, weeks, and even months—in one case nine months— 
without suffering the slightest inconvenience, all the bodily func¬ 
tions being performed without the least departure from the normal 
standard. 

The warm vapor bath produces effects quite analogous to those 
of the warm water bath. Its effect upon the processes of perspiration 
and absorption is a little more marked, even with the same degree of 
temperature. The results differ somewhat, according as the whole 
body is enveloped, so that the warm vapor is taken into the lungs, or 
the head excluded. A more equable effect is produced by including 
the whole body in the bath, and no harm can result if the temperature 
is not raised above that of the body, as it should not be, in the warm 
bath. 


39 


G10 


RATIONAL REMEDIES FOR DISEASE. 


Sympathetic Effects .—There is scarcely room for doubt that 
many of the effects of the various kinds of water applications are 
wholly of a sympathetic character. All portions of the body are inti¬ 
mately associated together by a system of nerves called the sympa¬ 
thetic system, from their peculiar function. Certain portions, as the 
skin and mucous membrane, are particularly related. The large num¬ 
ber cf sensitive nerves which connect the skin with the brain, bring it 
in peculiarly close relations to that organ, and give additional potency 
to any agent applied to so extensive a surface. The well-known fact 
that burns of the skin are often the occasion of fatal ulceration of the 
mucous membrane of the intestines sufficiently attests the intimate re¬ 
lation between these two tissues; while the effects upon the skin of 
mental emotions, as of shame and of fear, are conclusive evidence of 
the peculiar closeness of relation between the cerebral and cutaneous 
organs. Another fact observed by physiologists clearly shows the 
sympathetic effects of water under some circumstances, at least. It 
has been noticed that if one foot be placed in cold water, the other 
foot becomes warmer, an effect undoubtedly due to the sympathy ex¬ 
isting between the two organs, both being alike affected by the effort 
of the system to maintain the normal temperature of the exposed 
or^an. 

O 

Dr. Chapman, of London, a few years ago called the attention of 
the profession to the fact which he claims to have demonstrated that 
the application of heat or cold to the spine produces opposite effects in 
the parts to which they are applied and the parts of the body to which 
the nerves originating in those parts are di .tributed. That is, cold to 
the spine causes an increase in the blood supply of remote parts, while 
heat produces opposite effects. This he explains by the supposition 
that cold paralyzes the vasomoter centers and that heat stimulates 
their action. We have verified many of his results in our own prac¬ 
tice, and believe the effects to be such as he claims. 

Modes of Administration. —There are numerous modes of ad¬ 
ministering baths of all temperatures, each of which produces some 
modification of the general effect of the given temperature. For ex¬ 
ample, such baths as the douche, the spray, and the shower bath, are 
much more cooling in their effects than a full bath at the same tem¬ 
perature ; since, in the latter case, nearly the whole body would be 
submerged in a medium of equable temperature, while in the case of 
the spray, etc., the body would be additionally cooled by the rapid 


REMEDIAL PROPERTIES OF WATER, (jj | 

evaporation taking place upon its surface. Packings of all sorts pro¬ 
duce powerful diaphoresis, or perspiration. Alternate hot and cold 
applications occasion strong stimulant or revulsive effects. Many 
other peculiar effects are obtained by particular modes of administra¬ 
tion, which will be described hi their proper place. 

REMEDIAL PROPERTIES OF WATER, OR HYDRO¬ 
THERAPEUTICS, 

Under this head we shall consider, briefly, the different remedial 
purposes to which water may be applied, endeavoring to explain its 
various medical uses by its physiological effects, which we have al¬ 
ready studied. 

The value of most remedies is usually estimated by the number of 
“properties” which they possess and the efficiency and certainty with 
which their various effects may be obtained. Considered in this light, 
water may be presented as one of the most useful of all known reme¬ 
dies. Indeed, when the great diversity of its uses and the prompt 
and efficient character of its effects, together with the kindly manner 
in which it is received by the system, are considered, it is not to be 
wondered at that it has found not a few enthusiastic advocates who 
have believed it to be a universal remedy, a panacea for all human 
ills. Those who are best acquainted with its properties and its 
potency when properly applied are the most enthusiastic in its praise. 
The eminent Dr. Fothergill, of England, well known in this country 
through his admirable papers in American medical journals, would 
seem to be almost as warm an advocate of its use as the most ardent 
disciple of Priessnitz. In his “Hand-Book of Treatment” he says, 
“ Personally I believe that hydropathy, rescued from quackery and 
under proper professional guidance and superintendence, will form one 
of the most universal remedies of the future.” The same author 
again remarks in the work referred to, “ Indeed, in hydropathy we 
see empirically achieved what a scientific physiology would ere long- 
have indicated as the logical and rational plan of treatment of numer¬ 
ous affections of mature and advanced life, which take their origin in 
the imperfect elimination of waste, either the products of tissue 
change, histolysis, or the results of proteine compounds imperfectly as¬ 
similated or furnished to the system in excess of its needs.” 

Percy, an eminent foreign physician, surgeon-in-chief of the armies 


612 


RATIONAL REMEDIES FOR DISEASE. 


of the Moselle and the Rhine, declared that he would abandon the prac¬ 
tice of medicine if water were denied him as a remedial agent, saying, 
“ Water furnishes immense resources as a curative agent.” 

The remedial or therapeutic properties of water at various tempera¬ 
tures and applied in various forms may be stated to be the following:— 

Refrigerant or antiphlogistic, tonic, sedative, antispasmodic, ano¬ 
dyne, anesthetic, styptic, dissolvent, eliminative, laxative, emetic, de¬ 
rivative, and alterative. Others might be added, but these are sufficient 
to represent its several uses. 

Water as a Refrigerant. —Refrigerant, antiphlogistic, or antipy¬ 
retic remedies are such as have the effect to diminish bodily heat and re¬ 
strain inflammation. These remedies are very useful, indeed indispensa¬ 
ble, in the rational treatment of fevers and local inflammations, as well 
as in the prevention of inflammation from contusions, lacerations, fract¬ 
ures, and other surgical inj uries. When applied at a temperature less 
than that of the body, water lessens the production of heat, and also ab¬ 
stracts it by conduction. For this purpose it is unrivaled in the whole 
range of remedial agents. No other remedy will so readily, so easily, 
and so certainly, bring down the temperature of a fever, diminish the 
pulse, and ameliorate all the symptoms depending on exaggeration of 
vital activity as this. How this is effected has been previously ex¬ 
plained in considering the physiological effects of water. 

Water as a Tonic. —Water may be used in such a way as to in¬ 
crease the rapidity of the circulation and the temperature very quickly 
and powerfully. The hot bath is a most efficient stimulant, in the true 
sense of the word. It will so excite the circulation as to increase the 
pulse from seventy to one hundred and fifty in fifteen minutes. The 
tonic effects of a short cool bath are well appreciated by all who have 
ever enjoyed it. 

Sedative Effects of Water. —Remedies which depress vital action 
are termed sedatives. Cold water is one of the most effective sedatives. 
It will lower the temperature, rapidly diminish the pulse, and restrain 
excessive vital action to almost any degree desired, and without any of 
the unpleasant after-effects and few of the immediate dangers which ac¬ 
company the use of such remedies as prussic acid, tobacco, and blood¬ 
letting. The cool or tepid bath will often reduce the pulse twenty to 
forty beats per minute in a short time. 

Antispasmodic. —No remedy is so certainly successful in hysterical 
convulsions as water. In infantile convulsions, its success is also unri- 


REMEDIAL PROPERTIES OF WATER. 


613 


valed. In cramp, tetanus, and various forms of spasmodic affections, and 
even in puerperal convulsions, its utility has been well demonstrated. 

W ater as an Anodyne. —The effects of local applications of both 
warm and cold water in relieving pain are well known. In many other 
modes of application it is also effective in a very high degree in relieving 
pain and nervous irritability. 

Water as an Anesthetic. —The anesthetic effects of water at a 
very low temperature or in the form of ice are too well known to need 
more than mention. 

Styptic Effects of W ater. —The efficiency of cold water as a ready 
means for arresting hemorrhage has long been recognized in surgery; 
within a few years, however, it has been discovered that hot water, when 
properly applied, has a still more powerful effect, especially in cases of 
capillary oozing or bleeding from small vessels. We have on several oc¬ 
casions checked almost instantly a bleeding which resisted all other 
means which could be applied. 

Water as a Dissolvent. —The power of water to secure the ab¬ 
sorption or dispersion of some forms of morbid growths, particularly 
glandular enlargements, is now well recognized. By cold, or alternate 
hot and cold, applications, chronic swellings of the joints and other parts, 
serous accumulations, enlargements of lymphatic glands, of the thyroid 
gland, and even of the spleen and liver, may be successfully treated. 

Eliminative Effects of Water. —As water is a perfect solvent for 
the various excrementitious substances produced in the body through 
tissue waste, as well as of all the foreign elements which find entrance 
to the blood, it is of all substances the most efficient and powerful elim¬ 
inative. It has been proven to be thus eminently useful as a diaphoretic, 
in increasing the action of the skin ; as a diuretic, in facilitating excre¬ 
tion by the kidneys ; and as a most excellent cholagogue, in increasing 
the activity of the liver and occasioning a consequent increase in the 
production of bile. It is also, when properly applied, an excellent ex¬ 
pectorant, and undoubtedly also increases the action of all the excretory 
organs of the bodv. 

Laxative. —Used in various ways, water is very effectual in produ¬ 
cing: movement of the bowels, but never occasions those violent and un- 
pleasant symptoms which accompany and succeed the use of purgatives. 

Emetic. —In the great majority of cases no other emetic is needed, 
and no better can be found. Nearly all emetics require water to render 
them efficient. 


614 


RATIONAL REMEDIES FOR DISEASE. 


Alterative. —For a long period, mercury has been considered as the 
champion alterative of the materia medica. It must yield the place to 
water, however; for the most it can do is to destroy the elements of the 
blood, while water not only accelerates waste, but increases construction 
in the same proportion, according to the experiments of Prof. Liebig and 
other eminent observers. This efleet of water results from both its in¬ 
ternal and its external use. 

Derivative, —One of the most important properties of water applica¬ 
tions is their powerful derivative effect. No other application, internal 
or external, can equal them in efficiency and certainty of action. 

There are very few agents which possess so many remedial properties 
as water. There are none which effect so much with so little expense to 
the vital powers of the patient. Many drugs will produce results similar 
to those obtained by the use of water, and thus accomplish good, no 
doubt; but at the same time they often work so much mischief in the 
system that the evil done is frequently much greater than the good ac¬ 
complished. The aim of the faithful physician should be to accomplish 
for his patient the greatest amount of good at the least expense of vital¬ 
ity ; and it is an indisputable fact that in a large number of cases water 
is just the agent with which this desirable end can be obtained. 

HISTORY OF HYDRO-THERAPEUTICS, 

The utility of water as an agent in the treatment of disease is not a 
modern discovery, as the pretensions of some aspirants for notoriety have 
led many to believe. A very cursory glance at the history of various 
ancient nations furnishes sufficient evidence that the use of the bath as a 
curative agent was of very remote origin. The works of the oldest 
medical authors contain numerous references to the bath, recommenda¬ 
tions of its use in cases of disease, and testimonials of its good effects 
when properly employed. As this is a matter of some interest to many 
of those who employ and advocate the use of water as a remedial agent, 
as well as to those who are investigating its merits, we shall devote a 
little space to a sketch of the use and estimation of the bath by various 
nations and tribes—civilized and barbarous—and regular and irregular 
physicians, from the remote ages of antiquity down to modern times. 

The Bath in Egypt .—That bathing was practiced to a considerable 
extent by the Egyptians at a very early period, is evinced by both sacred 
and profane history. It was through obedience to this custom that 


GREEK AND ROMAN RATES. 


G15 


Moses was discovered among the rushes by Pharaoh’s daughter as she 
went down to the river-side to bathe. Pictures discovered in ancient. 
Egyptian tombs represent persons preparing for the bath. We have no 
expression of the estimate which was placed upon the bath as a remedial 
agent; but it is hardly possible to believe that an agent held in such 
high esteem as a preventive of disease should not be valued as a useful 
remedy. 

Bathing among the Jews. —The code of laws prepared by Moses, 
under divine instruction, for the government of the Hebrew nation after 
its departure from Egypt, made bathing a prominent feature. The con¬ 
nection of the bath with the treatment of leprosy would naturally lead 
to the conclusion that it was employed for its curative effects. 

Pe rsian Baths. —The ancient Persians held the bath in such hicdi 

© 

esteem that they erected magnificent public structures devoted to 
bathing. The baths of Darius are spoken of as especially remarkable. 
According to the statements of a German physician, the Persians still 
continue the use of water as a remedial agent, especially in cholera 
times, when pails of water are in some cities placed at the street cor¬ 
ners and along the road to be in readiness for use as soon as an indi- 
vidual is attacked. The mode of treatment is the cold douche, fol¬ 
lowed by vigorous friction of the skin. 

The Batli among the Greeks. —The cold bath was employed 
among the Greeks. Lycurgus, the famous Spartan legislator, pre¬ 
scribed its daily use by all his subjects, not excepting the tenderest 
infants. In later times, the warm bath was introduced, and stately 

buildings were erected for the accommodation of bathers. 

© 

The learned Greek, Hippocrates, the father of medical literature, 
and a very acute observer of disease and the effects of various agents 
upon the body, highly recommended the use of water in many dis¬ 
eases, describing with great care the proper mode of administering a 
simple bath. He laid great stress upon the careful and skillful use of 
the bath, asserting that, when improperly applied, it, “ instead of doing- 
good, may rather prove injurious.” His directions for the employ¬ 
ment of the bath were very discreet. He very wisely remarks that 
those patients whose symptoms are such that they would he benefited by 
bathing should be bathed, even though some of the requisite conven¬ 
iences may be wanting; while those whose symptoms do not indicate 
the need of this remedy, should not employ it, though all the neces- 


616 


RATIONAL REMEDIES FOR DISEASE. 


sary appliances are at hand. He made great use of water as a bever¬ 
age in treating disease. 

© © 

Roman Baths. —The Romans excelled all other nations in the 
sumptuousness of their bathing arrangements. Their public baths 
were among their greatest works of architecture, and were supplied 
with every convenience for increasing the utility and luxury of the 
bath. Kings and emperors vied with each other in perfecting and en¬ 
larging these sanitary institutions. Accommodations were provided, 
in some cases, for nearly 20,000 persons to bathe simultaneously; and 
at one time the number of public baths in Rome was nearly one thou¬ 
sand. Even Nero, whose name has come down to us covered with in¬ 
famy, has the credit of doing at least one good act in erecting a mag¬ 
nificent public bath, though even the detergent effects of such an act 
can hardly cleanse his character of the many foul blots by which it is 
rendered odious. 

Celsus and Galen, two noted Latin physicians, extolled the bath 
as an invaluable remedy almost two thousand years ago. The latter 
pronounced the bath to be one of the essential features of a system of 
perfect cure which he termed opotheraphia, exercise and friction being 
the other essentials. If the regular physicians of half a century ago 
had followed the practice of Galen, as described in his works, they 
would have refreshed their languishing fever patients with cold water 
as a beverage instead of leaving them to be consumed by the pent-up 
fires which parched their lips, disorganized their blood, and finally 
ended their sufferings with their lives. Celsus was proud to boast of 
employing the bath more frequently and systematically than others 
had done before his time. 

The emperor Augustus was cured by the bath, of a disease which 
had baffled all other remedies. 

Testimony of Arabian Physicians. —Although the Arabians are 
at the present day looked upon, and justly, as a horde of wandering 
wild-men, a thousand years ago their physicians were among the most 
learned of the age; and they were as sensible as learned, we judge, 
for they were most enthusiastic advocates of the efficiency of the bath. 
Rhazes, one of the most eminent of them, describes a plan of treating 
small-pox and measles which would scarcely be modified by the most 
zealous advocate of water treatment at the present day. Avicenna 
and Meshnes, with others, may be mentioned as holding similar views. 


MODERN BATHING CUSTOMS. 


617 


The bath was much used in pestilences by this nation, and was 
largely employed in Constantinople in the fifteenth century. 

Modern Bathing Customs. —Three centuries ago, public vapor 
baths were very numerous in Paris, being connected with barber 
shops, as are many baths in this country at the present time. Accord¬ 
ing to Dr. Bell, Paris can still boast of a great number of bathing es¬ 
tablishments. He states that in the baths connected with the city 
hospitals nearly 180.000 baths were administered in a single year to 
out-door patients. Doubtless those treated in the hospitals -were duly 
washed and steamed as well. This is certainly a very marked con¬ 
trast with what we see in the hospitals in this country at the present 
day. Notwithstanding the advances in many other particulars of 
hospital management, the cuticles of patients are sadly neglected. In 
some of our largest hospitals, the filthiness of many patients is so great 
that close proximity to them is absolutely intolerable. Half a dozen 
of them, placed in a warm room, speedily impart to the air a fetor un¬ 
equaled by anything but the effluvia arising from a neglected pig-sty. 
Such neglect is inexcusable. 

C' 

The Germans of olden time were very fond of bathing, according 
to their historical records, and during the Middle Ages, when plagued 
with the leprosy, the national faith in the virtues of the bath was man¬ 
ifested by making it a religious duty. It is related of Charlemagne 
that he used to hold his court in a huge warm bath. Modern Teutons 
seem less partial to the bath, having transferred their fondness from 
aqua pura to lager-beer. 

Although the bath was very freely used in England while the 
island was occupied by the Romans, who erected commodious baths 
like those in Rome, the wholesome practice is now sadly neglected by 
the English people, if w r e may credit their own writers. 

It is a curious fact that the bath seems to be quite generally neg¬ 
lected by the most civilized races, while it is almost universally em¬ 
ployed by those less advanced nations, the Russians, Turks, Finland¬ 
ers, and the inhabitants of Persia, Egypt, Barbary, and Hindostan. 
The Finlanders make great use of the sweating bath. To nearly ev¬ 
ery house is attached a small sweat-house, where they subject them¬ 
selves to a temperature of more than 160 F., often emerging at once 
into an atmosphere much below freezing, with apparent impunity. 
The Turkish and Russian baths, similar to which are those in use in 
Egypt and India, are elsewhere described. 


G18 


RATIONAL REMEDIES FOR DISEASE. 


The North American Indians employ the bath for many diseases. 
They have original and peculiar ways of administering both water 
and vapor baths. The most common bath among them is the vapor, 
followed by a plunge into a neighboring stream. They generate the 
steam by pouring water upon hot stones while they are inclosed in a 
small, close hut, made of mud or skins. The native Mexicans secure 
a hot-air bath by confining themselves in a brick sweat-house which 
is heated by a furnace outside. These savages seem to have the most 
implicit confidence in the efficacy of the bath, always employing it 
when ill, and with excellent success. The Africans, also, are not un¬ 
acquainted with the medical uses of the bath. It is stated that on 
the outbreak of small-pox on a slave-ship many years ago the negroes 
begged so piteously when treated in the usual manner, by smoth¬ 
ering: beneath many thicknesses of blankets and mattresses, to be 
allowed to follow their own method that they were at last permit¬ 
ted to do so, when they at once tied ropes about the bodies of the 
patients and let them down into the sea. This was done several times 
a day; and all thus treated recovered. 

Modern Medical Use of Water.- —In the early part of the eight¬ 
eenth century, a Sicilian named Fra Bernado acquired the title of 
“ cold-watei doctor ” from his exclusive use of coll water in treating the 
sick. 

At the very beginning of the eighteenth century, Floyer published a 
history of bathing which contains accounts of many remarkable cures 
effected by means of the bath, which he recommended as a most efficient- 
cure for numerous diseases. 

A Mr Hancock, a clergyman, published in 1722 a tract entitled, 
“ Common Water the Best Cure of Fevers.” Another writer, in a work 
entitled “The Curiosities of Common Water,” published in 1723, speaks 
of water as an “excellent remedy which will perform cures with very 
little trouble, and without any charge,” and “ may be truly styled, a 
universal remedy.” Both French and German writers were zealously 
advocating the use of water as a remedy for many diseases at this same 
period. Many of the French surgeons had also discovered the immense 
utility of water in surgery, receiving their first lessons of instruction 
from an ignorant and superstitious miller, who used water in conjunc¬ 
tion with charms. 

In the latter part of the last century, Drs. Jackson and Currie each 
published reports of cases of fever in which they had found the use of 


MODERN MEDICAL USE OF WATER. 


610 


the bath a remedy of remarkable efficacy. Dr. Currie obtained many 
followers for a time, but no very deep impression was made upon the 
public mind, though his cases were authentic, and were very ably re¬ 
ported. 

About the end of the first quarter of the present century, a native 
of Grsefenberg, a small town in Austrian Silesia, by the name of Priess- 
nitz, met with an accident by which three of his ribs were broken. He 
treated himself by applications of cold water, and then tried the same 
remedy upon others in similar cases. His success encouraged him to 
make further experiments, and though an ignorant peasant, his natural 
acuteness enabled him to devise various means for applying water to the 
body, and to suit the application to different diseases. His increasing- 
success attracted numerous patients, and his fame became, in a few 
years, world-wide. Many of his methods were very rude, and his igno¬ 
rance of medical science often led him into errors; but he succeeded in 
restoring to health hundreds of patients whose maladies had been pro¬ 
nounced incurable. 

The interest in the new method became so great that numerous 
other individuals, equally ignorant and possessing less shrewdness, under¬ 
took to imitate the German innovator. Some of them were successful, 
many of them were not; all were alike in committing numerous blun¬ 
ders through ignorance of scientific medicine. But public attention 
was called to the utility of water as a remedial agent so forcibly that a 
powerful impression was produced in its favor. From that time until 
the present, the use of water has been largely in the hands of unscien¬ 
tific empirics who have advocated it as a specific, and employed it to the 
exclusion of other remedies in a large measure. This course, together 
with many other gross errors connected with the practice, has deterred 
scientific physicians from employing it sufficiently to test its merits, only 
in a few exceptional instances. 

The friends of Priessnitz claimed for him a great discovery; but as 
we have seen, he discovered nothing which was not known a century 
before, if not, indeed, some thousands of years previous. It was doing 
Priessnitz no injustice to say that he did little or nothing toward estab¬ 
lishing principles, but followed, chiefly, a routine method of practice. 

Testimony of Eminent Physicians. —A few scientific members of 
the medical profession have investigated the subject in some degree, 
however, at various times, and the result has been that at the present 
day the utility of water is a well-recognized fact, and it is now often 


G20 


RATIONAL REMEDIES FOR DISEASE. 


prescribed in the standard text-books as an excellent remedy for many 
diseased conditions. Yet, that there is still a want of appreciation of 
the remedy is fully attested by the infrequency of its use by the regular 
profession. This neglect may be due in part to a prejudice which the 
members of the regular profession have acquired on account of the 
quackery which has too often been connected with the use of this rem¬ 
edy. Nevertheless, there is no good reason why an efficient remedial 
agent should be suffered to receive the stigma which properly attaches 
only to those who are responsible for its abuse. Within the last few 
years there has been a growing interest in hydrotherapy, especially 
among the leading physicians of France and Germany. In this 
country, also, an interest has been awakened in the subject, al¬ 
though among the non-progressive part of the medical profession there 
still remains much of the “old-time” prejudice, which has for years pre¬ 
vented this powerful remedial agent from taking its proper place in the 
front rank of therapeutic agents. Perhaps it may be interesting to con¬ 
sider the testimony of a few distinguished medical authorities in favor 
of water as a remedial aeent. 

O 

In favor of the use of water in febrile diseases we may cite the well- 
known names of Brand, Hagenbach, Zieinssen, Winternitz, Immerman, 
Mosier, Wilson, Fox, Bartels, Liebermeister, Ludwig, Schroeder, Fiedler, 
Hartenstein, Weber, Greenhow, Thompson, Niemeyer, and Ringer, 
among foreign physicians of eminence; and a still larger list of physi¬ 
cians of the highest standing in this country might be added. 

A few years ago we were present at a meeting of the New York 
Academy of Medicine, where we had the pleasure of listening to an able 
paper by Prof. Austin Flint, M. I)., president of the Academy, entitled, 
“ The Researches of Currie, and Recent Views concerning the Use of 
Cold Water.” The following is a brief abstract of the paper:—• 

Currie employed scientific methods in observing the phenomena of 
disease. He was one of the first to employ the thermometer in studying 
disease, and his observations can be received as reliable. 

The use of water externally as a means of reducing the temperature 
of the body in disease has recently been coming quite prominently into 
notice. According to Liebermeister, a noted German medical author, 
Currie was the first to systematize the use of water. His work was 
published in 1797. Liebermeister, in his recent article on typhoid fever, 
accords to cold water the first place in importance as an article for re¬ 
ducing the temperature. The use of water for this purpose is at present 


EMINENT TESTIMON Y. 


621 


attracting much attention; and it is safe to predict that it will soon oc¬ 
cupy an important place as a remedial agent. 

Much harm has been done by the “ rude empiricism ” of Priessnitz, 
and the various water-cures in the country; though much good has also 
been accomplished by the latter institutions, and they have in a measure 
prepared the public mind for the general introduction of water as a 
remedial agent. 

After the publication of the views of Currie in 1707, his method 
of practice, which was chiefly hydropathic, became quite general, but 
it was soon nearly forgotten. Trousseau recommended water treat¬ 
ment in scarlatina, and the use of the remedy has continued to be rec¬ 
ommended in the text-books; but as a measure of treatment in prac¬ 
tice it has become nearly obsolete. It is, however, obvious that unless 
we accept the absurd proposition that diseases have changed since 
Currie’s time, the remedy which he recommended so highly must be 
just as efficient now as then. 

Dr. Currie made use of the cold douche in fevers, applying it vig¬ 
orously to the patient while in the height of the fever, and continuing 
it until the temperature became decreased, as indicated by the ther¬ 
mometer and the pulse. He treated seven cases of continued fever by 
this method at the Liverpool infirmary. All recovered. In an epi¬ 
demic of typhoid fever among a regiment of troops, he treated fifty- 
eight cases, using the cool tepid douche in all but two cases. The lat¬ 
ter died. The remaining fifty-six recovered, the disease being greatly 
shortened in more than half the cases. 

Dr. Currie asserted that in small-pox, the use of the bath afforded 
instant relief to the patient, and caused the disease to assume a benig¬ 
nant form. 

He found the cold bath always effectual in tetanus and convulsions, 
as also in hysteria. 

In temporary insanity from the use of liquor, this acute observer 
found that the cold plunge was the most efficient remedy for the 
worst cases. 

But Dr. Currie’s practice was not confined to cold water. He ob¬ 
served that affusion with tepid water was not only a more pleasant 
application, but that it was even more effectual in reducing unnatural 
heat than cold water, as it produced no reaction, not being at all stim¬ 
ulating in character. 

With regard to the efficacy of this agent, Dr Currie stated that by 


622 


RATIONAL REMEDIES FOR DISEASE. 


its use in fevers the pulse would be reduced thirty or forty beats, with 
a corresponding decrease of temperature and almost immediate re¬ 
lief of headache. 

In his second volume, published some six years after his first vol¬ 
ume, Dr. Currie declared that although his experience in the use of 
water, especially in fevers, had been very extensive, he had had only 
four fatal cases in which water was employed, and had never met 
with a single evidence of its being in the least degree objectionable or 
injurious. Neither had he found that it had been thought to be ob¬ 
jectionable by those whom he had treated. He details a very inter¬ 
esting account of his treatment of scarlatina in the cases of his two 
sons, aged, respectively, three and five years. He gave the older, in 
thirty-two hours, fourteen affusions, varying from cold to tepid. 
Twelve were found to be sufficient for the younger one. Both became 
convalescent in three days. 

It was established by Currie that by the use of water the course 
of typhoid fever may be abbreviated. This is not even claimed for 
the modern remedies in common use. 

In referring to his own exoerience in the use of water, Dr. Flint re* 
marked, “ The relation of my own experience will of necessity be 
stated in a few words, as my employment of the remedy has hereto¬ 
fore been much more limited than it will be in the future if my life is 
spared.” He then related some ver}^ interesting cases in which he had 
employed water as the chief remedy with the most excellent success. 
He also took occasion to recommend, as one of the best means of ap¬ 
plying water in fevers, the wet-sheet pack as employed in the various 
hydropathic institutions of the country. He had used the continued 
cold pack in a number of the worst cases of sun-stroke in Bellevue 
Hospital with marked success. This remedy is still employed there in 
this class of cases. 

In a case of obstinate remittent fever, which was not in the least ben¬ 
efited by the thorough use of quinia, he employed the cool pack thirty- 
five times in a week, continuing each application from ten to thirty 
minutes, and always with great relief to the patient, although he 
finally died. He expressed the opinion that if he had employed the 
pack more thoroughly, making the applications longer and more fre¬ 
quent, the patient might have recovered. 

Currie announced a true theory when he said that the voice of nat¬ 
ure should not he superseded by theories. He advocated the free use 


EMINENT TESTIMONY. 


623 


of water as a beverage in febrile diseases as an important remedial 
agent. Dr. F. unhesitatingly advanced the belief that the chief ben¬ 
efit derived from the numerous mineral waters so largely used was 
only that which was due to the properties of pure water. He stated 
as proof, that it was not long since demonstrated by chemical analysis 
that the only thing peculiar about the water of a certain spring, fa¬ 
mous for medicinal virtues, was its remarkable purity. He also sug¬ 
gested the introduction of distilled water for cooking and drinking 
purposes as a necessary sanitary measure. 

Dr. F. then related a remarkable case of acute inflammation of the 
kidneys in which the patient exhibited the characteristic symptoms of 
poisoning from the retention of urea. After other remedies were 
tried in vain, the patient’s life was saved by the simple administration 
of water as a beverage at short intervals. The diuretic effects of the 
water soon washed away the poison and gave immediate relief. 

After the conclusion of the paper, by Dr. Flint, the venerable Dr. 
Richards arose and gave his experience in the use of water. His 
ideas of hydropathy were obtained when he was a young man, from 
Dr. Currie’s works. He adopted the practice of Dr. C. at that time in 
an epidemic of typhoid fever, and with such remarkable success as to 
astonish old practitioners. He stated that he had cured more than one 
hundred cases of obstinate constipation by simply directing the pa¬ 
tient to drink a glass of cold water half an hour before breakfast, each 
morning. In one of these cases the patient had not had a natural pas¬ 
sage from the bowels for a number of years; but he was effectually 
cured, by the simple remedy mentioned, in the course of a few months. 

Dr. Lovle gave an interesting resume of ten years’ experience in 
the use of water, with uniform success, especially in convulsions and 
scarlatina. He had employed water alone in about one hundred cases 
of acute inflammation of the kidneys and dropsy after scarlatina, and 
with wonderful success in every case. He had found it equally suc¬ 
cessful in coma, restoring consciousness when life was apparently ex¬ 
tinct. During the late war, he on one occasion renovated twenty am¬ 
bulance loads of exhausted soldiers who had fallen on the march, by 
the judicious use of water. He recommended water most highly as an 
excellent diuretic, and a capital regulator of the bowels, far superior to 
“ after-dinner pills.” He commended it also as an efficient remedy for 
sun-stroke and frozen feet. 

The sentiment of the audience—which was wholly composed of 


G24 


RATIONAL REMEDIES FOR DISEASE. 


medical gentlemen—was shown by the hearty applause with which 
the remarks of each speaker were received. 

We might add much other medical testimony, but as we could give 
no higher authority than the distinguished Dr. Flint, who stands at 
the head of medical practice in America, being author of the standard 
American text-hook on practical medicine, we will not weary the 
reader with further quotations. The German physicians, as well as 
German medical works, abound with tributes to the value of water. 
American medical journals are full of accounts of the beneficial results 
following its use in fevers and numerous other conditions. 

In surgery, the employment of water is rapidly gaining entire 
precedence. It has replaced nearly all other kinds of dressing for 
wounds, and its use has saved a valuable limb to many a poor sufferer 
who must otherwise have submitted to amputation. 

In short, wherever it is faithfully and intelligently applied, water 
is working wonders. Yet it is still little used in comparison with its 
importance. Especially is its use neglected in chronic diseases. The 
only reason we have been able to discover for this neglect of a remedy, 
the merits of which are so well demonstrated and so generally acknowl¬ 
edged, is that its use is more troublesome and laborious than the use 
of drugs. A half-dozen purgative pills are taken much more easily 
than an enema. The administration of a diaphoretic powder is far 
more convenient than a pack. A blister is easier to manage than a 
fomentation. But the true physician, who has at heart the real good 
of his patient, will not sacrifice the safety or comfort of the latter to 
his own personal convenience. 

Errors in the Use of Water. —Much of the prejudice against the 
use of water in treating disease has grown out of abuses of the rem¬ 
edy, and the putting forward of absurd claims by ignorant persons 
professing to understand its use. In order to vindicate the character 
of this powerful curative agent, it is necessary to expose the errors 
and ignorance of those who have abused it. 

In the early days of the modern water-cure practice, which was 
very largely introduced by Priessnitz, cold water was the universal 
remedy. No matter what the nature of the disease, or the condition 
or temperament of the patient, the remedy was the same. At the es¬ 
tablishment of the Graefenberg doctor, ice-cold douches, precipitated 
from a height of sixteen to eighteen feet, the plunge, directly supplied 
by the cold mountain springs, and the shower bath of the same tern- 


HEROIC TREATMENT. 


perature, were all administered to patients with little discrimination 
of modifying circumstances, in rooms unwarmed by artificial heat, 
even in the depths of the coldest mountain winters. As Grsefenberg 
was the source whence most water doctors of that time drew their 
knowledge, the same practice was pursued elsewhere. The unreasona¬ 
bleness of such a course was perceived by the more judicious, and thus, 
its influence was prejudicial. 

Heroic Treatment. —Such treatment as that described in the pre¬ 
ceding paragraph could not result otherwise than disastrously in nu¬ 
merous cases. The evil effects were sometimes seen at once, but more 
frequently they appeared after periods more or less remote. In some 
cases, patients were led to drink twenty or thirty glasses of cold water 
before breakfast, under the absurd doctrine that the evils of a small 
excess would be cured by greater indulgence. Hundreds of persons 
adopted the practice of daily bathing in cold water in a cold room, 
even in the coldest weather. A few even went so far as to spring 
from their warm beds on the coldest mornings, run to a neighboring- 
brook in a state of nudity, and plunge into its frigid waters through 
a hole in the ice. So infatuated were these enthusiasts that they really 
thought they enjoyed this refrigerating process; but, generally, a few 
years’ continuance of it was sufficient to produce such a “ sedative ” 
effect upon their systems that some became the victims of consump¬ 
tion and other constitutional diseases, while others were compelled to 
discontinue the practice from absolute inability to continue it. A few 
of the more vigorous were enabled to survive this violent treatment, 
without apparent injury for a long time; but those of weaker vital 
powers soon showed the results of its evil effects. 

By such processes, together with the cold sitz bath, the dry pack, 
and other harsh measures, the patient was sometimes brought to the 
very verge of the grave. 

Strange as it may appear, those who were formerly the strongest 
opponents of the use of water, themselves afford the best instances of 
its excessive use. For instance, in a case of low typhus fever, a “ reg¬ 
ular ” physician ordered the patient, a young woman, to be immersed 
in cold water for half an hour. The attendants attempted to carry 
out the prescription, but in a few moments her symptoms became so 
alarming that the patient was removed from the bath. It will not be 
considered remarkable that she died. A prominent New Tork phy¬ 
sician, a professor of practice in one of the largest medical colleges in 

40 


626 


RATIONAL REMEDIES FOR DISEASE. 


America, in a report of a case of remittent fever which he had treated 
with water, said that he administered thirty-five cold packs in a week. 
The patient died; but the doctor thought that if he had been more 
thorough in his treatment, giving more packs and longer ones, he 
would have lived. Another professor, of a rival college in the same 
city, cited, in a public lecture, a case of pneumonia which was treated 
hydropathically by a regular physician of note. The patient, while 
very feeble; was placed in a cold bath. He was taken out shivering, 
and died an hour afterward. His conclusion was that water was a 
very hazardous remedy. We would certainly agree with the profess¬ 
or’s conclusion if the case cited were an example of the proper use of 
water. In the preceding case, we will not say that the packs were 
not beneficial; but if they had been thus used by a professed hydro- 
pathist, the treatment would have been pronounced decidedly heroic. 

Crises. —By the violent processes which have been mentioned, the 
patient was frequently brought into a condition similar to that pro¬ 
duced by the old process of depletion by bleeding, antimony, mercury, 
and purgatives. Painful skin eruptions, boils, and carbuncles, often 
covered the whole body. Acute pains racked the body of the patient 
from head to foot. If he survived this “ crisis,” he usually got well, 
which was regarded as an evidence of the salutary effect of the crisis, 
and so it became an important object to be attained; and the worse a 
patient felt, the more certain and speedy, he was encouraged to be¬ 
lieve, would he his recovery. No account was taken of the immense 
waste of vital energy during these painful morbid processes. 

The use of the abdominal bandage, continued for a long time until 
an eruption is produced, is another means by which some have sought 
to effect a cure of their patients. This course is pursued under the 
belief that the discharge occurring from the surface which thus be¬ 
comes diseased is a vicarious means of removing impurities from the 
system—an absurd notion which no one acquainted with the first 
principles of physiology and surgical pathology could entertain for a 
moment. In many instances the skin is permanently injured by this 
process, as is evidenced by the appearance of pigment spots. 

Hydropathic Quacks. —Unfortunately for the reputation of water 
as a remedy, its use has been largely in the hands of empirics who 
have used it in a routine manner, and have supposed it to be a cure- 
all, and the only remedy of any value. At least, such have been the 
claims made for it. This has served to bring it into disrepute, the dis- 


A POPULAR ERROR. 627 

grace which ought to attach to individuals being applied by an undis¬ 
criminating public to the innocent victim of abuse. 

Ignorance. —The greatest bane of all has been the ignorance of 
those who have professed to be qualified to administer water as a 
remedy understandingly. Priessnitz himself was an ignorant peasant. 
He was innocent of either anatomical or surgical knowledge. His 
slight acquaintance with physiology was gathered by cursory observa¬ 
tions of patients. Of the effects of water he knew more, studying 
them with a good degree of acuteness. His lamentable want of 
knowledge allowed him to fall into many errors. It is related of him 
that he treated hopeless cases of solid anchylosis of joints just as 
though they were mere cases of stiffness from rheumatism. Cases of 
hopeless organic disease he pronounced curable and submitted to long 
but unavailing treatment, not knowing the real nature of the disease. 
A young lady died of what he supposed an internal abscess. No ab¬ 
scess was found, upon which he remarked that “ she had too short a 
neck for long life.” It is but fair to remark, however, that Priessnitz 
became more careful and discriminating in later years, and either re¬ 
fused cases of advanced phthisis or employed cold water in their treat¬ 
ment with great caution. 

It could be no wonder that the disciples of such a master 
should be sadly lacking in many of those qualifications essential for a 
successful physician, no matter what the remedies employed. The 
most lamentable feature of the matter is that the same ignorance has 
continued to be, with few exceptions, characteristic of those who have 
employed water as a remedy; this has been especially disastrous be¬ 
cause a man with the native shrewdness and acuteness of perception 
of Priessnitz has rarely appeared in the ranks of hydropathists. 

A Popular Error. —It is a grievous popular error that any one 
can apply water as skillfully as the most experienced physician, and 
that its successful use requires no knowledge of the structure and 
functions of the human body. No doubt this has grown out of an¬ 
other error, perhaps quite as common; viz., that water is so simple a 
remedy that it will do no harm if it does no good. Such notions have 
frequently led to most disastrous results. Water, as already shown, is 
one of the most powerful remedies. And while it is, undoubtedly, far 
safer in the hands of the uneducated than blisters, purgatives, diuret¬ 
ics, and such agents as opium, chloral, alcohol, and most other drugs, 
yet it certainly requires careful usage, and the more scientific lcnowl- 


628 


RATIONAL REMEDIES FOR DISEASE. 


edge the user possesses, the more skillfully will he be able to apply it. 
It is, furthermore, true that a great majority of ordinary diseases are 
commonly so void of danger under careful nursing and hygienic man¬ 
agement that the application of water is a simple matter which any 
intelligent mother can perform successfully. A case is related by 
good authority of a person who fell in apoplexy an hour after taking 
an excessively hot bath. Another patient became a paralytic from the 
same cause. Water is a remedy which cannot be safely used by one 
who has not informed himself of its effects, and of the proper modes 
of application. It is especially important that the £>eople should be¬ 
come intelligent in the use of this excellent remedy, since there is no 
doubt that one of the great obstacles which stands in the way of its 
general introduction by all intelligent physicians is the difficulty in 
getting people to carry out with care and accuracy the measures 
prescribed. 

Absurd Claims. —Sensible people have been rightfully disgusted 
with the claims which have been made by certain pretentious persons for 
the use of water. One declares that the bath will dissolve out of the 
body mineral substances which have been taken into it. Another 
claims to have been able, by the application of fomentations to a 
rheumatic knee, to extract in regular order the ointments which had 
previously been successively applied. Numerous other claims equally 
preposterous might be related, if it were necessary. They have all 
tended to excite a feeling of contempt for a means of treating disease 
which is really worthy of the highest estimation. 

Neglect of Other Remedies. —As has been previously remarked, 
many seem to have forgotten that water is not the only remedy for 
disease, and not only attempt to cure every disease by its application, 
but use it to the exclusion of all other remedies. In nearly all cases, 
sunlight, pure air, rest, exercise, proper food, and other hygienic agen¬ 
cies are quite as important as water. Electricity, too, is a remedy 
which should not be ignored ; and skillful surgery is absolutely indis¬ 
pensable in not a small number of cases. Even drugs are sometimes 
useful auxiliaries, though doubtless, infinitely more harm has resulted 
in the past from the employment of drugs in conjunction with water 
treatment than from their omission. 

Rational Hydropathy leaves room for every other remedy of value. 
It does not regard water as a specific nor as a panacea, but only as one 
of the most valuable of numerous excellent remedies. It discards the 


EFFECTS OF WATER APPLICATIONS. 


629 


erroneous and harmful practices of empirics and ignorant charlatans, 
whether they concern water or other agents, and gives to the aqueous 
element only its due share of importance. 

APPLICATIONS OF WATER, 

The indications which are to be met in the treatment of disease are 
chiefly those enumerated below; and how admirably they are met by 
applications of water may be easily demonstrated by following the di¬ 
rections given. 

1. Equalization of Circulation. —Disease cannot exist without 
some disturbance of the circulation. In perfect health each part re¬ 
ceives its due share of blood. One of the first indications in disease, 
then, is to balance the circulation. If an organ contains too much 
blood, the application of cold water to the part will occasion contrac¬ 
tion of the minute vessels of the part, and thus the amount of blood 
is lessened, as explained more at length in considering the physiolog¬ 
ical effects of water. 

Or, the part may be relieved by the application of warm water in 
some form to adjacent or remote parts of the body, by which means the 
surplus blood will be drawn to other parts, thus relieving the suffering- 
organ. Again, if an organ contains too little blood, the opposite 
course must be pursued. Warm or hot applications are made to the 
part, while cold applications may be made to other parts if necessary. 
Very often the two remedies may be advantageously combined, 
since one part cannot contain too much blood without some other 
part or parts being deprived of the due proportion, and vice versa: 
so that while a cold application is needed at one part, the opposite is 
required at another. 

2. Regulation of Temperature. —As the condition of the bodily 
temperature is closely associated with that of the circulation, the two 
are usually controlled by the same remedies applied in the same man¬ 
ner. A part which contains too much blood has usually, also, too high 
a degree of heat. The cold application relieves both. If the entire 
surface of the body is involved, the application must be as extensive 
as necessary to affect the whole. In general fevers, the admirable 
adaptation of water to this end is well exhibited. When the tempera¬ 
ture of the body rises above 100°, or even above 98°, a cooling bath 
should be resorted to. It may consist of a simple sponging with water, 
scarcely below the bodily temperature, an affusion with tepid water, a 


630 


RATIONAL REMEDIES FOR DISEASE. 


full bath of a tepid, temperate, or cold temperature, or some other form 
of cooling application, according to the degree of cooling effect desired. 
Any temperature below 98° will be cooling. In general, it is better to 
employ a bath only a few degrees below the bodily temperature, as its 
application will not be followed by an increase of heat, called reaction, 
which follows a brief application of a cool bath. To obtain the proper 
cooling effects of a cool or cold bath, it must be continued for some 
time, from ten minutes to half an hour, at least. The same remark 
applies also to the application of cool baths for the purpose of equal¬ 
izing the circulation. 

3. Removal of Pain. —Pain is usually dependent upon disturb¬ 
ance of the circulation, being caused by the pressure of overfilled ves¬ 
sels upon the nerves in a confined space. Pain may be relieved by 
either hot or cold applications. The first object should be to remove 
the surplus blood, by local cold applications and remote hot ones. If 
this plan is not successful, relief will be obtained by a local hot appli¬ 
cation, which operates by relaxing the surrounding tissues, so that the- 
nerve fibres are relieved from pressure, as well as by quickening the 
local circulation, and so relieving congestion. The latter method is. 
usually most quickly successful; but it is not so radically curative as 
the former. Pain dependent on passive congestion will be best re¬ 
lieved by the method next described. 

4. To Excite Activity. —Many organs often become torpid or inact¬ 
ive, as the skin and liver especially. Sometimes the blood-vessels of 
an organ become relaxed and inactive, passive congestion resulting. 
No remedy will so readily induce a return of activity to the affected 
parts as alternate hot and cold applications, continued for some min¬ 
utes, fifteen to thirty or more. This is one of the best applications 
for the relief of old pains. Short applications of cold water in the 
form of the douche, spray, or ice-rubbing, are also an excellent means of 
increasing functional activity. 

5. Removal of Obstructions. —A very large class of diseases are- 
attributable to obstruction in various organs, caused by the reception 
of foreign matters into the system, and the accumulation of the nat¬ 
ural waste of the tissues. The warm bath, to remove external ob¬ 
structions, and the internal use of water as a solvent for internal 
sources of obstruction, are the remedies which will achieve success in 
nearly all cases. Offending substances in the stomach are readily re- 


TEMPERATURE OF BATHS. 


G31 


moved by the water emetic; and hardened accumulations in the large 
intestine are removed with equal facility by means of the enema. 

6. Dilution of the Blood .—In fevers, cholera, and other diseases, 
the blood often becomes abnormally thickened, dark, and viscid, circu¬ 
lating with difficulty, and not imparting due nourishment to the tis¬ 
sues. Nothing but water can remedy this difficulty. It may be got 
into the blood by absorption from the skin, if the mucous membrane 
ef the stomach will not absorb it. 

7. Influence on the Nervous System. —Finally, it is often im¬ 
portant to affect certain organs through their nervous centers. Water, 
properly applied, will accomplish this also. A fomentation applied to 
the abdomen will often remove headache, and is an excellent remedy 
for general nervousness, seeming to affect the whole system, just as 
does galvanic electricity when applied to the same locality, doubtless 
through the large nervous ganglia located in that region. It is well 
established that applications to the spine affect the nerve centers in a 
powerful manner, inducing various and prompt effects in remote or¬ 
gans. The relaxing, quieting effect of the warm full bath in cases of 
nervous irritability is well known. 

Temperature of Baths. —The thermometer is the only accurate 
measure of temperature; hence the importance of its use in the 
administration of baths. Yet the thermometer may be abused. 
A given temperature may seem warm to one individual and tepid 
or cool to another. The same difference of sensation will occur 
in the same individual on different occasions. What seems cool to¬ 
day will be thought warm to-morrow. The susceptibility of the 
body to sensations of heat and cold largely depends upon its condition 
and the temperature of surrounding objects. In consequence of this 
physiological fact, it is improper to attempt, as some have done, to fix 
certain exact temperatures at which baths must be given to all per¬ 
sons under all conditions. 

For convenience and perspicuity, the temperatures of baths have 
been divided into six grades, as given in the following table by Forbes; 
all who attempt to use the bath according to the directions should 
carefully learn and preserve the distinctions here made:— 


632 


RATIONAL REMEDIES FOR DISEASE. 


1. Cold Bath, 

2. Cool, 

3. Temperate, 

4. Tepid, 

5. Warm, 

G. Hot, 


OO 0 

uO 

to G0° 

o 

o 

o 

“ 75° 

75° 

“ 85° 

85° 

“ 92° 

92° 

“ 98° 

98° 

“112° 


The vapor bath ranges from 08° to 120°; the hot-air or Turkish 
bath from 100° to 1G0°, or even higher, though not usefully so. 

A bath of any temperature above the natural heat of the body, 
93°, is a hot bath. At 32°, water becomes ice; a bath is very rarely 
given at this temperature, and then the application should be made to 
•only a small surface. Water at 32°, and even ice and snow, may be 
usefully employed as topical remedies in local diseases. It will rarely 
be necessary to employ a full bath at a lower temperature than 65°, 
which will usually seem very cold to the patient. A temperature from 
■85° to 95° is the most generally useful for baths which involve a con¬ 
siderable portion of the body, though of course higher temperatures 
■are employed in local applications. 

How to Determine the Temperature of a Bath without a 
Thermometer. —It is often necessary to administer a bath when a 
thermometer cannot be obtained. In such cases it is customary to 
test the temperature by placing the hand in the water. This is an 
unreliable method, however; for the hand becomes, by usage, so ob¬ 
tuse to heat that water which would seem only warm to it would be 
painfully hot to the body of the patient. To avoid this source of er¬ 
ror, it is only necessary to plunge the arm to the elbow into the 
water, by which means its real temperature will be determined. 
Water which causes redness of the skin is hot; when it feels simply 
comfortable, with no special sensation of either heat or cold, it is warm. 
Slightly cooler than this, it is tepid. When it causes the appearance 
•of goose-flesh, it may for practical purposes be called cool, a still lower 

decree being cold. 

© © 

Another Method .—The method about to be described is somewhat 
more accurate than the preceding, and may be found convenient for 
facilitating the preparation of a bath of proper quantity as well as 
temperature, a matter which though simple enough is often quite an¬ 
noying to inexperienced persons. It is a fact of common knowledge 
that water boils at 212° F. Boiling water, then, is always of this 







ADMINISTRATION OF BATHS. 


G33 


temperature. Well and spring water, and the water oil cisterns in 
winter, does not vaiy greatly from 53°. The temperature of well and 
spring water changes very slightly with the seasons. By combining 
in proper quantities water of these known temperatures, any required 
temperature may be produced. Not having seen this method sug¬ 
gested before, we have prepared the following table, which may per¬ 
haps be used to advantage in the absence of a thermometer; we ad¬ 
vise all to use a thermometer, however, when it is possible to do so:— 


Tem. 53 

2 

o 

qts. 

added 

Tem. 2 

to 1 

12°. 

qt. 

equals 

o 

o 

qts. 

a o 

10G° 

91 

9 

CC 

cc 

1 

CC 

cc 

H 

cc 

cc 

98° 

3 

cc 

cc 

1 

CC 

cc 

4 

cc 

cc 

93° 

4 

CC 

CC 

1 

CC 

cc 

5 

cc 

cc 

85° 

5 

cc 

cc 

1 

cc 

cc 

G 

cc 

cc 

80° 

G 

cc 

cc 

1 

cc 

cc 

7 

cc 

cc 

7G° 

8 

iC 

cc 

1 

cc 

cc 

9 

cc 

cc 

71° 


When larger quantities are needed, it is only necessary to multiply 
each of the combining quantities by the same number. For instance, 
if a gallon and a half of water is needed for a foot bath at 106°, pour 
into a pail or bath-tub four quarts of fresh well water and then add 
two quarts of boiling water. If four gallons of water are wanted for 
a sitz bath at 93° (a very common temperature), pour into the bath¬ 
tub three gallons of fresh well or spring water, and add one gallon of 
boiling water. Thus any required quantity can be obtained at the 
temperatures given. The cold water should be placed in the vessel 
first, and there should be no delay in adding the hot water, as it would 
rapidly lose its heat, and thus make a larger quantity necessary. De¬ 
terminate measurement is not essential. The ct)ld and hot water may 
be added alternately in proper proportions, being measured by the 
same vessel until the requisite quantity is prepared. 

RULES FOR BATHING AND THE ADMINISTRATION OF BATHS. 

The following general rules should be carefully studied and thor¬ 
oughly understood by every one who expects to employ the bath. Much 
injury to health and most of the discredit cast upon the use of water as 
a remedy have arisen from a disregard of some of them. 

1. A full bath should never be taken within two or three hours after 
a meal. Such local baths as fomentations, compresses, foot baths, and 


G34 


RATIONAL REMEDIES FOR DISEASE. 


even, sitz baths, may be taken an hour or two after a meal; indeed, 
compresses and fomentations may be applied immediately after a light 
meal without injury. 

2. Employ the thermometer to determine the temperature of every 
bath when possible to do so; if not, employ the other methods described. 

3. The temperature of the room during a bath should be 70° to 85°. 
Invalids require a warmer room than persons in health. Thorough 
ventilation is an important matter; but drafts must be carefully pre¬ 
vented, by screens of netting placed before openings into the room when 
necessary. 

4. Never apply either very cold or excessively hot treatment to aged 
or feeble patients. Cold is especially dangerous. Hot baths are rarely 
useful in health. The warm bath answers all the requirements of 
cleanliness. 

5. Never take a cold bath when exhausted or chilly. A German 
emperor lost his life by taking a cool bath after a fatiguing march. 
Alexander came near losing his life in the same manner. Many have 
been rendered cripples for life by so doing. No harm will result from a 

, cool bath if the body is simply warm, even though it may be in a state 
of perspiration. Contrary to the common opinion, a considerable degree 
of heat is the best possible preparation for a cold bath. The Finlanders 
rush out of their hot ovens—sweat-houses—and roll in the snow, with¬ 
out injury. 

6. Cold baths should not be administered during the period of 
menstruation in females—unless there is fever with an extremely high 
temperature. At such times, little bathing of any kind is advisable 
with the exception of warm or tepid sponge baths, or such treatment as 
may be advised by a physician. 

7. Bath attendants should carefully avoid giving “shocks” to nerv¬ 
ous people or to those inclined to apoplexy or affected with heart disease. 
Shocks are unpleasant and unnecessary for any one. 

8. Never apply to the head such treatment as will cause shock, as 
the sudden cold douche, shower, or spray bath. 

9. In applying a bath to sick persons, it should always be made of a 
temperature agreeable to the feelings. 

10. The temperature of a warm or hot bath should always be de¬ 
creased just before its termination, as a precaution against taking cold. 

11. Very cold and very hot baths are seldom required. The bar¬ 
barous practices of half a century ago are now obsolete, or should be if 


ADMINISTRATION OF BATIIS. 


635 


they arc not quite discontinued as yet. No good resulted from them 
which cannot lie attained by milder means, and much harm was occa¬ 
sioned which is avoided by the use of less extreme temperatures. 

12. Those not strong and vigorous should avoid drinking freely of 
cold water just previous to a bath. 

13. The head should always be wet before any bath; and the feet 
should be warmed—if not already warm—by a hot foot bath, if 
necessary. 

14. A light hand bath every morning will be none too frequent to 
preserve scrupulous bodily cleanliness. More than a week should never 
be allowed to elapse without a bath with warm water and soap. 

15. One very important element in the success of a bath is the dex¬ 
terity of the attendant. The patient should be inspired with confidence 
both in the bath and in the skill of the attendant. The mind has much 
to do with the effect of a bath. 

16. Patients should receive due attention during a bath, so that they 
may not feel that they are forgotten. Nervous patients often become 
very apprehensive on this account. It is also important, in most cases, 
that a reasonable degree of quietude should be maintained. 

17. When any unusual or unexpected symptoms appear during a 
bath, the patient should be removed at once. In case symptoms of 
faintness appear, as is sometimes the case in feeble patients, during a hot 
bath, apply cold water to the head and face, give cool water to drink, 
lower the temperature of the bath by adding cool water, and place the 
patient as nearly as possible in a horizontal position. 

18. In general baths, the patient, unless feeble, will derive benefit by 
assisting himself as much as possible. 

19. The best time for treatment—especially cool treatment—is about 
three hours after breakfast. 

20. In health, a cool or cold bath should be very brief, lasting not 
more than one or two minutes. A tepid bath should not last more than 
ten or fifteen minutes. A warm bath may be continued thirty or forty 
minutes, or even longer, but nothing; could be more absurd than the 
custom prevailing in some places of prolonging the bath to great length. 
At Pfeffers and Leuk, in Switzerland, many persons spend the whole 
day in the water, taking their meals on floating tables, and occupying 
their time in reading, playing chess, and other games. Some remain in 
the water as many as sixteen hours out of the twenty-four. Of course, 
certain baths may be advantageously prolonged in cases of disease ; but 


630 


RATIONAL REMEDIES FOR DISEASE. 


no intelligent physician will now recommend the antiquated practice 
which we sometimes see represented by a patient seated in a tub, with 
an open book in hand. 

21. It is of extreme importance that the patient should be carefully 
dried after any bath. A large sheet is much better for this purpose 
than a towel. An old linen or cotton sheet is preferable to a new one, 
being softer. Full directions are given under the heading, “ Dry Rub¬ 
bing-Sheet.” 

22. A patient should never be left chilly after a bath. Rub until 
warm. It is equally important that the body should not be left in a 
state of perspiration, for it will soon become chilly. 

23. Patients who are able to do so should exercise a little both before 
and immediately after a cool bath, to insure thorough reaction. 

24. For feeble persons, an hour’s rest soon after a bath will add to its 
beneficial effects. It is best to go to bed and cover warm. 

25. If a bath is followed by headache and fever, there has been 
something wrong, either in the kind of bath administered, or in the 
manner of mving it. 

26. Always employ for bathing purposes the purest water attain¬ 
able. Soft water is greatly preferable to hard on many accounts. 

27. Patients should not be allowed to become dependent on any 
special form of bath, as an after-dinner fomentation to aid digestion, 
the abdominal bandage, or any other appliance. Destroy such a habit 
if it has been formed. 

28. Order, cleanliness, dispatch, and a delicate sense of propriety, are 
items which every bath attendant should keep constantly in mind, and 
which will often contribute in no small degree to success in the use of 
this agent. 

29. Never employ a bath without a definite and legitimate purpose 
in view. It is somewhat customary, in many institutions where water 
is employed, to apply it in a routine way. Many baths are prescribed 
for the sake of producing variety or pleasing the patient. A faithful 
and scientific physician will carefully adapt his remedies to the condition 
of his patient, and will observe the results. 

It seems to be a prevalent error that it makes little difference 
how water is applied, provided the patient is only wet. Warm, 
hot, tepid, temperate, cool, and cold baths are used indiscriminately. 
So, also, the different modes of administering baths of the same 
temperature are disregarded in many cases. In general, each particu- 




GENERAL BATHS. 


G37 


lar form of bath is especially adapted to the treatment of special con¬ 
ditions, and it is the best test of the proficiency of a physician, in the 
use of water, to observe whether he recognizes the distinctions between 
the various kinds of baths, and is able to adapt them to the appropri¬ 
ate conditions. 

Giving too much treatment is likely to be the error into which 
the inexperienced will fall, rather than the opposite extreme. Nature 
cannot be forced to do more than she is capable of doing; and as nat¬ 
ure must do the healing, if a cure is accomplished, remedies should be 
of a helping rather than a crowding or forcing nature. The vitality 
of patients may be expended uselessly by treatment; for baths excite 
vital resistance, as well as drugs, a. fact which many overlook. The 
dangers of over-treatment are not so great as some imagine, however, 
who take the opposite extreme, and advocate rest as the great cure-all. 
We have seen patients who seemed to be quite monomaniacs on the 
subject of “ rest cure,” who needed a good thorough stirring up with 
useful exercise more than any other kind of treatment. 

GENERAL APPLICATIONS. 

Baths applied to the whole surface of the body are, as we have al¬ 
ready seen, among the most powerful means of affecting the human 
system either in health or disease. Baths of a temperature less than 
that of the body, 98°, unless of very brief application, uniformly de¬ 
crease the bodily temperature. That the diminution of temperature 
is not merely local, being confined to the .‘.kin and superficial struct¬ 
ures, is shown by the fact that the thermometer indicates a decline of 
temperature in the interior of the body as well. The cool full bath, 
when prolonged, diminishes the production of heat throughout the 
whole system, besides abstracting large quantities by its contact with 
the body, as previously explained. The diminution of temperature 
continues for hours after the bath, in cases in which it was excessively 
high at the time of administration. Hot baths have, in general, an 
opposite effect. 

Swimming. —Swimming is a general bath combined with vigorous 
exercise, as nearly all baths should be. It is one of the most health¬ 
ful kinds of exercise, if not continued too long, as it frequently is. 
The temperature of the water is commonly between 70° and 80°, I., 
which makes it a temperate bath. Its effects are not far different from 
other forms of bath of the same temperature. We have not space to 


638 


RATIONAL REMEDIES FOR DISEASE. 


devote to a description of the art, since there are valuable treatises on 
the subject. 

Plunge Bath. —The hot baths of the ancient Greeks and Romans 
were usually followed by a plunge up to the neck in a large basin of 
water four or five feet deep, and large enough to allow the exercise of 
swimming. Many hydropathic establishments employ the same bath 
after packs and sweating baths. A bath of this kind is not always 
attainable without great expense; and it possesses no particular ad¬ 
vantage over other methods of cooling the surface after a warm bath. 
It is a very severe form of bath when employed at a low temperature. 
In the days of Priessnitz, it was used at a temperature of 45° or 50°. 
More harm than good would result from a continuous employment of 
such treatment. The cool plunge should be of but a very few min¬ 
utes’ duration, and the patient should rub himself vigorously during 
the bath. In this, as in all other cool baths, the first contact with the 
water produces chilliness or shock. After two or three minutes, or 
less, this will be followed by a partial reaction, even while the patient 
is in the water, accompanied by a feeling of comfortable warmth. 
This will shortly be again succeeded by a second chill, which is not so 
likely to be followed by prompt reaction ; hence, the patient should al¬ 
ways take care to leave the bath before the occurrence of the second 
chill, if he would avoid unpleasant after-effects. 

Sponge Bath.—The sponge or hand bath is perhaps the simplest 
and most useful mode of applying water to the surface of the body; 
for it requires the use of no appliances which every one does not pos¬ 
sess, and it can be employed by any one without elaborate preparation, 
and under almost any circumstances. A great quantity of water is not 
required; a few quarts is a plenty, and a pint will answer admirably 
in an emergency. A soft sponge, or a linen or cotton cloth, and one 
or two soft towels, or a sheet, are the other requisites. The hand may 
be used in the absence of a cloth or a sponge for applying the water. 

The temperature of the bath should not be above 95°, and 90° is 
generally better. Most people can habitually employ a temperature 
of 75° or 80° without injury. The use of a much lower temperature 
is not commonly advisable, and is often productive of great injury. 

Begin the bath, as usual, by wetting the head, saturating the hair 
well. Wash the face, then the neck, chest, shoulders, arms, trunk, and 
back. Rub vigorously until the skin is red, to prevent chilling; for 
even when the temperature of the room is nearly equal to that cf the 


RUBBING WET-SHEET. 


030 


body, the rapid evaporation of water from the surface will lower the 
external temperature very rapidly unless a vigorous circulation is 
maintained. 

After thoroughly bathing the upper portion of the body, turn the 
attention to the lower portion, continuing the rubbing of the upper 
parts at brief intervals to prevent chilliness. As soon as the bathing 
is concluded, envelop the body in a sheet and rub dry, or dry the skin 
with a towel. When the surface is nearly or quite dried, rub the 
whole vigorously with the bare hand. 

The bath should not be prolonged more than ten or fifteen min¬ 
utes. Five minutes is sufficient to secure all the benefits of the bath, 
and even three minutes will suffice for a very good bath. 

Persons who chill easily will find it better to bathe only a portion 
of the body before drying it. Some will even find it necessary to retain 
a portion of the clothing upon the lower part of the body while bath¬ 
ing and drying the upper part. 

Weakly patients may receive this bath with very little disturb¬ 
ance, even in bed. Only a small portion of the body should be uncov¬ 
ered at a time, being bathed, dried, rubbed, and then covered while 
another part is treated in a similar manner. 

The sponge bath may be administered anywhere without danger of 
soiling the finest carpet, by using care to make the sponge or cloth 
nearly dry before applying it to the body. A rug may be spread upon 
the floor as an extra precaution. When used for cleanliness,—as it 
should be daily,—a little fine soap should be added two or three times 
a week, to remove the oleaginous secretion from the skin. 

This bath is applicable whenever there is an abnormal degree of 
bodily heat, and in such cases may be applied every half-hour without 
injury, and even oftener. It is useful in cases of nervousness and 
sleeplessness, in chorea and laryngismus stridulus, also in that curious 
affection of children known as “catch in the breath.” In fact, when¬ 
ever water is required in any form this bath may be used with ad¬ 
vantage, the temperature being suited to the case. Sponging with 
water as hot as can be borne will often relieve for several hours the 
profuse sweating of consumptives. Hot sponging of the face, neck, 
and head are useful in relieving the headache of catarrh and influ¬ 
enza, and in stopping nose-bleed. 

nubbin? Wet-Sheet.— See Fig. 196. This bath is administered in 
two ways; with the sheet very wet, or dripping, and with it wrung 


640 


RATIONAL REMEDIES FOR DISEASE. 



nearly dry. The first method is frequently called the dripping-sheet 
bath. In giving it, proceed as follows:—• 

When necessary to prevent injury to the floor or carpet, place upon 
the floor a large rug or oil-cloth. In the center, place a large wash- 

tub, in the absence of a more convenient 
vessel. While the patient is making him¬ 
self ready for the bath, procure two large 
cotton sheets. Gather one end of each 
into folds so that it can be easily and 
quickly spread out; lay one upon a chair 
close at hand, and place the other in the 
tub. At a distance of three or four feet 
from the tub, place a low stool. Now place 
in the tub—if a bath at about 93° is de¬ 
sired, and this will be the most usual tem¬ 
perature—half a pailful of fresh well 
or spring water, and one-third as much 
boiling water. If a thermometer is at 
hand it should, of course, be used to test 
the temperature. After the patient has wet his head, let him step 
into the tub, facing the assistant, with his arms straight and pressed 
close to his sides. Now draw up the wet sheet by its gathered end 
to its full length; draw out one side quickly, place the corner over 
one shoulder of the patient, and while holding it in place with one 
hand, quickly draw the remainder of the sheet around him with the 
other, bringing it up well around the neck, and folding the second 
corner under the top so as to hold it in place. But a few seconds 
should be occupied in applying the sheet. Then commence rubbing 
the patient vigorously with both hands, one upon each side, rubbing 
to and fro three or four times in each place, passing over the whole 
body very rapidly, and then repeating the same, to prevent chilling 
of any part. Coarse, rob.ust, and phlegmatic people may be rubbed 
with a good deal of severity; but persons with delicate skin and 
acute sensibilities require gentler manipulation. 

After three or four minutes of energetic rubbing, pour over the chest 
and shoulders a pailful of water four or five degrees cooler than that 
of the bath, which should be in readiness for instant use. Then rub 
two or three minutes longer. Now quickly disengage the wet sheet, 
allowing it to drop into the tub. While the patient is stepping 














WET-SHEET PACK. 


641 


upon the stool, quickly grasp the dry sheet, and by the time he is in 
place, have him enveloped in it. Rub him dry, passing over the whole 
body several times in rapid succession, to prevent chilling. Care 
must be taken that every part is thoroughly dried. The head, arm- 
pits, groins, and feet are liable to escape attention. No moisture 
should be left between the toes. After wiping nearly or quite dry, 
apply the hand-rubbing, as elsewhere described, using care not to in¬ 
duce perspiration by too vigorous or long-continued rubbing. If the 
akin should become moist from perspiration after having been once 
dried, gradually lower the temperature of the room and continue light 
rubbing until the skin becomes dry and cool before allowing the pa¬ 
tient to dress. 

Very few baths afford a better opportunity for the display of skill 
and energy on the part of the attendant than this. Some practice is 
required to enable one to give it really well. 

The other form of rubbing wet-sheet is given in about the same 
manner, the only difference being that the sheet is wrung before its 
application, and is re-applied one or more times, according as a milder 
or more severe form of treatment is required. The douche may be re¬ 
served until the sheet is removed the last time. 

One precaution especially necessary to be observed in this bath, as 
well as in all others where a tepid application is succeeded by a cooler 
one, is frequently overlooked. The second , cooler application shoidd 
never he made until there is good reaction from the first. 

This is an excellent bath to apply after packs or warm baths which 
have induced perspiration, as hot-air and vapor baths. It is especially 
applicable to cases in which there is defective circulation in the ex¬ 
tremities, inactive skin and liver, and nervousness. It is of special 
benefit in cases of debility accompanied with night sweats; and is an 
admirable means of removing and preventing muscular soreness and 
stiffness from severe exercise. 

Wet-Slieet Pack. —When properly administered, this is one of the 
most powerful of all water appliances. Some skill is needed to apply 
it with a uniform degree of success. Two or three comfortables or 
thick blankets, one woolen blanket, and a large linen or cotton sheet, 
are the articles necessary. It is important to be certain that the sheet 
is sufficiently large to extend twice around the patient’s body. More 
blankets are required in cool weather and by weak patients. Spread 
upon a bed or straight lounge the comfortables, one by one, making 
41 


Ii42 


RATIONAL REMEDIES FOR DISEASE. 


them even at the top. Over them, spread the woolen blanket, allow¬ 
ing its upper edge to fall an inch or two below that of the last com¬ 
fortable. Wet the sheet in water of the proper temperature, having 
gathered the end so that it can be quickly spread out. Wring so that 
it Avill not drip much, place its upper end even with the woolen 
blanket, and spread it out on each side of the middle sufficiently to 
allow the patient to lie down upon his back, which he should quickly 
do, letting his ears come just above the upper border of the sheet, and 
extending his limbs near together. The patient should then raise his 
arms, while the attendant draws over one side of the wet sheet, taking 
care to bring it in contact with as much of the body as possible, bring¬ 
ing it closely up beneath the arms, and pressing it down between the 
limbs so as to make it come in contact with both sides of them. Tuck 
the edge tightly under the patient on the opposite side, using care not 
to include the other edge of the sheet. Now let the patient clasp his 
hands across his chest, and then bring up the other side of the sheet. 
Grasp it by its upper corner with one hand, drawing it down over the 
shoulder and lengthwise of the body; then place the other hand upon 
the covered shoulder, holding the sheet firmly in place while the cor¬ 
ner is carried upward upon the opposite side and tucked under the 
shoulder, thus drawing the upper edge of the sheet well up under the 

chin. Tuck the edge of the sheet 
under the body, carefully envelop¬ 
ing the feet. Then bring over 
each side of the blanket and com¬ 
fortables in the manner last de¬ 
scribed, being very careful to ex¬ 
clude all air at the neck, and al¬ 
lowing the blankets to extend below the feet so that they can be 
folded under. 

It is not desirable that th^ patient should be bound as tightly as a 
mummy. All that is necessary is the exclusion of air, and as the neck 
and feet are the points at which it is most likely to enter, these parts 
should receive particular attention, as directed. If too tightly bound, 
the patient will be more likely to be nervous than if allowed some 
freedom. The application of the wet sheet should be made in a few 
seconds, as it cools very rapidly when spread out. The first blanket 
should be brought over the patient as soon as possible. If the feet are 
not warm, a hot foot bath should be taken before the pack. If they 





















WET-SHEET PACK. 


G43 


become cool in the pack, hot jugs, bricks, or stones should be applied 
to them. If the patient does not become comfortably warm in a few 
minutes,—ten or fifteen at most,—more blankets should be added, and, 
if necessary, dry heat should be applied to the sides. If he still re¬ 
mains chilly, he should be promptly removed and placed in a warm 
bath, or vigorously rubbed with a dry sheet and then placed in a dry 
pack. The head should be kept cool by frequent wetting while the 
patient is in the pack. If a compress is applied, it should be often 
renewed. 

The temperature of the pack must depend upon the condition of 
the patient, being determined by principles elsewhere explained. A 
woolen sheet is better for the adminif tration of a hot pack than one 
of cotton or linen. The cold pack is very rarely required. The usual 
temperature should be about 92°. It is proper to wet the sheet in 
water of about 100°, as it will be cooled several degrees while being 
applied. 

The duration of the pack should be carefully regulated by the condi¬ 
tion of the patient, the effects desired, and the immediate effects produced. 
If the patient becomes very nervous, or sweats excessively, or becomes 
faint, or has other seriously unpleasant or dangerous symptoms, he 
should be removed from the pack at once if he has not been more than 
ten minutes in it. Ordinarily, the pack may continue thirty to forty- 
five minutes. If the patient sleeps naturally, he may remain in the pack 
a full hour, if strong, or even longer in many cases. In fevers, short 
packs, frequently repeated, are more beneficial than long ones fewer in 
number. 

The pack should be followed by the spray, the sponge bath, the 
douche, or the rubbing wet-sheet. It is a powerful remedy, and should 
not be used to excess in chronic diseases ; it has been much abused in 
this way. Its depurating effects are really wonderful. The increased 
action of the skin, together with determination of blood to that part, is 
so great that poisons long hidden in the system are brought out and 
eliminated. The odor of a sheet used in packing a gross person is 
often intolerable. If the patient be a tobacco-user, the sheet will be 
reeking with the odor of nicotine. Many times, the sheet will be actu¬ 
ally discolored with the impurities withdrawn from the body. 

The applications of the pack in treating disease are very numerous. 
In almost all acute diseases accompanied by general febrile disturbance, 
and in nearly all chronic diseases, it is a most helpful remedy if rightly 


644 


RATIONAL REMEDIES FOR DISEASE. 


managed. It is an admirable remedy for nervousness, skin diseases ac- 

O V 

companied by thickening of the skin, as psoriasis and icthyosis, and irri¬ 
tations of the mucous membrane. The warm pack is an invaluable 
remedy in the treatment of children’s diseases. It is a most successful 
application in convulsions. 

Shower Pack. —Fig 198. 
In many cases of fever in 
which the temperature rises so 
high as to produce delirium, 
the ordinary pack does not 
seem to be sufficiently power¬ 
ful to fully control the excess¬ 
ive heat. In such cases, the 
shower pack is found of great 
service. It is thus used in 
Bellevue Hospital, New York: 

A rubber blanket is placed 
upon an ordinary mattress. 
Upon this, the patient is 
placed, enveloped in a wet sheet as in the ordinary pack. Instead of 
being covered with blankets, however, he is left exposed to the air, .so that 
the powerful cooling effects of evaporation may be obtained. As the 
sheet becomes warmed by the heat of the body, cool water is show¬ 
ered upon it from a sprinkler or watering-pot. The bath is continued 
thus until the temperature of the patient, as indicated by the ther¬ 
mometer, is sufficiently diminished. 

This bath, combining as it does the cooling effects of cool water and 
of evaporation, is the most powerful refrigerant that can be employed; 
yet it is perfectly safe when judiciously used, being applied only hi cases 
of extreme urgency on account of the high temperature. 

Some practice opening the ordinary pack at intervals, and sprinkling 
cool water upon the patient, thus obtaining, in some degree, the prolonged 
cooling effect. The pack must be studied well to enable one to apply it 
with skill, and certainty of success. 

Dry -Sheet Pack.—Though this can hardly be called a bath at its 
commencement, it really becomes a wet-sheet pack before its termination. 
Its application differs from that of the wet-sheet pack in that the patient 
is wrapped in woolen blankets instead of the wet sheet. The object of 
this treatment is to produce perspiration, which may be encouraged by 




























FULL BATH. 


645 


drinking either cold or hot drinks in considerable quantity, and by the 
application of dry artificial heat to the feet and sides. It is a very severe 
form of treatment, and is now seldom practiced. Many years ago, pa¬ 
tients at hydropathic establishments were often kept for several hours in 
the dry pack, smothered beneath loads of comfortables, blankets, and 
feather-beds. If cautiously employed, it is occasionally useful in “ break¬ 
ing the chills ” in fever and ague. For this purpose it should be admin¬ 
istered about half an hour before the time for the beginning of the chill. 

Sweating Pack. —Wrap the patient in woolen blankets. Place to 
his hands, sides, thighs, and feet, hot bricks, or jugs filled with hot water, 
wrapped with moist flannels. Beer bottles filled with hot water and 
covered with wet stockings are very convenient. Give frequent and 
copious draughts of hot water or some simple tea, as peppermint or win- 
tergreen, or some similar drink. Keep the head cool by tepid compresses. 
In a few minutes most copious perspiration will be produced. After 
bath treat as after pack. Useful in all cases in which powerful action 
of the skin is desirable, as in chronic rheumatism, obesity, jaundice, etc. 
It is one of the most excellent means of curingf a'cold. 

O 



Fig:. 199. The Full Bath. 


Full Bath. — See Fig. 109. For this bath a tub is required the 
length of the body, about eighteen inches deep, two feet wide at the 
top, and, preferably, six inches narrower at the bottom. It is better to 
have the end intended for the head a little elevated. Place in the tub 
sufficient water so that the patient will be entirely covered, with the 
exception of the head, when he lies upon his back. During the bath, 
the body should be vigorously rubbed by the bather or an attendant, or 
both, particular pains being taken to knead and manipulate the abdo¬ 
men, in a gentle but thorough manner. The temperature of the bath, 
when taken for cleanliness, or for its soothing effects, should be not higher 
than 95° to 98°, aud it should be cooled down to about 85° or 90° before 
the conclusion of the bath, by the addition of cool water. 

Very cold baths are used by some, especially in Germany, in the 









RATIONAL REMEDIES FOR DISEASE. 


treatment of fevers, so low a temperature as GO 3 being often employed. 
The most approved mode, however, is what is called the graduated bath, 
in which the temperature is gradually lowered until the desired effect 
has been produced. 


When used to excite action of the skin, a hot bath should be em¬ 
ployed. Begin bath at 98° or 100° F., and gradually raise to 108° or 
110°, continuing for 10 to 15 minutes. Then remove the patient, wrap 
him in blankets, and let him remain sweating two or three hours. 

Every family ought to possess 
conveniences for the full bath. In¬ 
deed, it is now found in every well- 
resfulated modern house in our 
large cities. It is not so expensive 
but that any one can possess it. 
Portable baths of rubber, see Fig. 
200, can be obtained, which are worth many times their cost. A sta¬ 
tionary bath may be made of wood, of the dimensions given, and lined 
with lead or zinc. There should be an opening in the lower end for 
withdrawing the water. 



Fig. 200. Portable Rubber Bath. 


The full bath is one of the most refreshing of all baths, being also 
one of the most pleasant. Employed at a low temperature, it is a pow¬ 
erful means of reducing excessive heat in fevers. The hot full bath very 
greatly relieves the pains of acute rheumatism, colic, gall-stones, and 
sciatica, and is almost a specific for colds, if taken soon after their con¬ 
traction, j ust before retiring. 

Immersion in warm water is undoubtedly the best known remedy 
for extensive burns. Hebra, the renowned professor of skin diseases at 
Vienna, has kept patients immersed in the warm bath for periods vary¬ 
ing from two weeks to nine months, with most excellent results, and, 
he affirms, without interference with any of the vital functions. Eat- 
ing, digestion, sleeping, and all the functions of life, were performed in 
the bath without difficulty or interference. 

Very hot and very cold temperatures are quite hazardous with this 
bath, since it involves so large a portion of the body. Such extremes are 
rarely useful in any case, and should not be used except under the eye 
of a physician. We have found that the cold bath is much better borne 
if the patient is well anointed with vaseline before being placed in the 
water. The effects are not diminished. 





HALF AND SHALLOW BATHS. 


(347 


Half Bath. —See Fig. 201. The half 
bath is much the same as the full bath. 

A smaller tub is required, as the bather 
sits upright with his limbs extended. The 
water should be at least a foot deep. 

During the bath, the body should be well 
rubbed, and water should be poured over 
the upper portion of the body. Its gen¬ 
eral effects are nearly the same as those 

of the full bath, and it may be used for 

%/ 

the same general purposes. A little more vigorous rubbing is required to 
prevent chilling, as so large a portion of the body is exposed. It affords 
a better opportunity for exciting action in the bowels and abdominal vis¬ 
cera by shaking, percussing, and kneading the abdomen. 

Shallow Bath. —Of this bath there are two varieties; sitting shal¬ 
low and standing shallow. 

Sitting shallow differs from the half bath in employing less water, 
and being 1 much more vigorous. Its effects and uses are about the 
same. The bather should rub his limbs and the front portion of his 
body while the attendant pours water over his chest and shoulders, 
and rubs vigorously his back and sides. A person can take the bath 
very well alone by using a rather long coarse towel which can be 
drawn back and forth across the back by grasping one end with each 
hand. It is a very valuable means of applying water, and is in con¬ 
stant requisition in the hydropathic establishments. From 85° to 90° 
is the proper temperature for this bath. It may be used at a lower 
temperature in fever cases. At Bellevue Hospital it is applied at 
about 70° in such cases, and is administered whenever the temperature- 
exceeds 103°. To avoid the shock of a cool bath, it may be com¬ 
menced at a temperature little below blood-heat and then gradually 
cooled by the addition of cool water until the desired temperature is. 
reached. The reduction of the temperature obtained by this means 
fully equals that obtained by the sudden application of cold, and the 
shock and subsequent reaction are prevented. This applies equally 
to all cool baths as well as the cool shallow bath. 

The duration of the bath may be from two to thirty minutes. Ten 
or fifteen minutes will be the usual extent. 

The standing shallow is in some cases preferred by some to the 
preceding. The patient stands erect in a varying depth of water 














048 


RATIONAL REMEDIES FOR DISEASE. 


from six inches to one or two feet being employed—while his 
body is vigorously rubbed by one or two assistants, water being poured 
upon the chest and shoulders at brief intervals. It is a very enliven¬ 
ing bath. 

The shallow bath should be completed by a pail douche at a tem¬ 
perature three or four degrees lower than that of the bath. 

Affusion. — This consists simply in pouring water over the body 
of the patient, who may be sitting or standing in a bath-tub. It is a 
very efficient bath for reducing unnatural heat. This mode of treat¬ 
ment was used by Hippocrates, Galen, and other ancient physicians. 
In the last century, Currie, Jackson, and many others used it with 
great success in scarlatina. It is a sovereign remedy for delirium tre¬ 
mens, sun-stroke, hysteria, and sometimes of acute mania, when ap¬ 
plied of the proper temperature. It is used by the Persians in cholera 
Avith great success. It is useful in drunkenness and convulsions, and 
has been successfully used in tetanus. 

Pail Douche.— This bath scarcely differs from the preceding. It 
consists in the dashing of one or more pailfuls of water upon the body 
of the bather by an assistant. By means of a proper arrangement, 
the bather can administer the bath himself. For this purpose, a pail 
or other vessel filled with water may be suspended or supported above 
the head of the bather in such a way that it can be quickly upset by 
drawing upon a string attached to the side. The stream should fall. 
upon the shoulders, chest, back, or hips, but not upon the head or over 
the region of the stomach. This bath may be'applied after any warm 
bath, and should be a little cooler than the bath which precedes it. 
Whether taken alone or after another bath, it should always be fol¬ 
lowed by vigorous rubbing. 

Cataract Douche. —This is a modification of the douche bath, in 
which a broad sheet of water is allowed to fall upon the body of the 
bather. The force of the bath depends upon the height from which 
the water falls, and should be regulated according to the strength of 
the patient. Almost any one will bear a fall of three or four feet. 
When the height of the bath cannot be easily modified, it should be 
of such an altitude as to be well borne by the feeblest patients; the 
more vigorous can increase its effects by subjecting themselves to it 
for a longer time. 

The observations made relating to the application of the pail douche 
apply equally well to this bath. 


SHOWER BATH. 


649 


Hose Douche. —In this bath, water under pressure is thrown upon 
the patient from a hose, through a small nozzle. The bather turns 
his body while the attendant directs the stream upon different parts. 
It is a less pleasant bath than the spray or other forms of douche. 
Applied locally, it is a powerful means of causing absorption in en¬ 
larged glands, as hepatic and splenic enlargements, due to malaria. 
The alternate hot and cold douche is best for this purpose. Also ex¬ 
cellent in dyspepsia, applied to the spine opposite the stomach. Its 
^enei’al effects are the same as those of the baths mentioned. 

Shower Bath. —See Fig. 202. 
This bath is simply an imitation 
of rain. Water is allowed to fall 
upon the body after being divid¬ 
ed into a number of small 
streams by passing through a 
vessel with a perforated bottom. 
Its effects depend upon the size 
of the streams and the height 
from which they fall, together 
with the temperature of the 
bath and its duration. Although 
formerly much employed in 
water-cure establishments, this 
bath is now less used, especially 
the cold shower, because its place 
is supplied by other more con¬ 
venient ones which produce the 
same results, as the spray and 
douche. The best manner of ad¬ 
ministering it is to commence 
the application with tepid water, 
and gradually cool it. The temperature may range from 70 to 95°. The 
water should not usually be allowed to fall upon the head, but should 
be received first upon the hands and arms, then upon the feet and 
limbs, and afterward upon the back and shoulders, the body being 
well rubbed during the application. 

Every family possesses in the ordinary colander a means of ad¬ 
ministering an efficient shower bath, by holding it above the patient 
and pouring in water of proper temperature from a pitcher. A veiy 



























650 


RATIONAL REMEDIES FOR DISEASE. 


simple and effective shower apparatus may be obtained at a cost of a 
few cents. It consists of a vessel of the shape shown in Fig. 203, hav¬ 
ing a perforated bottom and a hollow handle at the top, open at its 
upper end. By sinking this vessel into a pail or tub of water, it will 

be filled, and will remain full when re¬ 
moved from the water if the finger is 
placed over the opening in the handle. 
Upon partially uncovering the opening 
the water will escape in a shower. 

The cold shower bath, formerly so 
common almost everywhere, has been 
productive of much injury by its in¬ 
discriminate use, and has brought much 
reproach upon the use of water as a cura¬ 
tive agent. None but the most vigorous 
can enjoy the bath at a lower tempera¬ 
ture than 70°, and no advantage is gained 
by its employment at a lower tempera¬ 
ture than that, while considerable harm 





'■iWU 




Fig - . 203. A Simple Shower Bath. 


may be done in many cases. 


Spray Bath.—This bath consists in a number of fine streams of 
water thrown upon the bather, with considerable force. It may be 
produced by connecting a hose with spray attachment to a force-pump 
or reservoir from which to obtain w r ater under a sufficient pressure. 
The best form of attachment consists of a hollow double-convex brass 
or copper piece, one side of which is perforated with fine holes, the 
other side carrying a rim for attachment to the hose. It is preferable 
to have an arrangement by which the temperature may be readily 
and gradually changed from warm or tepid to cool without interrupt¬ 
ing the bath. In the absence of a proper spray attachment, the appa¬ 
ratus elsewhere described for the hose douche may be made to an¬ 
swer a very good purpose, the stream being broken by placing the 
thumb or finger over the nozzle in such a way as to partially obstruct 
the flow. 

This is an excellent bath to follow the pack, vapor bath, hot-air 
bath, sitz bath, or any other general bath which induces perspiration. 
It is very agreeable to most persons, and can be applied to feeble pa¬ 
tients who would be unable to take any more severe form of treat¬ 
ment. The alternate hot and cold spray is very successful as a means 





THE VAPOR BATH. 


651 


of reducing local inflammations. The warm spray is very grateful 
and soothing to swollen and rheumatic joints; in gout, also, and illy 
defined, wandering pains, it is an admirable remedy. The cold spray 
is very successful in the treatment of glandular enlargements, ab¬ 
scesses, and chronic ulcers, when thoroughly applied. 

The Vapor Batli .—As a remedial agent, wa¬ 
ter in the form of warm or hot vapor is 
scarcely less useful than in its ordinary form. 
The vapor bath can be readily and success¬ 
fully administered with such conveniences as 
every family possesses. Place the patient in a 
cane-seat chair, having first taken the precau¬ 
tion to spread over the seat a dry towel. Sur¬ 
round the patient and the chair first with a 
woolen blanket, and then with two or three thick comfortables, draw¬ 
ing the blankets close around his neck, and allowing them to trail 
upon the floor so as to exclude the air as perfectly as possible. Now 
place under the chair a large pan or pail containing two or three 
quarts of boiling water. Let the blankets fall quickly, so as to retain 
the rising vapor. After a minute or two, raise the blankets a little at 
one side and carefully place in the vessel a very hot brick or stone, 
dropping the blankets again as soon as possible to avoid the admission 
of cold air. Before the first brick or stone has cooled, add another, 
and so continue until the patient perspires freely. The amount of 
perspiration must be judged by the face and forehead, as much of the 
moisture on the skin beneath the blankets is condensed steam. 

Should the bath become at any time too hot, a little air may be 
admitted by raising the bottom of the blankets a little, being careful 
to avoid chilling the patient in so doing. The bath should seldom be 
continued more than half an hour, and fifteen to twenty minutes will 
usually accomplish all that is desired by the bath. If too long con¬ 
tinued, it induces faintness. A too high temperature will be indicated 
by a strongly accelerated pulse, throbbing of the temples, flushed face, 
and headache. The head should be kept cool by a compress wet in 
cool water and often changed. The temperature of the bath should 
be from 100° to 115°. Unpleasant effects are sometimes produced at 
120 °. 

After this bath, apply the tepid spray, rubbing wet-sheet, pail 
douche, or full bath. No time should be allowed to elapse after the 



Fig-. 204. Vapor Bath. 












652 


RATIONAL REMEDIES FOR DISEASE. 


blankets are removed before the concluding bath is applied, as the 
patient will chill. He should not be allowed to become chilly by ex¬ 
posure to cool air before the application of the spray, douche, or other 
bath, which should be followed by vigorous rubbing. 

For “breaking up a cold,” “breaking chills,” relieving rheumatism, 
soreness of the muscles from overexertion, and relaxing stiffened 
joints, this is a valuable agent. It may also be used to advantage in 
chronic diseases in which there is inactivity of the skin, liver, or kid¬ 
neys, being a powerful diaphoretic; but great care must be exercised 
to avoid excessive use, as too frequent repetitions of the bath produce 
debility. 

This is a milder application than the hot-air bath, unless employed 
at a high temperature, 120° or more, when it becomes more severe. 

In institutions where the bath is in daily requisition, a permanent 
arrangement for giving the bath is usually employed. It usually con¬ 
sists of a box in which the patient sits upon a stool, his head being 
allowed to remain outside by a suitable opening. A wet towel is 
placed around the neck to prevent the steam from rising about the 
head. See Fig. 204. 

Steam may be generated by boiling water in the box with a large 
spirit-lamp or a gas-burner, or it may be conducted into the box by a 
rubber tube connected with a tight boiler. 

The Russian Bath. —This bath resembles the va,por bath, the chief 
difference being that the patient is wholly surrounded by vapor and 
inhales it instead of having the head out as in the vapor bath. In a 
large room filled with vapor, marble or soap-stone slabs are so arranged 
that the patient, by being transferred from one to another, may be ex¬ 
posed to increasing heat. The temperature employed should be from 
100° to 115° F., rarely higher. The effects of the higher tempera¬ 
tures sometimes employed are in no way beneficial, and are often very 
harmful. The bath is followed by rubbing with soap and cooling 
with the shower, spray, or plunge bath. 

A simple form of Russian bath may be administered in a box or 
small room prepared for the purpose, which is large enough to allow a 
person to sit erect, surrounded by the warm vapor, which may be gen¬ 
erated in a boiler for the purpose and conducted into the bottom of the 
box by a rubber or metal tube. An opening guarded by a curtain is 
made in one side to allow the bather to inhale cool air if he should 
wish to do so, and to give the attendant access to the patient without 


SITZ BATn. 


653 


chilling him by the admission of a large quantity of cold air. As in 
the simpler forms of vapor hath, the head should be kept constantly 
cool by a cool wet compress often re-applied. Patients troubled with 
“ rush of blood to the head,” should be further protected by a large 
cool compress placed around the neck and the upper part of the chest. 


LOCAL APPLICATIONS. 


The use of water as a local application is not less important; and is 
much more varied than its general application. There is no other 
topical remedy which will produce such a variety of effects and such 
prompt results. In removing local congestions, subduing local inflam¬ 
mations, allaying circumscribed pain, and restoring activity to inactive 
parts, the appropriate applications of water give results which afford 
both physician and patient a degree of satisfaction which no other sin¬ 
gle remedy can rival, even electricity, an agent of acknowledged 
power, not excepted. 

Sitz Bath.— See Fig. 205. The 
sitz bath, also known as the hip bath, 
is one of the most useful baths em¬ 
ployed in hydropathic treatment. 

Its utility was fully recognized by 
the earlier practitioners, who some¬ 
times kept their patients so long in 
the bath that they became almost 
literally water-soaked, and were so 
numb from the long-continued appli¬ 
cation of cold water as to possess 
almost no external sensibility. It is 
said that in some cases the skin could 
be rubbed off in the attempts to obtain reaction, without the patient s 



knowledge. 

For this bath a common tub may be used, by placing a support 
under one edge to elevate it two or three inches; but it is better to use 
a tub made for the purpose, which should have the back raised eight or 
ten inches higher than the front, to support the back, the sides 
sloping gradually so as to support the arms of the bather. The bot¬ 
tom should be elevated two or three irfches. The depth in front should 
be about the same as that of a common wash-tub. 

Enough water is required to cover the hips and extend a little vay 



















RATIONAL REMEDIES FOR DISEASE. 


654 

up the abdomen; four to six gallons will suffice. Any temperature 
may be employed, being suited to the condition of the patient. The 
duration of the bath will also vary according to circumstances. A 
short cool bath is tonic in its effects, like all short cool applications; a 
more prolonged one is a powerful sedative. The hot sitz is very excit¬ 
ing in its effects if long continued. The warm bath is relaxing. The 
hips and trunk should be well rubbed during the bath by the patient or 
an attendant. The bather should be covered with a sheet or blanket 
during the bath. If sweating is desirable, use several blankets. 

The sitz bath should seldom be taken either very hot or extremely 
cold. A very good plan for administering it, and one which will be ap¬ 
plicable to most cases, is this: Begin the bath at 92° or 93°. If a ther¬ 
mometer is not at hand, pour into the bath-tub three gallons of fresh 
well or spring water, and then add one gallon of boiling water. This 
will give the desired temperature. After the patient has been in the 
bath ten minutes, cool it down to 85°, which may be done by adding a 
gallon of well water. Continue the bath five minutes longer, then ad¬ 
minister a pail douche or spray, at about 85 °, and wipe dry, as directed 
after a rubbing wet-sheet. 

The sitz bath is useful for chronic congestions of the abdominal and 
pelvic viscera, diarrhea, piles, dysentery, constipation, uterine diseases, 
and genital and urinary disorders. In treating many uterine and other 
diseases peculiar to women, it is an indispensable remedy. It is very 
valuable in various nervous affections, especially those which involve 
the brain, as cerebral congestion and hyperemia. 

There is no better remedy for a cold than a very warm sitz bath 
taken while fasting, and just before retiring. It should be continued 
until gentle perspiration is induced. 

The sitz may be converted into a general bath by rubbing the whole 
body with the wet hand while in the bath, and may 
thus be made to answer the purposes of the half and 
shallow baths. 

Leg Batli.—See Fig. 206. For this bath, a ves¬ 
sel deep enough to receive the limbs to the middle of 
the thighs is required. The bath may be taken at 
any desired temperature; but it is usually employed 
somewhat cooler than baths which involve the trunk 
of the body. It is a powerfully derivative bath, and 
is found very useful to prevent wakefulness in nervous persons, and to 



Fig. 206. Leg Bath. 





















FOOT BATH AND HALF, PACK. 


655 



Fig-. 207. 

Bath. 


Foot 


relieve palpitation of the heart, headache, and cerebral congestion. We 
have found it of great service in the treatment of epileptic patients. It 
is especially applicable to chronic ulcers of the leg, swollen knees and- 
ankles, varicose veins of the limbs, and limbs which have suffered by ex¬ 
posure to severe cold. It gives much relief in gout; there is no danger of 
causing a metastasis of the disease by the application of this bath. 

Foot Bath. —See Fig. 207. Any vessel sufficiently 
large to receive the feet, and enough water to cover 
them to the ankles, is suitable for this bath. The 
feet should be rubbed during the bath. If the water 
is cold, it should not be more than one-fourth of an 
inch deep. 

The alternate hot-and-cold foot bath is a very valuable remedy for 
cold feet, and is an excellent remedy for chilblains. It is given thus: 
Place the feet in hot water—100° to 110°—two or three minutes. 
Then withdraw them and plunge them quickly into a bath of cold 
water 60° or less. After two or three minutes, restore them to the hot 
bath. Thus alternate three or four times, and conclude by dipping the 
feet quickly into cold water and wiping dry. This bath produces most 
powerful reaction. 

The foot bath is applicable in the treatment of headache, neuralgia, 
toothache, catarrh, congestion of abdominal and pelvic organs, colds, and 
cold feet. It is very useful as a preparatory for other baths, and as an 
accompaniment of other local applications. 

Half Pack. —This bath is given in the same manner as the wet- 
sheet pack, except that the wet sheet extends only from the armpits to 
the thighs. The blankets are wrapped about the patient in the manner 
described for the full pack. All the precautions given in connection 
with the description of that bath are applicable to this. 

T1 lis bath is frequently employed in cases of patients who are too 
feeble to bear the full pack, or as a preparatory treatment for that bath. 
It is much milder than the full pack, and is usually more agreeable to 
the patient, as it does not confine him so closely. It is a very useful 
remedy in all inflammations of the abdominal and pelvic organs, pleu¬ 
risy, acute bronchitis, croup, and pneumonia. A hen a hot application 
is required, it is well to use a woolen sheet instead of a cotton one. It 
requires the same after-treatment as the full pack. When applied only 
to the trunk, the application may be distinguished as the body pack, an 
extremely useful application in fevers. 












65G 


RATIONAL. REMEDIES FOR DISEASE. 


Chest Pack. —This application is made in the same manner as the 
half pack, allowing the wet sheet to extend only from the armpits to the 
‘navel. The German method of applying the chest pack is to take a 
strip of cloth about three yards long, and two to two and one-half feet 
in width, folded lengthwise, and after wetting in cool, tepid, or warm 
water, and wringing dry as possible, apply as follows : Place the upper 
edge of one end close up under the arm of the left side. Pass the band¬ 
age across the front of the body and over the right shoulder, then across 
the back and under the left arm, then across the chest and under the 
right arm, then across the back and over the left shoulder, making the 
end fast in front at the point of starting. A dry flannel cloth is then 
applied in the same manner, and the patient is wrapped warm in 
blankets. An excellent remedy in empyema, chronic pleurisy, some 
forms of asthma, and other pulmonary affections. 

Leg Pack. —The pack may be applied to the legs with great ad¬ 
vantage in cases of habitual coldness of the feet and limbs or knees. 
The same principles mentioned in relation to other packs apply to this. 
The application should be made either cool or cold, and should extend 
from the hips downward. It should continue from half an hour to an 
hour and a half. 

Chest Wrapper. —This consists of a jacket made something like a 
vest, reaching from the neck to a little below the navel. It should be 
made of double thicknesses of soft toweling. To protect the garments or 
bedding from moisture, it should be covered with another jacket made 
like it, but a little larger. In applying it, the wrapper should be wet in 
tepid water, and should then be applied as snugly as consistent with the 
comfort of the wearer. It should be re-applied every two or three 
hours, as it becomes dry. The German method described for the chest 
pack is also used for the chest wrapper, being worn at night only. 

If properly managed, the chest wrapper is a valuable remedy; but 
it has been greatlv abused. It should not be worn more than a week 
without intermission. The practice of some in continuing it until it pro¬ 
duces an eruption of the skin, and even longer—to promote a discharge 
—under the idea that a vicarious elimination is thus performed, is highly 
reprehensible, and has no sound physiological principle to support it. 
Such treatment is damaging to the skin, and does the patient no good 
in any way. The better plan is to allow the wrapper to be worn dur¬ 
ing the night, but omitted during the daytime. If worn during the 
day it should be changed often, and should be removed as soon as the 


WET GIRDLE. 


057 


patient becomes chilly. Whenever removed, the surface of the skin 
should be washed or sponged with cool or tepid water. Feeble patients 
with defective circulation should wear the wrapper in the daytime only 
while walking, riding on horseback, or taking some other form of act¬ 
ive exercise. 

This appliance may be profitably employed in a large number of 
chronic diseases. In chronic bronchitis, pleurisy, pleurodynia, asthma, 
and the early stages of consumption, it gives relief. 

Wet Girdle. —This was a favorite remedy with the early German 
hydropathists, and it is a very useful appliance when properly employed, 
though it has been much abused bv excessive use, as in the case of the 
chest wrapper. To apply it well, a coarse towel about three yards long- 
is the most convenient for use. Wet one-half of this in tepid water, 
wring until it will not drip, and apply it to the abdomen, placing one 
end at the side, and bringing it across the front first, so that two thick¬ 
nesses of the wet portion will cover the abdomen. After winding the 
whole tightly around the body, fasten the end securely with pins or with 
tapes attached for the purpose. The remarks made in reference to the 
wearing of the chest wrapper apply with equal force to the wet girdle. 
For feeble patients, it is better to wet only that portion of the towel 
which covers the abdomen. 

This is a very efficient remedy for constipation, chronic diarrhea, and 
most other intestinal disorders. It is equally valuable in dyspepsia, tor¬ 
pid liver, enlarged spleen, and uterine derangements. 

Ascending Douche. —This modification of the douche is simply an 
ascending instead of a descending stream. It can be readily managed 
by constructing a reservoir in such position as to give the water ten or 
twelve feet fall, when the requisite force cannot be more easily secured. 
The water is conducted through a hose, and is allowed to issue through 
a nozzle near the floor. The patient sits or lies just over the nozzle, and 
a few inches above it. This is a valuable remedy in treating piles, pro¬ 
lapsus of the bowels or uterus, and constipation. 

Drop Bath. —Fig. 208. In applying this bath, a vessel with a small 
opening in the bottom is elevated to a considerable height, water placed in 
it being allowed to drop upon the part to be treated. The aperture in the 
vessel should be' only sufficiently large to give egress to a single drop at 
a time. The bath may also be given by placing in an elevated vessel 
one end of a skein of cotton yarn, the other being allowed to fall over 
42 


658 


RATIONAL REMEDIES FOR DISEASE. 


Fig, 208. The Drop Bath. 


the edge of the vessel and hang 
below it. By capillary at¬ 
traction the water will be 
drawn up into the yarn, and 
will drop off at the lower end 
very slowly. 

This is- a very convenient 
way of applying water where 
its cooling effects are required 
for a considerable length of 
time, as in wounds, bruises, 
sprains, and similar cases. It 
will “ keep down inflamma¬ 
tion ” in a wonderful manner. 
It is not commonly necessary 
that the water should be very 
cold, as evaporation will keep 


the part sufficiently cool in most cases. 

Ann Bath.—See Fig. 209. This is simply holding the arm in 
water of proper temperature. It is extremely useful in such painful 

affections as felons, sprains, 
and nearly all injuries of the 
hand and arm. Ulcers and 
acute and chronic skin dis¬ 
eases of the hand and arm 
are usually benefited by this 
bath. If cold water is pain¬ 
ful, its application should be 
preceded by that of hot 
water, or alternated with it. In case of painful felons, the arm must 
be immersed to the elbow to relieve the pain, although the disease is 
only in the finger. 

Head Bath. —The patient should lie upon his back, resting his head 
in a shallow basin of cool water. The attendant should bathe the fore¬ 
head, face, and temples, during the bath. The bath may be continued 
until the heat is removed or lessened. 

The pouring head bath is often preferable to the preceding. The 
patient should lie upon a bed or sofa, face downward, allowing his head 
to extend outward over a tub or other wide vessel, while the water is 



Fig. 209. Arm Bath. 










































































































































EYE BATH. 


659 

poured upon the head from a little height, by an assistant. The water 
may be either hot or cold, according to existing conditions. Very ct Id 
water is not usually advisable, as its application soon becomes painful, 
and produces powerful reaction. It should be tepid or temperate. 
Some cases require very hot water for a few minutes, followed by a 
slight affusion of tepid water. 

In hysteria, epilepsy, apoplexy, sun-stroke, acute mania, delirium 
tremens, and cerebral congestion from any cause, the cold head bath is a 
promptly efficacious remedy. In many of these cases the pouring head 
bath is the most effective. The most prompt and almost universal relief 
will result from the application of the cold douche to the nape of the 
neck in cases in which persons have had sun-stroke and continued to suf¬ 
fer from headache and dizziness from exposure to the sun, the arteries 
and veins of the head and neck being Too full of blood; in all cases of 
headache confined to one side of the head; in many cases of roaring or 
ringing in the ears; in the crowing respiration of children, or false croup. 

Eye Bath .—Water may be applied to the eye in various ways. A 
convenient method when only a brief application is necessary, is to lave 
the eye with water dipped by the hand. A gentle spray may be applied, 
or the eyes may be opened and closed in water, thus bringing them freely 
in contact with the element. Small glass cups made for the purpose 
may be filled with water and placed over the eye, the water being fre¬ 
quently changed ; or wet cloths may be laid upon them. 

In applying water to the eye, it is important to be able to first dis¬ 
tinguish the exact nature of the difficulty, as much damage may other¬ 
wise be done by a wrong application. As a general rule, inflammations 
of the conjunctiva and external structures of the eye require cool or cold 
applications, while inflammations of the cornea, iris, and other internal 
structures, require hot applications. This rule is often violated in hy¬ 
dropathic establishments through ignorance of the structure and diseases 
of the eye. 

Cool applications are best made by laying upon the eyes thin folds of 
linen cloth wet in cold water. Not more than two or three thicknesses 
should be used, as a thick compress soon becomes warm, while a thin one 
is kept cool for a longer time by evaporation. The compress should be 
changed every five minutes at least, when there is much inflammation. 
The fomentation is as good as any method of applying hot water to the 
eyes. The application, when hot, should be as hot as the patient can 
well bear. If it affords relief, continue half an hour or more; if it in- 


6G0 


RATIONAL REMEDIES FOR DISEASE. 


creases the pain, desist at once. The same may be said of cold applica¬ 
tions also. 

Alternate hot and cold applications will give greatest relief in some 
cases. After a hot application, a slightly cooler one should always be 
applied for a few minutes. 

A little milk, quince-seed mucilage, or other bland substance, added 
to the water, makes it more agreeable to the eye in bathing it. 

The eye bath is applicable in all inflammations and injuries of the 
eye, and is infinitely superior to all other eye-washes. 

Daily bathing the eyes in tepid water is a good practice for those 
who use them much in reading, writing, or other work requiring close 
attention. Many eyes are ruined by neglect and maltreatment. 

Ear Bath.—Water applications are made to the ear by means of 
fomentations, compresses, the dpuche, or the spray. Compresses and 
fomentations are useful in inflammations of the structures of the ear, 

including abscesses which 
often form in the walls of the 
external canal. Alternate hot 
and cold applications are use¬ 
ful in causing the absorption 
of inflammatory deposits, and 
thus restoring the hearing. 
The douche, administered 
with the syphon syringe, is a 
valuable means of removing 
foreign bodies and insects. 
The warm douche has proved 
very serviceable in restoring 
the hearing by removing hard¬ 
ened ear-wax. In adminis¬ 
tering the douche, the head 
should be inclined over a 
basin, while the stream of 
water is allowed to issue from 
the nozzle held close to the 
external opening of the ear. 
Violent syringing of the ear should never be practiced, as it may oc¬ 
casion irreparable injury. 

Nasal Douche. —This bath is administered either by drawing wa¬ 
ter into the nose while the mouth is closed, or by injecting it by means 



Fig:. 210. The Nasal Douche. 



















































POST-NASAL DOUCHE. 


061 


of a syplion syringe. Great care should always be exercised to ap¬ 
ply the water gently, as a forcible application will cause pain and irri¬ 
tation. The nozzle should be pointed straight back, while the head is 
bent forward a little. See Fig. 210. The patient should on no account 
swallow, as the water may be forced back into the ear and cause 
injury to the hearing. Injection should never be practiced with apis- 
ton syringe, as there is liability of forcing the water into the Eustachian 
canals. The temperature of the water should be warm or tepid for 
most applications. 

Much benefit may be derived by the proper use of this bath in case 
of acute or chronic catarrh. Water rendered saline by the addition of 
salt in the proportion of a dram to the pint of water is less unpleasant 
than pure water, because it is more nearly like the mucous secretion of 
the nasal membrane. Drawing cold water into the nose is sometimes 
recommended for hemorrhage from the nose; but it is of doubtful util¬ 
ity, because the application cannot be continuous, and transient appli¬ 
cations of cold water are always followed by an afflux of blood to the 
part so exposed. The hot nasal douche is a much better remedy for 
nose-bleed. 

Post-Nasal Douche. —So much harm 
has been done by the nasal douche that 
some aurists have been led to condemn 
its use altogether. For many cases the 
post-nasal douche is preferable. In this 
application, the water is injected through 
a curved tube passed behind the soft pal¬ 
ate, the fluid being thrown forward and 
out at the nostrils. More effectual cleans¬ 
ing is obtained by this method than by 
the first described, but care must be used 
to avoid irritating the back part of the 
throat. An irritation at this point may 
extend to the ears and cause deafness. 

The syphon and the fountain syringe are 
the best for edvinff the nasal douche. The 

O O 

former is represented in Figs. 211 and 
212. 

The Uterine Douche. —This very important application of water 
consists in applying to the uterus through the vagina a gentle stream 



(TX 



HI 


Fig. 211. The Syphon Syringe. 




























GG2 


RATIONAL REMEDIES FOR DISEASE. 


of water by means of the syphon, fountain, or Davidson syringe. The 
force of the stream should not be so great as to occasion the slightest 
discomfort. The syphon syringe should be elevated not more than 
three or four feet above the patient; in very sensitive cases, less. The 
position of the patient should be horizontal, with the hips elevated. 
The length of time occupied in the bath and the amount of water used 
will depend upon the condition of the patient. In general, we may 
say that one to four or five gallons should be used. The temperature 

of the water must al¬ 
so depend upon the 
special conditions re¬ 
quiring treatment. 
In the great majority 
of cases it should 
be from 98° to 108° 
F. In special cases 
a higher temperature 
is required. Cold 
water is rarely or 
never required. 

The vaginal douche 
is given in essen¬ 
tially the same way 
as the uterine douche, the principal difference being that a nozzle hav¬ 
ing several openings upon the side near the end is employed instead 
of one with a single opening or two or three smaller ones, at the end. 

In Figs. 211 and 212 the syphon syringe is shown in readiness for 
use, together with the different nozzles used for the nose, ear - , and rec¬ 
tum, in applications to these organs. It will be seen by Fig. 212 that 
the syringe can be made to supply a large amount of water by con¬ 
necting it with a pail or other vessel in the manner shown. 

The uterine and vaginal douche is an indispensable measure of 
treatment in nearly all diseases of the uterine organs. Its value is 
far greater than that of any other one remedy in these cases. It re¬ 
moves congestion, induration, the results of acute and chronic inflam¬ 
mation, and relieves leucorrhea, and numerous other morbid conditions 
of these organs. There is probably no remedy for uterine hemorrhage 
so eminently useful as the hot local douche. It should be applied at 
as high a temperature as the patient can bear, which will be 106° to 










































ENEMA. 


GG3 


120° F. In surgical operations on these parts we have felt most 
deeply grateful for the aid received from this useful measure. 

Enema, —Fecal accumulations in the lower bowel are more quickly 
and easily removed by an enema of warm water than by any purgative, 
laxative, or cathartic ever discovered or invented; and the use of this 
remedy is never accompanied with the unpleasant and painful griping and 
tenesmus which often accompany the use of cathartics. The adminis¬ 
tration is a trifle more troublesome, hut the results are enough superior 
to more than repay the inconvenience. The syphon syringe is far 
preferable to any other for administering injections. Water about blood- 
warm should be used when the purpose is to relieve constipation, and a 
considerable quantity—one to three pints, or more—may be used. The 
water should be retained for a few minutes, while the bowels are kneaded 
and shaken. If there is difficulty in i-etaining the water, a folded napkin 
should be pressed against the anus. In hemorrhage and inflammation 
of the lower bowel, cool or cold clysters should he employed, and should 
he retained as long as possible. The copious cool enema is a valuable 
antiphlogistic remedy used in conj unction with the cool bath in cases of 
violent febrile excitement, as typhoid fever, when the temperature rises 
above 103° F. Large enemas of water, or of water containing quassia, 
are the best mode of treatment of ascarides, or the so-called seat worms. 

Large, or what are termed forced, enemata are also recommended by 
Dr. Mosler as the most successful means of relieving intussusception. 
They are also recommended in hernia and in the treatment of tape-worm, 
in connection with other anthelmintics. In catarrh and other diseases of 
the large intestines they are useful in cleansing and washing away acrid 
secretions and foreign matters as well as in applying local treatment. 
A. Rohrick, of Vienna, lias observed that injections of water into the 
colon increase the fluidity of the bile secreted by the liver. This fact has 
led to its employment in jaundice due to catarrh of the biliary ducts as 
well as to other causes, and, according to Dr. Mosler, with successful re¬ 
sults. In administering a forced injection the syphon syringe should 
be employed. The patient should lie on his back with his hips elevated, 
and the enema should be administered slowly. When colicky pains oc¬ 
cur, the injection should be withheld for a few minutes, until the pain 
subsides. When it is desired to force fluid into the small intestine, 
which may be done in case of necessity, the patient should be placed on 
his knees and shoulders, so as to lift the pelvis as much as possible, and 
the fluid should be introduced slowly. 


6GI 


RATIONAL REMEDIES FOR DISEASE. 


The enema is a most perfect substitute for purgatives in general. 
Cases are very rare in which a cathartic drug will be found necessary if 
the enema is properly used But the enema may become a source of 
mischief if abused. If habitually relied upon to secure a movement of 
the bowels for a long time, the bowels lose their activity, and the most 
obstinate constipation sometimes results, precisely as from the prolonged 
use of purgatives. 

Compresses. —The compress is a wet cloth or bandage applied to a 
part. The object may be to cool the part under treatment, or to retain 
heat. The compress may be used with equal success for either purpose. 
When the part is to be cooled, a compress composed of several folds 
should be wet in cool, cold, or iced water, as required, and placed upon 
the part after being wrung so it will not drip. It should be changed as 
often as every jive minutes. This is often neglected, to the injury of the 
patient. A very cold compress may be prepared by placing snow or 
pounded ice between the folds of the compress. This will not need re¬ 
newal so frequently; but its effects must be carefully watched, as in¬ 
jury may be done by neglect. In applying cold to such delicate parts 
as the eye, a very thin compress is better. It should be renewed once in 
five minutes, at least. 

When moist warmth is required, a thick compress is applied, being 
wrung out of tepid water, and covered with a dry cloth to exclude the 
air. Soft, dry flannel is an excellent covering. Rubber or oiled silk 
may be employed when the compress is not to be retained more than a 
few hours', but if it is to be worn continuously, they will be injurious, 
as they are impervious to air and thus interfere with the function of the 
skin. The effects of a compress thus applied are identical with those of 
the poultice, and the application is a much more cleanly one. 

Compresses are applicable in all cases in which poultices are com¬ 
monly used. They mav replace the old-fashioned plasters with profit 
and comfort to the wearer. The wet-sheet pack, half pack, chest pack 
and wrapper, leg pack, and wet girdle are all large compresses. 

When applied continuously in the same place for a long time, the 
compress occasions a considerable eruption of the skin, and sometimes 
boils and carbuncles. There is no particular advantage in these erup¬ 
tions, and they sometimes do much harm by producing a great degree 
of general irritation. The notion that they purify the system, though a 
very popular one, has really a very slight foundation. The discharge is 
largely made up of elements which would be of great utility if retained 


FOMENT A TIONS. 


685 


in the system, and the amount of foul matter eliminated in this way is 
certainly infinitesimal compared with the amount thrown oft’by a few 
inches of healthy skin. The skin can always do more and better work 
when healthy than when diseased. The eruptions are no doubt due to 
debility of the skin, produced by a too long continuance of the very ab¬ 
normal conditions supplied by the compress. Yet, strange as it may ap¬ 
pear, there are those claiming to be physicians who directly aim to pro¬ 
duce inflamed and irritated surfaces by the continuation of the compress 
for months and even years. 

The wet head cap is a compress made to fit the head. It should con¬ 
sist of several thicknesses of cotton or linen cloth, so as to retain moisture 
for some time. It is a good temporary appliance in diseases of the scalp, 
and for headache; but it should never be worn continuously for the 
purpose of relieving congestion, as it will have an effect just the opposite 
of that desired. In eczema of the scalp it may be worn until the disease 
is cured, being frequently re-wetted. It is an excellent means of pre¬ 
venting sun-stroke and other effects of heat when worn beneath the hat 
in summer; but even for this purpose its use should be temporary, the 
cap being worn only during the hotter portion of the day. 

Fomentations. —The fomentation is a local application analogous 
to such general appliances as the hot pack, vapor bath, and hot-air bath. 
It consists in the application of a cloth wet in hot water. It may be 
considered as a hot compress. Fold a soft flannel cloth twice, so that 
it will be of three or four thicknesses. Lay it in a basin, pour boiling 
water upon it, and wring it dry by folding it in a dry towel. Or, if 
only one end of the cloth is wet, it may be wrung by folding the dry 
portion outside of the wet; in wringing, the whole will become equally 
wet. Apply it to the patient as hot as it can be borne. The second ap¬ 
plication can usually be made much hotter than the first. Frequently 
dipping the hands in cold water will enable the attendant to wring the 
cloth much hotter than lie would otherwise be able to do. 

A better way is to fold the flannel as it is to be applied, and then dip in 
very hot water, lifting it out by the corner and placing it in the middle 
of a towel. Roll up quickly lengthwise of the towel, and wring nearly 
as dry as possible by twisting the ends of the towel. In this way the 
fomentation can be wrung out much hotter than with the hands. Of 
course it will be too hot to apply to the bare flesh ; but do not waste heat 
by letting it cool. Protect the skin by one or more thicknesses of flannel 
and apply at once, covering with another dry flannel. The fomentation 


CGG 


RATIONAL REMEDIES FOR DISEASE. 


will gradually warm through, and will retain its heat two or three times 
as long as when applied in the ordinary way. 

A still more convenient way is to heat the cloths in a steamer; by 
this means they are made as hot as boiling water, and yet they are more 
easily handled, not being saturated with water. W hen no hot water is 
at hand, a fomentation may, in an emergency, be quickly prepared by 
wetting the flannel in cool water, wringing it as dry as desired, folding 
it between the leaves of a newspaper, and laying it upon the top of the 
stove, or holding it smoothly against the side. The paper prevents the 
cloth from becoming soiled, the water protects the paper from burning, 
and the steam generated quickly heats the cloth to boiling heat. For a 
long fomentation, the heat may be made continuous by applying a bag 
of hot meal, salt, or sand, a hot brick or bottle, or, best of all, a rubber 
bag filled with water may be used,—covered with a moist flannel. 

The hot cloths should be re-applied once in five minutes. Two 
cloths should be employed, so that the second may be applied the mo¬ 
ment the first is removed. To retain the heat, a dry flannel, rubber, or 
oil-cloth should be placed over the fomentation. The application may 
be continued from ten minutes to half an hour, or longer in special cases. 
This appliance is very powerful, and should not be employed to excess. 
Alternate hot and cold fomentations are frequently more efficient than 
the continuous fomentation. Hot applications should be generally fol¬ 
lowed by a cool or tepid compress for four or five minutes, or the part 
should be rubbed with the hand dipped in cool water until the redness 
produced by the fomentation in part disappears. In neuralgia, gout, 
and chronic rheumatism, in which the cooling has a tendency to cause a 
return of the pain, the parts should be covered by dry, warm flannels 
and so protected from the air. By this means the good effect of the ap¬ 
plication may be prolonged. 

When applied to the head for some time without intermission, it will 
often occasion faintness; hence, a cooler application should be made after 
the use of the hot cloths for fifteen or twenty minutes. 

If the applications must be continued for a long time, it is well in 
most cases to apply them at a temperature slightly lower than when 
they are to be used for only a few minutes. 

The uses of the fomentation are very numerous. It is indicated 
whenever there is local pain without excessive heat or evidences of acute 
inflammation. Local congestions, neuralgia, toothache, pleurisy, pleu¬ 
rodynia, and most local pains, vanish beneath its potent influence as if 


APPLICATIONS OF ICE. 


GG7 


by magic. For indigestion, colic, constipation, torpid liver, dys¬ 
menorrhea, and rheumatic pains, it is a remedy of great power, and is 
vised with almost uniform success. In relieving sick-headache by appli¬ 
cation to the head, neck, and stomach, its efficiency is unrivaled. The 
fomentation is also extremely useful in cases of great loss of blood, in 
which fatal syncope may be prevented by making hot application to the 
head and so encouraging the circulation of blood in the brain. 

Applications of Ice. —Ice may be applied directly to the skin, or, 
as is usually better, it may be inclosed in flannel, in dried bladders, or 
better, when dry cold is needed, in a rubber bag. The ice-cap is a 
double head-cap of rubber, filled with pounded ice. 

The application of ice is found extremely serviceable in many in¬ 
flammatory diseases, and in some nervous affections. In inflammation 
of the brain, the ice-cap is of inestimable value. Ice applied to the spine 
will check the convulsive spasms of chorea and hysteria when other 
remedies fail. In putrid sore throat or malignant diphtheria, ice is a 
sovereign remedy. It should be applied to the neck externally, and 
held in small bits in the mouth. Small bits swallowed will sometimes 
relieve the pains of gastralgia. The application of ice is a useful means 
of checking hemorrhage. It may be applied over the stomach in lueinat- 
emesis with advantage. It is most effective, however, when it can be 
applied to the bleeding surface. Applied to the spine it is also most use¬ 
ful in tetanus, in sea-sickness, in the vomiting of pregnancy, and in 
cerebro-spinal meningitis. Its use in surgery, in preventing inflamma¬ 
tion after severe accidents, cannot be overestimated. There is no better 
remedy for checking the spread of erysipelas. Ice taken internally, by 
swallowing small pieces of it, Is a useful measure in inflammation of the 
stomach and in fevers. 

Some physicians recommend the application of ice to the spine in 
cases of congestive chill and paralysis. The real worth of such applica¬ 
tions in these cases has yet to be determined by careful and repeated ob¬ 
servations. We would not advise an unskillful person to attempt 
to relieve a violent ague chill by rubbing ice on the patient’s back, and 
we have some fears that a very skillful operator would hardly succeed 
to his entire satisfaction and that of the patient; we have, however, 
obtained good results from the application of ice to the spine in paralysis. 

The snow bath, applied by rubbing the part vigorously with snow, 
is a useful application for restoring the circulation to frosted parts. In 
cases of extreme chilling or absolute freezing, there is perhaps no better 


668 


RATIONAL REMEDIES FOR DISEASE. 


remedy. Powdered ice may be used when snow cannot be readily 
procured. 

Water-Drinking. —Baron Liebig and many subsequent observers 
have shown that the internal use of water powerfully stimulates tissue 
change, both assimilation and disassimilation, or disintegration, being 
greatly increased. There is usually a greater increase in the building 
up than in the eliminative processes, so that a person gains weight under 
the copious use of pure water as a drink. It was, undoubtedly, for this 
reason that Banting forbade the use of fluids to those suffering with 
obesity. It is a valuable measure, and ought to be more frequently em¬ 
ployed than it is. It is an admirable thing to give nature an abundant 
supply of the great cleansing agent, to wash the tissues free from im¬ 
purities, and thus remove obstacles to the free play of all the vital func¬ 
tions. The amount of water to be taken must depend upon the condi¬ 
tion of the patient and the effect desired. A dyspeptic whose absorbents 
act slowly, can take but small quantities of fluids, and only a few sips 
at a time. In general, it is better to take but small quantities at once, 
and to drink frequently. We have ordered patients to drink two or 
three quarts a day with advantage to them; but ordinarily,one-third of 
that quantity is sufficient. Care should be taken, also, to take no large 
quantity within one or two hours after eating. For “bilious” persons, 
and those whose bowels are very torpid, one to three glasses of water 
may be taken in the morning half an hour before breakfast. This 
should not be done, however, by persons with “ a weak stomach.” The 
purest water obtainable should be employed, and the temperature should 
not be too much below that of the body; the temperature of ordinary 
well water is as low as should be used in any quantity. Iced water, if 
drank at all, should be taken so slowly that it may be warmed to the 
temperature of ordinary well water before it reaches the stomach. 

Copious water-drinking is a very useful measure for patients suf¬ 
fering from the effects of inactivity of the skin, kidneys, liver, and 
bowels, and is also eminently useful in cases of defective assimilation. 
It is a valuable aid in the cure of the tobacco and the opium habit. 
Cold water, taken frequently, is a most useful means of allaying 
discomfort and diminishing temperature in fever, when used in con¬ 
junction with other remedies. Cold drinks also exert a powerful in¬ 
fluence in exciting action in the kidneys. Warm drinks produce an 
equally marked effect upon the skin. Hot drinks, in very small quan¬ 
tity, are often useful in promoting digestion by exciting to action a 


WATER EMETIC. 


GG9 


debilitated and inactive stomach. The quantity taken for this pur¬ 
pose should be very small, and it should be taken about half an hour 
to an hour after eating. The practice should not be long continued, 
as it will have a tendency to cause increased inactivity on the part of 
the stomach by producing relaxation of its walls. The fluids drank 
should not be too hot, not over 102° to 10G°, as they may impair the 
quality of the gastric juice, besides injuring the mucous membrane of 
the stomach. 

When water alone is insipid and is not readily absorbed, the juice 
of limes, lemons, or other acid fruit may be added. 

Water Emetic. —Warm water at about 92°—not hot water—is a 
most excellent emetic if taken in sufficient quantity. It is prompt in 
action, and is unaccompanied by the painful nausea, retching, and 
straining produced by most other emetics. From half a pint to a 
quart is required to produce emesis. The patient should slowly swal¬ 
low a tumblerful; then, after two or three minutes, swallow another, 
so continuing to drink for ten minutes or more. As soon as the 
slightest disposition to vomit is felt,—or even if it is not felt, after a 
considerable quantity of water has been taken,—the patient should 
touch the back part of his mouth with the end of his finger or a 
feather, as far down as he can reach. This will usually excite the de¬ 
sired action. If it does not, all that need be done is to continue drink¬ 
ing. A little salt added to the water will make it more sickening, 
and will do no particular harm, as it is thrown out again. 

It is not claimed that the warm-water emetic can replace all other 
emetics in all cases. When instant vomiting is necessary, as in cases 
of poisoning, some more prompt emetic may be used with it. But for 
all ordinary purposes it clearly has no rival. 

Local Applications of Vapor. —Warm vapor may be used to ad¬ 
vantage in the treatment of swollen joints and painful parts, especially 
the different forms of neuralgia. The inhalation of warm vapor is a 
sovereign remedy in true croup, and is of immense value in nearly all 
acute and chronic affections of the air-passages, in diphtheria especially, 
and also in pulmonary consumption in certain stages. In some 
cases its efficiency is much increased by the addition of some volatile 
substance, as will be noticed elsewhere under the head of inhalations. 
Local applications of vapor can be made in various ways; but the best 
are those described in connection with the subject named, when the 
applications are to be made to the throat or nasal cavity. When the 


670 


RATIONAL REMEDIES FOR DISEASE. 


application is to be made to other portions of the body, it may be 
effected by means of rubber tubes connected with a suitable boiler. 
A vapor-bath apparatus generally comprises arrangements that can be 
used for this purpose. By inclosing the end of the rubber tube in a 
flannel cloth a continued fomentation may be administered. 

Applications of Water ill Surgery. —No other remedy is so uni¬ 
versally useful in surgery as water. As a dressing for wounds, cool or 
tepid, it is applicable to nearly all accidental and surgical wounds. Used 
either very cold,—as in the form of ice,—or very hot, at a temperature 
of 106° to 120° F., it is the most effectual means of stopping hemor¬ 
rhage, not requiring the ligature of arteries. Its utility as a remedy 
for extensive burns has already been referred to under the head of 
“Full Bath.” A few years ago Dr. F. H. Hamilton, of New York 
City, then professor of surgery in Bellevue Hospital Medical College, 
called attention to the fact that immersion in warm or hot water was 
the most effectual means of preventing inflammation, gangrene, or 
mortification, and promoting the healing of severe injuries to the limbs. 
By this means he saved many limbs which must otherwise have been 
sacrificed, and many lives as well. The practice has now been em¬ 
ployed by so many others that its utility is fully established. When 
not convenient to immerse parts, they are kept covered with thick 
layers of sheet cotton, which are kept saturated with warm water. 
The temperatures usually employed are 90° to 106° F. No remedy, is 
so excellent for bruises and lacerations as hot fomentations. When 
applied immediately after the accident they will often prevent sore¬ 
ness and discoloration almost altogether, hence their applicability in 
such cases as bruises upon the face and hea^ or other exposed parts of 
the body. 

MISCELLANEOUS BATHS. 

Under this head we shall include a number of different bath ap¬ 
plications, in most of which other substances besides water enter, some 
of neutral character, others possessing properties which occasion con¬ 
siderable irritation or stimulation of the skin. Among these may 
be mentioned as one of the most commonly used— 

Sea-Batliing. —Bathing in the sea is much practiced by fashiona¬ 
ble people who make annual visits to the sea-coast for this purpose. 
It is no doubt useful, though many who participate in it would doubt¬ 
less receive quite as much benefit if they took as many baths at home 


MINERAL - WATER BA THS. 


671 


during the whole year as they take at the fashionable watering-places 
in a single week. It is a tine thing to be well washed once a year, 
however, if not more often. 

As generally conducted, sea-bathing is usually not more beneficial 
than harmful. The dissipation accompanying it more than counter¬ 
balances what good might be gained. It is rather absurd to attribute 
any specific virtues to sea-water, as many do. Quite a large business 
is carried on in the evaporation of sea-water and the sale of the resi¬ 
due, which is again dissolved in water and used in bathing by those 
who live too far inland to enjoy the benefits of bathing in the sea, or 
who prefer to take their sea-bath in their own private bath-room. 
Everything must have a counterfeit, and so this sea-salt is imitated by 
base swindlers who prepare a mixture of chemicals just as powerful, 
but not quite so complicated, though certainly equally good. All of 
this trouble and swindling might be saved if people would only con¬ 
sider for a moment the fact that the chief benefits they receive from 
sea-bathing are derived from the exercise, the temperature, and pure 
water, and not from any impurities which the water may chance to 
contain. At any rate, the same effects may be obtained by adding a 
liberal quantity of salt to ordinary water employed in bathing. This 
we frequently do, especially in cases of night-sweats, or of great inac¬ 
tivity of the skin. 

Sea-bathing is usually overdone. More benefit will be gained by 
one or two daily baths than by a half-dozen. Fifty baths in a single 
week are not equivalent to a single bath each in fifty weeks. 

Mineral-Water Baths. —Water containing in solution salts of 
iron, magnesia, or other metallic elements, as well as sulphur, arsenic, 
iodine, or any compound of these or other elements which are capable 
of imparting a nauseous or saline taste, an unpleasant odor, or medic¬ 
inal properties, has been much employed for the cure of all sorts of 
chronic ailments. Such waters are totally unfit for general use for 
drinking or cooking purposes, and certainly possess no particular ad¬ 
vantage as cleansing agents. Whether they are useful as medicines is 
a medical question which we do not purpose to consider here; but one 
would naturally suppose that water which is unfit to cleanse the out¬ 
side of the body could not be of very great utility as an internal 
application. 

No doubt a great many people are benefited by visiting places of 
this sort, but it is quite probable that at least a large share of the ben- 


G72 


RATIONAL REMEDIES FOR DISEASE. 


efit is derived from the change of scenery, the rest from business, 
study, or care, together with the influence of the imagination, and the 
therapeutic influence of bathing, independent of the quality of the 
water. We would hesitate long before sending a patient to a mineral¬ 
spring establishment, for two reasons: 1. So far as the specific virtues 
of the water are concerned, we could supply the same mineral constit¬ 
uents in more agreeable form if we deemed best for him to employ 
those compounds; 2. Almost without exception, those institutions are 
in the hands of men of very limited medical education. Many of the 
managers of mineral springs have no exact knowledge of the science 
of medicine whatever. In short, they are quacks, and utterly incom¬ 
petent to undertake the professional management of any invalid’s case. 
In consequence of this ignorance on the part of managers, patients are 
often allowed to do themselves very great injury by excessive drink¬ 
ing of saline and other waters, by too frequent repetition of baths, and 
by the employment of baths at improper extremes of temperature. 

It is an interesting fact in this connection that many of the springs 
which have attained most notoriety for curative virtues on account of 
supposed special properties in the water afforded by them have been 
found, upon examination by experts, to be in no way peculiar 
except in the remarkable purity of the water furnished by them. 
It is an equally interesting fact that very soon after the announce¬ 
ment of the extreme purity of the water of any spring, its fame be¬ 
gins to wane, and its waters shortly lose their reputation altogether. 
A pure-water spring in Maine was for a number of years resorted to 
by thousands of invalids, thousands of barrels being also shipped away 
for use in other parts of the country. When a Boston chemist dis¬ 
covered that all the solid constituents—remedial or otherwise—of a 
gallon of the water could be held upon the point of a penknife, its 
notoriety speedily diminished. 

Robley Dunglison, an eminent medical authority, taught that the 
beneficial effects derived from the use of mineral waters were the re¬ 
sults of “ corrected habits of life, the change of air and scene, the rest 
from labor or dissipation, and the increased amount of aqueous fluid 
imbibed, which are always associated with the springs.” With this 
we fully agree, as also with the views held by the able editor of the 
Detroit Lancet, who remarks as follows on this subject: “Topers, glut¬ 
tons of full habit, chronic rheumatics, etc., who are full of waste ma¬ 
terials, effete matters, are benefited by drinking large amounts of any 


THE OIL-BATH. 


673 


bland water. Their sewers need flushing, and to guzzle from a spring 
is more fashionable than to do the same thing from the well at home.” 

This view is still further confirmed by the testimony of Dr. E. 
Dewey, an eminent physician of Vienna, who in a recent lecture 
“ proved that the human skin is completely impenetrable to the chem¬ 
ical contact of mineral waters, and that therefore the explanation of 
the effects of baths in these waters at the numerous bathing-places 
has to be sought exclusively in the domain of physics, and not in that 
of chemistry. This important discovery annuls all common views-re¬ 
garding the bathing cures effected by the various mineral springs, and 
explains in the simplest manner that, from a chemical point of view, 
the action of the most opposite waters must be one and the same.” 

The Oil-Batli, or Inunction. —Inunction was greatly practiced by 
the ancients in connection with the Roman and Turkish baths. It con¬ 
sists in rubbing the skin very thoroughly with some unctuous sub¬ 
stance. Olive-oil may be employed, but cosmoline and vaseline, re¬ 
fined products of coal-oil, are much preferable. Olive-oil cannot be 
obtained pure except at almost fabulous prices. That sold in the drug¬ 
stores as olive-oil is really cotton-seed oil and mixtures of lard with 
various other vegetable oils. We have found pure refined cocoanut 
oil to be the best of all oils for this purpose. 

A warm bath should first be administered. Then dry the patient, 
as usual, and apply the unguent, taking care to rub it in thoroughly. 
Simply greasing the surface is not the object sought. The skin and 
flesh should be worked, rubbed, and kneaded until the oil nearly dis¬ 
appears from the surface. The skin should then be wiped clean with 
a soft cloth. 

The object of this application is to supply the place of defective 
natural secretion of oleaginous material, to increase the activity of the 
skin, and to diminish susceptibility to cold. How this is accomplished, 
readily appears. The oil is a simple substitute for the sebaceous se¬ 
cretion, which is, in a certain class of diseases, notably deficient. The 
thorough manipulation of the skin which is necessary in applying the 
oil, and which is facilitated by a lubricant, directly promotes cutaneous 
activity. Whether the oil itself has any direct effect in increasing the 
functional activity of the skin cannot be positively affirmed, although 
it is reasonably supposable that the skin would act more nearly nor¬ 
mal when a deficient element is supplied than when it is wanting. 
Recent experiments have shown that the skin radiates heat faster 
43 


RATIONAL REMEDIES FOR DISEASE. 


‘<374 

'•when varnished or anointed, and this may account in part for the 
warming effect of the inunction, as also for the protection which it af¬ 
fords against taking cold after warm baths, as the warm full bath, 
or the hot-air, Russian, vapor, or Turkish bath. 

More than thirty years ago, Dr. Taylor, of London, and Dr. Schnee- 
man, of Germany, published the results of experiments in the use of 
unguents in the treatment of disease, which attracted some considera- 
ble attention at the time, and have since been confirmed by the ob¬ 
servations of numerous other physicians. We quote the following from 
the work of Dr. Taylor, which appeared in 1S50:—■ 

“ Fever assuming all the typhoid symptoms will be found to change 
its character completely under this treatment in twenty-four hours. 
It especially soothes the nervous system, procures sleep, lessens the 
frequency of the pulse, and correspondingly the thirst. The pulse 
may be reduced from 120 to 90 in a few hours, after a few applica¬ 
tions of the ointment. It corrects the fetid and offensive odors aris¬ 
ing from patients. Contagion seldom spreads after its use, very rarely 
uven in crowded rooms; when early employed, the fever is prevented 
from running into the continued type, and the patient soon becomes 
convalescent. Finally, it should be observed that it is always at com¬ 
mand, perfectly safe, harmless, and is perhaps never contra-indicated.” 

All of the results claimed by Dr. Taylor have been confirmed by 
many others. We have found it of great value in the treatment of 
consumptives, dyspeptics, diabetic patients, and all classes of invalids 
suffering with dry or inactive skins. It will sometimes produce al¬ 
most marvelous results in the cases of infants that seem to be wast¬ 
ing away without adequate cause. A few applications will not infre- 
■ quently occasion a very apparent change for the better which will con¬ 
tinue until the child is restored to health. We have also found the 
remedy of great value in the treatment of scarlatina, measles, diphthe¬ 
ria, and different forms of diseases of the skin. It is very serviceable 
also in lowering the temperature in typhoid and typhus fevers, pneu¬ 
monia, and, in fact, all febrile disorders. It is particularly applicable 
in the treatment of small-pox, alleviating the suffering of the patient 
v by soothing the skin and lowering the temperature. It is believed, 
-also, to have the effect of lessening the liability of pitting and of com¬ 
municating the disease to others. Some prefer for use in small-pox 
and scarlatina a mixture of equal parts of olive-oil and lime-water, or 
carron oil, a mixture which we have used with satisfaction in eruptive 


NOVEL BATHS. 


675 


fevers. Inunction has also been used with success in tetanus, beincj 
applied particularly to the spine. It will be found of very great serv¬ 
ice in preventing bed-sores in patients long confined to their beds, for 
which purpose it should be applied once or twice a day. 

Novel Baths. —Many strange substances have been used in the 
form of a bath, by various nations at different periods, only a few of 
which are worthy of attention, and those more on account of their 
novelty than for any practical value which they possess. 

The Milk Bath .—With some of the ancient Roman emperors and 
empresses milk was largely employed as a fancied means of preserving 
health. It was supposed to have a specially beneficial effect upon the 
skin. It is still used somewhat for the same purpose. 

Mud Bath .—Immersion of the body in warm mud has been a fa¬ 
vorite practice at several places in Italy, France, Germany, and other 
countries. The effects are not very different from those of any warm 
bath, and are said to be very pleasant, by those who have taken them. 
If the mud were not medicated, this kind of bath would not be espe¬ 
cially objectionable for those who could enjoy it. In some instances 
the mud contains saline and other elements which have a decidedly 
stimulating effect upon the skin, sometimes even amounting to irrita¬ 
tion. Peat and turf are used for the same purpose in Germany, being 
made into a poultice which is smeared over the body. 

Earth Bath .—Burying the body in the moist earth has also been 
practiced. We have known of one instance in which this remedy was 
successfully used in the treatment of ague. Sand baths are employed 
in Blankenberg and Norderney, a hole being dug in the sand and the 
patient being placed in it and the sand shoveled around him. Spanish 
sailors used to treat yellow fever by this method; with what success 
we are not aware. 

Bees eggs, blood, xuine, pitch, and gelatine have also been em¬ 
ployed by different nations, at different periods, in bathing. None 
of these applications are superior to pure water, which all nature rec¬ 
ognizes as the proper material for bathing purposes. 

THERAPEUTICAL APPLICATIONS OF TEMPERATURE. 

In nearly all of the various applications of water to which we have 
called attention, thermal influences play a large part. In fact, most 
applications of water affect the body beneficially or otherwise through 


(376 RATIONAL REMEDIES FOR DISEASE. 

/ 

their influence in the modification of temperature. In this section we 
shall notice only such thermal appliances as have not been already 
noticed in connection with the description of the several baths. 

APPLICATIONS OF HEAT. 

The therapeutic indications of heat may be inferred from what has 
already been said of its physiological action, or influence upon the 
body in health, so that we need not dwell particularly upon the indi¬ 
cations for the use of this important agent, and we shall proceed at 
once to describe some of the modes of applying heat in which it seems 
to be the only factor in the effects produced, or what is sometimes 
termed dry heat. 

The Turkish Bath. —In taking this bath the patient is placed in 
an atmosphere of dry air heated to a temperature of from 120° to 180° 
F. The bathing apartments usually consist of two or three rooms 
which are maintained at different temperatures, so that a person 
may by passing from one to another become gradually accustomed to 
the extreme heat to which he is exposed before leaving the bath. 
The room first entered from the dressing-room has a temperature of 
120° to 140° F. After remaining in this room for a time, reclining in an 
easy-chair or upon a sofa, the bather passes into the second room, 
where the temperature is 150° to 170° F. Sometimes a third room is 
added in which the temperature is 200° to 240° F.; but this degree of 
heat is rarely if ever required. The temperature of the bath need not 
exceed 140° to secure all the good results which can be derived from 
it, and 170° is much safer than higher temperatures. 

The first sensation upon entering the hot, dry atmosphere is to a 
novice in the use of the bath usually not pleasant; but soon he begins 
to perspire freely, and the unpleasant symptoms disappear. The pro¬ 
fuse perspiration loosens the epidermis, and prepares the patient for 
the subsequent processes of the bath. After having remained in the 
bath until the perspiration has been thoroughly established for the de¬ 
sired length of time—varying, of course, with the effect required—the 
patient is conducted into a room a few degrees lower in temperature, 
preferably not much above or below 100°, where he is placed on a 
marble slab and thoroughly rubbed, kneaded, and otherwise manipu¬ 
lated by an attendant for the purpose of removing the dead epidermis 
and effete matters deposited upon the skin. After this process is thor¬ 
oughly performed, the attendant applies a thick lather to the whole 


THE TURKISH BATH. 


677 


surface of the body, and rubs or scours the skin with a flesh-brush or 
with the hand. In Eastern countries the flesh-brush is not used, and 
we believe that in general it is unnecessary and often harmful to the 
skin. After this thorough rubbing and shampooing, the patient is by 
means of the shower and spray baths gradually cooled to the normal 
temperature. Usually, after the spray, the bather completes this bath 
by a plunge in cool water. The latter is unnecessary, however, and on 
some accounts is objectionable. The graduated shower and spray are 
milder and better means of securing all the toning up of the super¬ 
ficial blood-vessels necessary. 

After being thus cooled, the patient is quickly dried with towels and 
then enveloped in a sheet, and, if necessary, a blanket also, and lies down 
to cool in a room in which the temperature is maintained at 70° to 80°. 
After becoming well cooled, he dresses himself, and the bath is complete. 
The time usually occupied in the bath is one to two hours. Water should 
be taken freely before and during the bath to supply the loss by per¬ 
spiration. 

While the heated air is the chief agent in the bath, the rubbing and 
other manipulations, and the spray and shower baths also, produce bene¬ 
ficial effects. The Turkish bath is one of the most powerful diaphoretics 
known, and stimulates elimination in a most marked degree. It may 
be used in such a way as to either diminish or increase flesh. It is a 
sovereign remedy in acute and chronic rheumatism, rheumatic gout, 
obesity, dropsy, jaundice, malarial and syphilitic diseases, and numerous 
other affections. We have broken up what appeared to be typhoid fever 
in its first stages, with two or three Turkish baths, and consider the rem¬ 
edy almost a specific for remittent and intermittent fevers. Its value in 
some forms of skin disease, particularly psoriasis and mingled psoriasis and 
eczema, is very great. It has also been used with success in hydrophobia. 

The Roman bath is the same as the Turkish, except that after the 
patient has been dried after the spray or plunge he is thoroughly rubbed 
with some sort of unguent. Sweet-oil and vaseline are most often used; 
we have found a fine quality of cocoanut oil superior to any other. 
After much rubbing and kneading, which is greatly facilitated by 
the inunction, all remains of oily matter which have not disappeared 
from the surface are removed by a towel. Persons who have a very 
defective circulation and take cold easily are benefited by the Roman 
bath much more than by the Turkish. It is also a better bath for en- 
courairino- assimilation. 

o o 


678 


RATIONAL REMEDIES FOR DISEASE. 


Hot-Air Bath .—In administering this bath, prepare the patient 
precisely as directed for the vapor bath. Instead of placing under the 
chair a vessel of hot water, place a large alcohol lamp or a small dish 
containing a few ounces of alcohol. When all is ready, light the lamp 
or alcohol, and ^carefully exclude the air. It is hardly necessary to sug¬ 
gest the propriety of putting the lamp in such a position as to insure 
safety from fire. If alcohol is used in an open dish, it is important to 
wipe the outside of the vessel quite free from any trace of the fluid, as 
otherwise it might be communicated to the floor or carpet. Also avoid 
spilling the alcohol in putting the lamp or dish in place, for the same 
reason. It is a wise precaution to put the lamp or dish in a plate or 
shallow dish containing a little water. The hot-air bath should be con- 
ducted in the same manner as the vapor bath; but the patient will bear 
much higher temperatures, as air is a much poorer conductor of heat 
than vapor. A heat of 130° to 160° F. is not at all disagreeable to the 
patient. It should be followed by cooling baths as directed for the vapor 
bath. When perspiration is not readily produced by the hot-air or Turk¬ 
ish bath, the patient should be given a hot full bath or spray bath from 
three to five minutes and then again exposed to the hot air, when per¬ 
spiration will start quickly. The vapor bath may be used for the same 
purpose. 

This bath is useful for all cases for which the vapor and Turkish 
baths are recommended, and is more convenient for use in families, as it 
can be improvised so readily. It cannot be excelled as a diaphoretic, and 
is an excellent means of eliminating the poison of malaria, syphilis, and 
hydrophobia. An English naval surgeon reported through the British 
Medical Journal, a year or two ago, a large number of cases of syph¬ 
ilis successfully treated by the hot-air bath combined with careful diet. 

Local Applications of Dry Heat. —The use of fomentations is 
often less convenient or desirable than dry applications of heat, which 
may be made in a variety of ways. Bottles, jugs, or rubber bags, filled 
with hot water, hot bricks or stones wrapped in papers or cloths, hot 
cloths, bags filled with hot sand, salt, or corn meal, are all convenient 
methods of applying dry heat. 

A few suggestions with reference to the manner of using hot appli¬ 
cations may be useful. In applying heat to the feet when the circula¬ 
tion in those organs is defective, it is frequently insufficient to apply the 
heat only to the bottoms of the feet. For this reason, jugs or bottles 
and stones are often applied without effecting any satisfactory results.. 


APPLICATIONS OF DRY COLD. 


G7 ( J' 

A much more efficient method is the following: Heat to a suitable tem¬ 
perature two or three pounds of com meal or salt. Place the salt or 
meal in a bag sufficiently large to envelop the feet. After distributing 
it evenly through the bag, wrap the latter about the feet and cover 
them with a woolen blanket. A rubber bag partially filled with hot 
water is an excellent appliance for use in cases of neuralgia, toothache, 
and nearly all acute pains in the region of the head, as it will conform 
so perfectly to the shape of the part to which it is applied, and may be 
used as a pillow. 

As a general rule, hot applications should not be continued more 
than an hour or two, at longest, without, at least, a transient applica¬ 
tion of a lower temperature. Too prolonged an application may result 
in injury to the part. 

APPLICATIONS OF COLD. 

Dry cold applications 
may often be made when 
moist cold is not well 
borne. In such cases, 
cold water may be used 
in bottles, jugs, or rubber 
bags; or pounded ice in¬ 
closed in dried bladders 
or in rubber bags may be 
employed. For persons 
who are troubled with 
burning of the feet at 
night, cold bottles or jugs 
afford as much comfort 
and relief as do hot bags, bricks, etc., to those who suffer from the op¬ 
posite cause. Dry cold applied by means of the syphon bag, as shown 
in Fig. 213, is an excellent means of controlling hemorrhage of the 
lungs, or restraining inflammation in pneumonia. 

Freezing.—By means of freezing, parts may be rendered wholly in¬ 
sensible to pain, so that slight surgical operations may be easily per¬ 
formed. When the freezing is long continued, the frozen parts may lose 
their vitality entirely, which will cause them to slough away. By this 
means, excrescences,—as warts, wens, and polypi, fibrous and seoa- 
ceous tumors, and even malignant tumors, as cancer, may be successfully 



Fig\ S13. Application of Continuous Cold to the Chest, 
in Hemorrhage of the Lungs or Pneumonia- 





































680 


RATIONAL REMEDIES FOR DISEASE. 


removed. Small cancers may sometimes be cured by repeated and long- 
continued freezing. Their growth may certainly be impeded by this 
means. A convenient mode of application in cancer of the breast is to 
suspend from the neck a rubber bag filled with pounded ice, allowing it 
to lie against the cancerous org an. 

o o 


Fig. 214. Double Bag for Applying Continuous 
Cold to the Knee. 



Fig. 215. Ice Head-Cap. 




Freezing may be accomplished by applying a spray of ether, by 
means of an atomizer, or by a freezing mixture composed of ecpial parts 
of powdered ice and salt or two parts of snow to one of salt. Mix 

quickly, put into a gauze bag and apply to the 
part to be frozen. In three to six minutes the 
skin will become white and glistening, when the 
bag should be removed. Freezing should not be 
continued longer than six minutes at a time, as 
the tissues may be harmed, though, usually, no 
harm results from repeated freezing if proper care 
Is used in thawing the frozen part. It should be 
kept immersed in cool water, or covered with 
cloths kept cool by frequent wetting with cold 
water, until the natural feeling is restored. 

Felons may often be cured, especially when they 
first begin, by freezing two or three times. Lum¬ 
bago and sciatica, as well as other forms of neu¬ 
ralgia, are sometimes almost instantly relieved by 
freezing of the skin immediately above the painful 
part. We have cured some obstinate cases of sci¬ 
atica by this means after other remedies had failed. 


216. Spinal Ice- 
Bag. 


















THE AIR-BATH. 


68 i 


AEROTHERAPY, OR REMEDIAL APPLICATIONS OF AIR. 

In its broadest sense, aerotherapy includes all remedial applications 
in which the atmosphere is made the chief agent. In the Turkish and 
hot-air baths it of course plays a necessary part, but the chief effect is 
obtained by the application of heat through the medium of the air. 
That the atmosphere itself is a powerful medium of affecting the sys¬ 
tem beneficially or otherwise, is evidenced by a large number of facts 
well known to every one, as the influence of climate, altitude, and 
other familiar means of securing what is termed “ a change of air.” 
It is not, however, to these applications of air that we wish now to re- 
fer, but rather to more specific uses of the element, and methods that 
may be made use of in all latitudes alike. Aerotherapy is still in its 
infancy, but enough facts have been determined and tested by experi¬ 
ence to warrant the conclusion that the air is a potent therapeutic 
agent for use in certain classes of cases at least. 

Air-Bath. —The air has a very soothing effect upon the body when 
allowed to come in contact with the entire surface. It answers a very 
valuable purpose when a water bath is impossible, or when the patient 
is too feeble to endure the application of water. A sleepless person 
will often fall into a sound and refreshing slumber after walking a 
few minutes in his room with the whole body exposed to the air. The 
effects of night labor upon literary people may be partially counter¬ 
acted by the air-bath. Benjamin Franklin was accustomed to pursue 
his writing to a late hour after divesting himself of his clothing, and 
he recommends the practice to others Compelled to labor late with 
the pen. 

The Use of Compressed and Rarefied Air. —What is known as 
the Pneumatic treatment, which consists in the use of compressed and 
rarefied air, has become quite popular in France and Germany within 
a few years. This treatment has been little employed, however, in 
this country, its use having been conflned almost wholly to irregular 
practitioners and quacks, who have employed it in a form which 
is known as the vacuum treatment. This treatment consists in expos¬ 
ing either the whole or a part of the body to air which has been either 
compressed or rarefied. 

In the application of compressed air to the whole of the body the 
patient is placed in a small room constructed for the purpose, into 


G82 


RATIONAL REMEDIES FOR DISEASE. 



which air is admitted until a pressure of one and one-half or two at¬ 
mospheres is obtained, the air being withdrawn as rapidly as needed 
to remove the products of respiration. The patient sits or lies in this 
room from one or two hours to several hours, according to the effect 
desired. A cabinet of this kind, such as is employed in Paris, is repre¬ 
sented in Fig. 217. 

In the cabinet described, the patient may be 
subjected to the influence of rarefied as well as 
compressed air; hut the use of rarefied air is 
usually confined to the exterior of the body. 

For this purpose it is applied by means of suita¬ 
ble receptacles for the arms and legs from which 


Fig:. 217. Pneumatic Cabinet. 

the air can be partially exhausted. The first 
impressions produced by the applications of 
rarefied air, especially when made in the manner 
last described, are decidedly unpleasant. The 
same is true to some extent of local applications. 

Dr. Waldenberg, Professor in the University of 

Berlin, has devised a portable apparatus by means of which com¬ 
pressed air may be inhaled. A representation of the apparatus is 
given in Fig. 218. These various devices are chiefly employed in the 
treatment of diseases of the chest, although the so-called vacuum 


Fig:. 218. Apparatus for 
inhaling Compressed Air. 































































































COMPRESSED AND RAREFIED AIR. 


683 

treatment has a wider range of application and is said to be useful in 
the treatment of paralysis, defective development of the limbs, and 
also as a derivative, relieving the brain and nerve centers of conges¬ 
tion. We have employed vacuum treatment to some extent, and be¬ 
lieve it to be a useful agent. Figs. 219 and 220 represent the forms 
of apparatus which are in use at the Sanitarium. From experiments 
which we have recently 
made with Waldenberg’s 
apparatus, represented in 
Fig. 218, we think it capa¬ 
ble of producing most excel¬ 
lent results, especially in 
chronic bronchitis, asthma, 
incipient consumption, and 
other chronic lung affections. 

It may be used in such a 
manner as to increase ex¬ 
halation as well as inhala¬ 
tion, and thus produce a 
greatly increased develop¬ 
ment of the chest. The 
same apparatus used for 
compressed air may be em¬ 
ployed in the inhalation of 
superoxygenated air, or air which contains more than the usual propor¬ 
tion of oxygen. Various medicated vapors are also employed by this 
means. The remedial value of pneumatic treatment is less thoroughly 
established than almost any other of the remedial agents, on account of 
the small amount of attention which this agent has received from sci¬ 
entific investigators. We believe, however, that it is capable of pro¬ 
ducing excellent results. In a case of chronic emphysema in which 
we employed the apparatus, causing the patient to breathe into rare¬ 
fied air, one-fiftieth of the ordinary pressure being removed, the patient 
was able to exhale 160 cubic inches of air after an ordinary respira¬ 
tion, though he could ordinarily exhale but 40. A consumptive pa¬ 
tient, a young lady with remarkably narrow chest, who could inhale 
but 30 cubic inches of air, by a few weeks’ treatment became able to 
inhale 120 inches. 



































684 


EAT IONA L REMEDIES FOB DISEASE. 


SUNLIGHT AND INSOLATION, 

The value of sunlight in the maintenance and restoration of health, 
although well recognized, is seldom made of practical utility in the 
treatment of disease. The important relation of sunlight to health is 
shown in the effect produced upon plants as well as animals by depriv¬ 
ing them of its influence. In caves, mines, and other places excluded 
from the light, plants do not grow, or, at most, they attain only a 
sickly development. The same is true of animals. In the deep val¬ 
leys among the Alps of Switzerland, the sun shines only a few hours 
each day. In consequence, the inhabitants suffer terribly from scrof¬ 
ula and other diseases indicative of poor nutrition. The women, al¬ 
most without exception, are deformed by huge goiters, which hang 
pendant from their necks unless suspended by a sling. A considera¬ 
ble portion of the males are idiots. Higher up on the sides of the 
mountains, the inhabitants are remarkably hardy, and are well devel¬ 
oped, physically and mentally. The only difference in their modes of 
life is the greater amount of sunshine higher up the mountain side. 
When the poor unfortunates below are carried up the mountain, they 
rapidly improve. 

The value of sunlight for the sick has been amply demonstrated 
by hospital experience, which shows a much larger percentage of re¬ 
coveries in rooms abundantly exposed to the sun than in those ex¬ 
cluded from its rays. That the sun has a powerful influence upon the 
skin is shown by the great increase of pigment, referred to ordinarily 
as “ tan,” which is produced by free exposure to the sun and air. This 
results from an increased activity of the cutaneous tissue. 

The sun-bath, or insolation, consists in exposing either the whole 
or a part of the body to the direct rays of the sun, or protected by a 
single covering of thin white muslin. In taking the bath the head 
should be protected from the rays of the sun, as the effects upon the 
head are ordinarily so powerful as to excite unpleasant sensations. In 
warm weather the bath may be taken in any inclosed space the top 
of which is open, admitting the sun in such a manner as to allow it to 
fall upon a person lying upon a bed or couch within it. Such an ar¬ 
rangement may be easily made of sheets of muslin in the back yard or 
upon the roof of flat-roofed houses. Ordinarily, however, it is best to 
have a room constructed in the attic for the purpose, a window being 
placed in a roof having a south slope in such a way as to make the 


THE SUN-BATH. 


685 


sunlight admitted available for three or four hours during the middle 
of the day. Means should be provided for ventilation, as otherwise 
the heat within such a room may become too great for comfort and so 
excessive as to interfere w T ith the efficiency of the treatment. All the 
benefits to be derived from the use of the sun-bath can be obtained 
from ordinary glass. During the “ blue-glass mania ” a few years ago, 
we made a number of experiments with the blue glass, by which we 
were thoroughly convinced that the only difference in the effects of 
different-colored glass, aside from the mental effect upon sensitive pa¬ 
tients, is in the modification of the intensity of the rays of light pro¬ 
duced by the different kinds of glass. 

The length of time the patient should remain in the bath depends on 
the condition of the patient and the effect desired. Highly sensitive 
patients, especially when first beginning to use the bath, should remain 
exposed to the rays of the sun but a short time, ten to twenty minutes 
usually being long enough. Less sensitive patients, and those who are 
accustomed to the effects of sunlight, may remain in the bath for from 
half an hour to an hour. The bath should be concluded by a tepid 
sponge bath or wet-hand rub, as the activity of the skin is greatly in¬ 
creased by exposure to the sun, the patient often perspiring very freely. 
The effect of the bath is usually to produce a feeling of languor and las¬ 
situde. Many patients fall asleep while in it. Unpleasant effects are 
rarely produced. In cases where they occur, the usual cause is too long 
continuance of the bath or too great intensity of the sun’s rays. To 
guard against unpleasant effects from the latter cause, it is well to cover 
the patient at the first of the bath with a sheet, or to draw over the 
sash through which the light is admitted a screen of very thin material, 
as gauze or musquito netting. It should be recollected that the solar 
rays sometimes produce very powerful effects, as seen in sun-stroke, and 
hence patients should receive careful attention while in the bath, espe¬ 
cially if they are known to be very sensitive, or easily affected by the 
sun. Cold water should also be kept at hand for wetting the head in 
case headache is produced, and also for ready use to guard against sun¬ 
stroke. By the use of different-colored screens the intensity of the sun’s 
rays may be modified at pleasure. The sun-bath is an excellent means 
of treatment in all cases of defective nutrition, in convalescence from 
various acute diseases, in nervous affections and skin diseases, and espe¬ 
cially in consumption and dyspepsia. For the last two diseases we have 
used it very extensively and with excellent success. Consumptives 


€86 


RATIONAL REMEDIES FOR DISEASE. 


under the stimulating influence of the sun’s rays, gain flesh, improve in 
appetite, are relieved of their exhausting night-sweats, gain color, and, 
in fact, improve in every respect. The dry, inactive, almost lifeless skin 
of the dyspeptic becomes moist and supple, and shows marked increase 
of activity. Rheumatic patients also are benefited by this bath. In 
fact, nearly all classes of invalids may employ it with advantage. It 
has been found also that wounds heal much more rapidly when exposed 
to the sun’s rays two or three times a day than when kept continually 
covered. 

Use of the Concentrated Solar Rays. —A solar ray consists of heat 
rays as well as rays of light. It also contains actinic or chemical rays, 
and its therapeutic effects are doubtless due to the combined influence of 
these three potent forces. By means of a lens all of these rays may be 
concentrated, and their potency thereby increased, as illustrated by the 
well-known properties of the burning-glass. The rays of the sun con¬ 
centrated by means of a lens have been used in the treatment of obsti¬ 
nate ulcers, discolorations of the skin, and various morbid growths. 
Undoubtedly, the remedial power of the sun’s rays used in this way would 
be, upon thorough study and utilization, found to be of very great value 
in a large number of cases. 

Ancient Use of the Sun-Bath. —There are numerous evidences 
that the sun-bath was not only known among the ancients, but was 
employed by them to a considerable extent. Plutarch tells us that Di¬ 
ogenes, the renowned Athenian cynic, was, in his old age, accustomed to 
lie in the sunshine for the purpose of recruiting his energies,—a custom 
which, according to Pliny, was common among old men in Greece. It 
is stated that Diogenes valued his sun-bath so highly that when called 
upon by Alexander, who offered to render him any service in his power, 
he replied in answer to his kind offer, “ Only stand a little out of my 
sunshine.” According to Pliny, the custom of the sun-bath w r as com¬ 
mon among the Romans. Indeed, both the older and the younger 
Pliny were accustomed to spend an hour in exposure to the sun daily 
after dinner. Hippocrates prescribed the sun-bath for chills. Numer¬ 
ous other evidences might be cited of the ancient use of the sun-bath, 
but these will perhaps be sufficient. A French physician once said to 
some people who had brought their children to him for treatment, “Take 
these children to the country; feed them as well as you can; but, above 
all, roast them,—roast them in the sun.” 


APPLICATIONS OF ELECTRICITY. 


687 


ELECTRICITY, 

Probably, next to water, no single remedial agent fulfills so many re¬ 
quirements in the treatment of disease as different forms of electricity. 
It is one of the most powerful agents in nature, for evil as well as good 
it is true, but, nevertheless, it is capable of being controlled so perfectly 
as to be made useful in the treatment of a large number and great di¬ 
versity of conditions. Electricity can be applied in such a manner as to 
produce its most beneficial results only by a person who is familiar with 
the physical properties of electricity and the principles and mode of con¬ 
struction of batteries. In order to be able to apply it, it is necessary, in 
addition, to understand well the structure and functions of the various 
parts of the body, particularly of the nervous system, and also to be well 
acquainted with the effects of electricity upon each of the several por¬ 
tions of the body in health. To become possessed of this knowledge re¬ 
quires long study and experience. 

We have not space in this volume, in which so many different 
subjects are considered, to attempt anything like a thorough treatise 
upon the nature and medical uses of this powerful agent. All we shall 
attempt to do will be to point out some of the principal modes of appli¬ 
cation, aud mention a few diseases and morbid conditions to which it is 
especially applicable. We are led to do this particularly as we have 
many .times been requested by patients who have been benefited 
by the use of electricity under our care, to give them instruction in its 
employment, so that they might continue its use after returning to their 
homes, and retain the benefit which they had received. While we do 
not, in general, recommend the self-application of electricity, yet the re¬ 
quest referred to has come many times from persons whose intelligence 
and quickness of perception, together with their personal experience in 
the application of the remedy, from having been some time under treat¬ 
ment, rendered them entirely competent, with the proper instruction, to 
continue at least in the particular mode of application which had been 
found most beneficial in their particular cases. The principal kinds of 
electricity to be employed are known as the galvanic and the faradic 
current. 

Galvanic electricity as used in medicine is produced by chemical 
reactions taking place in a battery composed of several cells. The 
strength of the current depends on the size of the cells, and the number 
employed. 

Faradic electricity is produced by passing the current from a very 


683 


RATIONAL REMEDIES FOR DISEASE. 


weak galvanic battery consisting of one or two cells through a coil of 
wire arranged around an iron bar. By this simple device the intensity 
of the current is very greatly increased. By using several coils, one out' 
side of the other, a very high degree of intensity can be produced from a 
very weak galvanic current. 

The faradic current, although inferior for some purposes, is much 
more generally useful than the galvanic. Fig. 221 represents a con¬ 
venient form of faradic battery Fig. 222 is a small battery made on 
the same plan, for family use. 



Tig 1 . 221 . Faradic Battery 


RULES FOR THE USE AND CARE OF A FARADIC BATTERY. 


The following directions for the use and care of this battery we 
copy from Beard and Rockwell’s excellent work on medical and sur¬ 
gical electricity; the same directions will apply in general to most other 
faradic machines 

“ To Prepare the Apparatus for Use. —Fill the glass jar with a so¬ 
lution of water and sulphuric acid,—one part sulphuric acid to eight or 
twelve parts water. It is not necessary to be rigidly mathematical in 
regard to the quantity of the sulphuric acid. The average proportion 


































































































TIIE FAR A DIC BATTERY. 


G8Q 

is one-tenth, but it may range between one-sixth and one-sixteenth. 
The jar should be about two-thirds tilled with the solution. 

“ It is also necessary to put about a teaspoonful of quicksilver into 
the cup. This touches the lower end of the zincs and keeps them con¬ 
stantly amalgamated. 

“ The quicksilver should not be allowed to touch the central plate 
of platinum, as it may injure it. In some of the modifications of this 
apparatus it is necessary to close the prongs between one of the brass 
posts that is labeled and the one in the middle that has no label. 

“ The apparatus is now ready for action 
If the spring does not at once vibrate, give it 
a slight stroke with the finger. If it still re- 
fuses to vibrate, it may be necessary to re¬ 
adjust the screw. If the spring vibrates irreg¬ 
ularly or too slowly, the evil may usually be 
remedied by re-adjusting the screw 

“ Now connect the strings attached to the 
electrodes with the lettered posts. A is al¬ 
ways the positive pole, and B, C, and D are al¬ 
ways negative relatively to A. 

“To Distinguish the Poles. —It is always 
possible to distinguish the negative pole by 
holding the electrodes for a moment in the two hands; the one in 
which the current is strongest felt is the negative pole. 

“ If the apparatus refuses to go, or if it stops at any time while in 
use, the cause may be looked for— 

“ 1. In the screw of tlte rheotome , or current-breaker. This may 
not be properly adjusted. The point may be too far from the spring, 
or too closely pressed upon it. This want of proper adjustment of the 
screw is the most frequent cause of a stopping of the machine, and of 
the refusal of the spring to vibrate. The spring may sometimes be 
corroded at the point where the screw touches it. 

“2. In the connection of the wires. The wires that unite the zincs 
and platinum may not be properly screwed at their point of connec¬ 
tion, or may be corroded, or may be broken in their course. 

“ 3. In the battery itself. The battery—that is, the zincs and plat¬ 
inum, with the solution in the glass jar—may get out of order in four 
ways. First, the solution may lose its strength. This difficulty may 
be remedied either by pouring in some sulphuric acid or by making 
an entirely new solution, or by simply adding more water. Secondly, 

44 



Figr. 222. Family Faradic 
Battery. 











690 


RATIONAL REMEDIES EOR DISEASE. 


the zincs may become so corroded and incrusted as to become incapa¬ 
ble of generating a current. When the zincs have lost their amalgam, 
local action may take place; this will be indicated by rapid evolution 
of hydrogen. Thirdly , a portion of the mercury may have fallen onto 
the platinum, and corroded it. When this happens, little or no current 
can be obtained. When we have reason to suspect that such is the 
case we should clean them with an old tooth-brush or cloth, or amal¬ 
gamate them. Fourthly, the platinum and the zincs will, in time, by 
hard and long usage, wear out, and will need to be replenished. 

“ 4. In the helix. It is very rarely indeed that the helix of this 
apparatus ever becomes so injured as to be incapable of service. If, 
after we have properly adjusted the screw and spring, made sure of the 
connections of the wires, replenished the solution, and cleaned the zincs, 
the apparatus persistently refuses to go, we have reason to suspect 
that something may be wrong with the wires that compose the helix. 
If such be the case, the evil can be remedied only by the inventor him¬ 
self, or, at least, by some one practically familiar with the construc¬ 
tion of helices. But we should try very patiently and perseveringly 
before we accept the conclusion that the helix is thus out of order, for 
it is an accident of extremely rare occurrence. 

“ When no current is felt at the electrodes, although the apparatus 
acts properly, we know that the connection is broken somewhere in 
the insulated connecting wires. Sometimes the union of the wires 
with the electrodes is imperfect, and occasionally the wire in some part 
is broken. Finally, the electrodes themselves may become very much 
corroded and may need cleaning before a good current can be ob¬ 
tained. 

“ To Take Care of the Apparatus. —When not in use, the element 
•can be taken out of the solution. When the tip battery is used, all that 
is necessary is to merely turn over the jar. If the element remains too 
long a time in the jar, an incrustation of salt will sometimes accumu¬ 
late on the top of the zincs, which will need to be brushed or washed 
off. This salt is the sulphate of zinc, resulting from the action of the 
sulphuric acid on the zinc. 

“ W e may know that action is taking place in the battery when 
bubbles of hydrogen are rising up by the side of the zinc. 

“ Methods of Modifying the Current.— The strength of the cur¬ 
rent of this machine may be modified in several ways, as follows:— 

“1. It may be modified by withdrawing or pushing in the metallic 
tube that covers the helix. 


CONDUCTING-WIRES AND ELECTRODES. 


691 


“ When this tube covers the helix, an indefinite number of branch 
currents are induced in it that interfere with the main current and 
weaken it. In proportion as this is withdrawn, the induction of 
branch currents, and the consequent interference with the main cur¬ 
rent, grows less. 

“ This method of modifying the strength of the current must he 
used continually both in general and localized faradization. 

“ 2. The current may be modified by increasing the quantity of the 
solution, or of the sulphuric acid in it. This measure can be resorted 
to when the current fails to accomplish our purpose, even when the 
metallic tube is entirely or nearly withdrawn. 

“ 3. When the current passes through the body of the operator, the 
current may be modified by increasing or diminishing the pressure of 
the hand on the sponge connected with the positive pole. 

“The direction of the current can be changed at any time, by re¬ 
versing the position of the electrodes, or by reversing the conducting 
wires in the posts.” 

Conducting-Wires. —These are usually composed of several twisted 
or braided copper wires covered with silk. When the battery is used 
very much, the silk frequently becomes worn so much that the wire is 
easily broken. On this account it is well to pass the wire through a 
small rubber tube, which will act as a protection without doing it any 
injury. One advantage is that the wire will be kept dry, so that it 
will not communicate electricity to the hand or other parts of the body 
of the patient or operator which it may fall upon, as it may do when 
uncovered. 

Electrodes. —In addition to the cojDper plate to which reference has 
already been made, which is applied to the feet, several sheets of cop¬ 
per of different sizes and shapes may be used for lengthy applications 
to different parts of the body. One, for instance, a plate the size of the 
hand, may be used for application to the back or to the pit of the stom¬ 
ach. The same plate or a larger one may be used for application to 
the abdomen. Electrodes of all shapes and sizes can be obtained of 
the manufacturers of batteries. Metal electrodes should never be ap¬ 
plied directly to the skin; a covering of cloth or a sponge moistened 
in water should always intervene. Some electricians use salt water for 
moistening the electrodes, as it is a better conductor of electricity than 
ordinary water. The metal electrodes should frequently be scoured, as 
the electric current causes rapid corrosion to take place. I hey should 
be kept bright and clean. Care should also be taken to thoroughly 


692 


RATIONAL REMEDIES FOR DISEASE. 


cleanse the cloth and sponge covers by boiling and thoroughly wash¬ 
ing in a solution of soda or chlorinate of soda. 

O 




Fig. 223. Galvanic Battery. 


Fig:. 224, Galvano-Cautery Battery. 


A galvanic battery is 
shown in Fig. 223 which 
represents the form 
manufactured by the 
Galvano-Faradic Co., of 
New York. This bat¬ 
tery we have employed 
for a number of years 
with entire satisfaction, 
and can recommend it 
to any one needing a bat¬ 
tery of this sort. It is 
much more difficult to 
care for and requires 
much more experience 
in its use than the fara- 
dic battery, and hence is 
not well adapted to use 
by persons who have 
not had special training 
for the purpose. On 
this account we shall 
give no description of 
the mode of using or 
caring for the machine. 
Fig. 224 represents the 
battery which is used 
for galvano-cautery in 
the removal of tumors 
and other morbid 
growths. It is of course 


useful only in skilled hands. Figs. 225 to 230 represent some of 
the different instruments used in the application of electricity to 
various parts of the body. 

The Effects of Electricity. —Probably no other agent has so 
powerful an effect upon the human system as electricity. Its general 
influence is to increase vital activity. Just how this is accomplished 
U not known. Its close resemblance to what is known as nerve force, 














































































































GENERAL FARADIZATION. 


6°3 


lias led some to believe that nerve force and electricity are identical, 
but numerous facts and experiments show that this cannot be true. 
It does not act as a stimulant, however, as there is no reaction from 
its proper use. Its effect seems to be that of a corrector of the vital 
actions. An organ which is acting too slowly will be quickened by it 
to increased activity : while one that is in a state of morbid activity, 
under the influence of electricity may be restored to its normal func- 
tions. It acts directly upon the several tissues of the body through 



Fig:. 230. 


which it is made to pass, and also through the medium of the nervous 
system. It is probable that its principal effects are produced in the 
latter manner. We have not space to describe its effects upon the 
body in health, upon which its remedial applications are based, and 
will content ourselves with a brief description of the principal modes 
of applying faradic electricity, and some of the principal diseases to 
which it is applicable. 

General Faradization. —In making this application, place the 
patient on an ordinary stool with his face toward the battery and his 
feet on a sheet of copper to which the conducting cord connected with 
the negative pole is attached. Patients who through paralysis or for 
any other reason are unable to sit up, may receive the treatment 
while lying in a bed or on a lounge, the sheet of copper being sup¬ 
ported against the feet by means of a pillow or cushion. Except 
in cases where there is a special indication of the application of elec- 
ti’icity to the lower limbs, the negative pole may be applied to the lower 
end of the spine instead of the feet. This plan is a better one with 
infants, with whom difficulty may be experienced in keeping the feet 





















694 


RATIONAL REMEDIES FOR DISEASE. 


upon a metallic plate. The right hand of the operator should be 
placed upon the forehead of the patient, while with the left he touches 
the sponge of the positive pole of the battery. The sponge should 
not be grasped at first, but simply touched with the tip of one finger. 
Then, if the patient does not feel the current as desired, it may be 
taken in the hand and pressed with sufficient firmness to obtain as 

This jilan is better than 
the application of the 
sponge directly to the 
head, as by this means 
the operator can deter¬ 
mine with exactness the 
strength of the current 
which is applied, and can 
modify it to the condition 
or feelings of the patient 
in the most delicate de¬ 
gree. Especial care should 
be taken in applying elec¬ 
tricity to the head, as it is 
one of the most sensitive 
parts of the whole body on 
account of the large num¬ 
ber of nerves which it con¬ 
tains and the very close 
proximity to the bones of the skull. After a few seconds, pass the 
hand to the top of the head, first wetting the hair, as otherwise the 
current would not be communicated to the bodv, on account of the 
poor conducting qualities of the hair. The top of the head at the 
point where phrenologists locate the organ of firmness, is an im¬ 
portant point, as the application of electricity here has a powerful 
effect upon the whole nervous system. 

Some patients, however, are so extremely sensitive about the head, 
that they will not bear even the mildest application. In such, the 
application should begin with the back part of the head, which, to¬ 
gether with the upper part of the spinal cord, will usually bear quite 
strong applications. This, too, is an important point, as very marked 
effects upon the whole system may be produced by application sim- 


much strength of current as is needed. 

O 














GENERAL FARADIZATION. 


695 


ply to the back and sides of the neck. This is doubtless due to 
the large number of nerve trunks which pass from the brain through 
this region to other parts of the body. The sympathetic and gan¬ 
glionic systems also lie near the surface in this region, and hence are 
easily affected by the application of electricity here. Although the 
hand is usually much more agreeable than the sponge as a means of 
applying electricity, the latter may be used on all parts of the body 
except the head. In using it, the handle is taken in the right hand 
and the sponge touched lightly to the patient at first, the pressure be¬ 
ing increased as the strength of the current is ascertained. After 
holding the sponge at the back of the neck for one or two minutes, it 
should be moved down the side of the neck on each side. Next ex¬ 
tend the application to the spine by slowly moving the sponge toward 
the back of the neck down to the lower end of the spine. Then 
gently remove it and return to the head, repeating the application. 
After eight or ten applications of this kind, the sponge may be applied 
on either side of the spine below the border of the scapula. It should 
not, however, be applied over the scapula, as the application will be of 
little benefit and will usually produce pain or unpleasant sensations. 
Special pains should be taken to apply the sponge over the region of 
the kidneys, spleen, and liver, and the lower part of the back. 

The application should next be made to the chest and abdomen. 
In applying it to the chest, place the sponge at the borders of the 
front part of the chest and move it toward the sternum, following as 
closely as possible the course of the ribs. This is an excellent means 
of developing the muscles of the chest. In applying to the abdomen, 
the sponge should be held stationary over the pit of the stomach, or 
the central portion of the abdomen may be manipulated with a sort 
of kneading movement. Complete faradization includes applications 
to the extremities also, although this is not always necessary. The 
application to these parts consists simply in passing the sponge over 
the muscles, using sufficient strength of current and pressure of the 
sponge to cause a slight contraction of the muscles. The chief bene¬ 
ficial effects of general faradization upon the nervous system may be 
obtained by application of the poles to the feet and head, only apply¬ 
ing the positive pole to the upper part of the neck or back part of the 
head, and retaining it in that position for ten or twenty minutes. 
This application usually produces very pleasant tonic effects. It 
should not be applied so strongly as to cause contraction of the muscles 
of the neck. 


RATIONAL REMEDIES FOR DISEASE. 


Local Faradization. —In this mode of using electricity, the cur¬ 
rent is applied only to some limited area of the body. This is chiefly 
used for local diseases, although local applications to the neck and 
spine affect the whole body, as well as those particular parts. The 
proper rule to be followed in making local applications is to use care, 
as a general thing, to keep the positive pole nearest the head. Local 
faradization has a wide range of application in the treatment of dis¬ 
eases. As its effects cannot be separated with great distinctness 
from those of general faradization, we will consider the two together, 
first calling attention to a few rules which should always be observed 
in the application of electricity. 

1. Use the mildest currents with which the effect desired can be 
obtained. No benefit and much harm may be caused by the use of 
too strong currents. Special care should be taken in the case of sen¬ 
sitive and nervous patients, especially at the outset. 

2. Avoid passing the hand or sponge over portions of the body 
where the bones come near the surface, as the scapula, the skull- 
bones, the sternum, the elbows, the patellae, the prominences 
about the hips and ribs, and other places where the bones are scarcely 
covered with flesh. The pains produced when electricity is applied to 
these parts, often cause serious irritation and alarm to patients who 
are unaccustomed to the use of electricity, and are likely to discourage 
them from continuing its employment. 

3. Applications should at first be very short, and it should be re¬ 
garded as a general rule, with few exceptions, that short applications 
frequently repeated are much more effective than long ones at greater 
intervals. From five to twenty minutes is usually sufficiently long 
for an application in any ordinary case. 

4. No attention should be paid to the slight muscular soreness 
which often follows the first two or three applications of electricity, 
as these will speedily pass away as the patient becomes accustomed to 
the use of this agent. The same may be said of the increased nerv¬ 
ousness and irritability sometimes noticed in patients beginning the 
use of electricity. 

5. It is also specially important that the patient’s nervous system 
should be in a quiet condition during the application. If his interest 
and confidence are fully secured, its effects will generally be much 
more marked than if the contrary is the case. This fact is true with 
reference to nearly all remedial agents, but more especially of electric¬ 
ity than of any other. 


THE ELECTRIC BATH. 


697 


Electricity is applicable—and more usually with success—to nearly 
all the curable diseases to which the human system is subject. It 
may also be used in incurable cases for the purpose of palliating symp¬ 
toms which cannot be wholly relieved. For this purpose it is one of 
the most successful remedies known. It is especially applicable in 
cases of obscure nervous disorders in which a diagnosis cannot be 
made out with absolute certainty, as in these cases it proves of value 
more frequently than any other agent, and if intelligently applied will 
certainly do some good and can do no harm. Excellent results may 
be expected from the use of electricity in diseases due to or associated 
with general debility of the vital functions, impairment of nutrition, 
such as dyspepsia, neurasthenia, or “ nerve-tire,” nervous debility, 
anemia, hypochondriasis, hysteria, chronic rheumatism, paralysis, 
chorea, some forms of skin disease, epilepsy, and various light affec¬ 
tions. In the forms of disease mentioned, general faradization should 
be used. 

Local faradization is indicated in all diseases which are dependent 
on a local cause, which include some forms of local paralysis, most 
cases of neuralgia, sprain, and other local injuries, diseases of the eye 
and ear, and disease of the larynx and lungs. Local applications are 
also exceedingly useful in painful affections of the stomach and bow¬ 
els, and particularly in neuralgia of the abdomen and pelvic organs, 
and local affections of the reproductive organs. Local applications are 
also frequently used in combination with general faradization to in¬ 
crease local effects, as in special application to the joints in chronic 
rheumatism, and to the stomach in nervous dyspepsia. 

The Electric Bath.—Electricity may be combined with water and 
other agents in a variety of ways. The simplest form of electric bath 
may be applied in connection with the foot and sitz bath by placing 
in the foot bath the negative pole and applying the positive pole as 
directed for general faradization, keeping the sponge very wet, so that 
a sponge bath is really administered to the patient at the same time 
with the electric current. 

The form of general faradization last mentioned in the description 
of that mode of applying electricity, is especially adapted to the sitz 
bath, as the positive pole may consist of a large wet sponge placed in 
such a position that the patient can rest the back of his head upon it. 
Application made in this way for ten or fifteen minutes, or during 
the usual time of the bath, constitutes a very excellent form 


698 


RATIONAL REMEDIES FOR DISEASE. 


of treatment for nervous patients. By employing plates, which can 
be held in position by tapes or bands, the positive pole may be applied 
to the stomach, abdomen, loins, or spine, in cases requiring such local 
application. 

A better form of the electric bath, when general effects are desired, 
may be administered in an ordinary wooden full-bath tub. The cop¬ 
per or zinc plates may be placed at each end of the bath, with which 
the positive and negative poles of the battery may be connected,—the 
positive to the head, the negative to the foot. The back of the pa¬ 
tient should be supported while in the tub by a sloping board of the 
width of the tub, and having in the center a slit four or five inches in 
width, so as to allow the passage of the electric current through the 
body. A still better plan is to place under the back of the head and 
neck a large sponge with which the positive pole may be connected as 
in the sitz bath, and the negative pole may be connected with the body 
by means of a sponge electrode used on the patient in essentially the 
same manner as directed for general faradization. Both methods are, 
however, rather crude, and only very imperfect results can be obtained 
from such forms of bath. To administer the bath successfully, secur¬ 
ing the best results, a bath apparatus is necessary. It consists of a 
wooden tub with a false bottom made so as to support the upper 
part of the head while in the bath. No part of the body comes in 
contact with the electrodes, as the water is a sufficiently good con¬ 
ductor of electricity to communicate the current to the body. At the 
head of the bath is placed an elaborate electrical apparatus consisting 
of a helix, in which the galvanic current is converted into faradic elec¬ 
tricity, and a switch-board, which bears a number of nickel-plated 
knobs connected with the interior of the apparatus by means of which 
the electric current can be controlled at pleasure. One knob starts 
the apparatus by connecting the battery with it; another connects the 
electric current with the electrodes of the tub. By means of another 
the current can be instantly reversed at pleasure. Twelve other 
knobs are used for bringing into connection any two of the twelve 
different electrodes connected with the bath. By means of this elab¬ 
orate apparatus it is possible to pass the electric current through any 
part of the body of the patient while lying in the water, or to pass 
divided currents in all directions through the body at the same time. 
The length of the bath should not be more than from five to fifteen 
minutes, and should be carefully adapted to the condition of the patient. 


ELECTRO- VAPOR BA TIL 


099 


The water of the bath should be of the same temperature as for the 
full bath. Salt and other mineral substances are frequently added to 
the water, but their principal effect is to increase its conducting power. 

The administration of this bath requires a skilled operator, as the 
electric current connected with it is so powerful that much harm might 
be done by a blunder on the part of the person administering the bath. 
It is, however, under such complete control that in the hands of a 
skilled attendant it can be adapted to the sensibilities of the most del¬ 
icate patient. This form of administering electricity is frequently 
well borne when the remedy can be used in no other way. 

This bath is useful in nearly all cases in which general faradization 
is indicated. It is only contra-indicated by great emaciation and 
want of power to react after the application of water. In these cases, 
however, by beginning with general faradization, the patient’s condi¬ 
tion may in many cases be so improved as to admit of the application 
of the bath. In cases of this kind, it is well to apply an inunc¬ 
tion with the bath to secure a thorough activity of the skin and pre¬ 
vent taking cold. Most persons experience much stronger tonic effects 
after the application of the electric bath than after general faradiza¬ 
tion applied in the usual way. In a very extensive use of this bath 
for a number of years we have come to consider it the most powerful 
and useful tonic available in the treatment of various forms of nervous 
prostration and debility. This bath has also been shown to be es¬ 
pecially useful in eliminating from the system metallic substances, such 
as lead and mercury. It has been stated by scientific authorities that 
lead can sometimes be discovered in the water of the bath after its 
application to a person suffering with lead-poisoning. We have never 
verified this statement by actual experiment, but the fact that every 
application of electricity is accompanied by electrolysis, or the decom¬ 
posing effect of the electric current, certainly gives grounds for the 
supposition that such an effect might be produced. We are positive 
of having seen most excellent results follow the administration of the 
bath in such cases, at any rate. 

Electro-Yapor Hath. —This is a combination of general faradiza¬ 
tion with the ordinary vapor bath. It may be administered by means 
of a faradic battery in connection with any one of the different 
methods of applying the vapor bath, in all of which it will be found 
usually effective. It is most conveniently applied in connection 
with a vapor box, or with a battery and apparatus constructed es- 


700 


RATIONAL REMEDIES FOR DISEASE. 


pecially for the purpose. It should he mentioned, however, that no 
electricity is communicated to the body through the vapor, as has been 
claimed by numerous charlatans who have employed the bath in va¬ 
rious forms. Vapor is not a conductor of either galvanic or faraclic 
electricity, and hence cannot be the means of communicating it to the 
body. We have taken pains to test in a thorough manner with the 
galvanometer electro-vapor baths in which it was claimed that the 
vapor was electrified, and have always found the claim to be false. 

This bath should be applied in cases in which both the vapor bath 
and general faradization are indicated. The advantages of the com¬ 
bination are that by means of electricity the relaxing effects of the 
vapor bath are counteracted by the tonic effects of electricity, so that 
the patient can endure longer and more frequently-repeated use of 
the powerful eliminative effects of the vapor bath than without the use 
of electricity. We have never been able to observe any specific effects 
from the bath, although we have for several years made daily use of 
it in a large number of cases. 

Thermo-Electric Bath. —This bath is a combination of faradic 
electricity with hot air. It may be administered by means of a faradic 
battery in connection with the ordinary hot-air bath, or by the appli¬ 
cation of general faradization during the exposure to hot air in the 
Turkish bath. The effects of electricity in combination with hot air 
are similar to those obtained by its use in connection with the vapor 
bath. We have found it particularly useful in the treatment of chronic 
rheumatism, as the application of electricity to the painful joints 
greatly enhances the soothing effects of the bath. In some cases we 
have secured relief in this way when all other means had failed. We 
have devised and had constructed for the administration of this 
bath at the Sanitarium an apparatus, the form of which is essen¬ 
tially as follows: It is a double-walled cabinet, having windows 
which slide upward upon two sides, and a door upon one 
side. It is lined throughout with zinc, with the exception of 
the bottom; this is composed of slats placed about one-lialf inch 
apart, underneath which is a coil of steam-pipe which is connected 
with the steam heating apparatus in the building. In the front part 
of the apparatus is placed a stool so constructed as to be raised or 
lowered at pleasure while the patient is seated upon it. In front of 
the stool is a foot-rest, upon which is placed a plate used as the nega¬ 
tive electrode. Another electrode is placed upon the stool, and still 


THERMO-ELECTRIC BATH , 


701 


others are so arranged as to be connected with various parts of the 
body at the will of the operator. A folding cover resting against the 
back side of the apparatus may be brought forward, and in connec¬ 
tion with an adjustable part just inside the door, behind the patient 
when he is seated upon the stool, the lower part of the cabinet may 
be divided from the upper part so that the hot air will be applied only 
to portions of the body below the head. By sliding up the windows, 
the patient may thus have pure air to breathe while taking the bath. 
If the effect of the Turkish bath is required, the folding cover can be 
thrown back and the windows brought down so that the whole body 
will be immersed in the hot air. No unpleasant effects are felt from the 
confinement as provision is made for sufficient ventilation to keep 
the air pure. During its application, the electric current can be passed 
at will in different directions through various parts of the body by 
means of a very convenient switch-board placed outside the appa¬ 
ratus and under the entire control of the attendant. By means of a 
perforated steam-pipe led into the bottom of - the cabinet beneath the 
false bottom, steam can be led into it, thus securing a vapor or Rus- 
sian bath instead of the hot-air or Turkish. At the conclusion of the 
bath, by means of valves also placed outside of the cabinet, either a 
shower bath or spray bath may be administered without exposing the 
patient to the cool air, the temperature of the water being accurately 
graduated by means of a device for the purpose which enables the at¬ 
tendant to ascertain the temperature of the water before it reaches the 
patient. The above-described apparatus we have found to be the most 
useful for bath purposes of any with which we have ever become ac¬ 
quainted, as by its use we are able to administer so large a variety of 
baths, hot-air, Turkish, vapor, Russian, thermo-electric, electro-vapor, 
spray, shower, and electric baths being all given with equal facility 
and efficacy. 

We have examined the bath lately introduced into several of our 
large cities which is called the thermo-electric bath, but which produces 
no such effects as are claimed for it. The electricity for this bath is gen¬ 
erated by the alternate heating and cooling of a set of zinc and copper 
plates in the bottom of the cabinet. It is claimed by the inventors 
and those by whom it is employed that the whole cabinet is filled with 
the electricity thus generated; but from a careful examination of the 
bath we have become satisfied that the amount of electricity thus gen¬ 
erated is so small as to be inappreciable in its effects, and we have 


702 


RATIONAL REMEDIES FOR DISEASE. 


shown beyond all possible question that the claims of its advocates are 
in the highest degree absurd and unreliable. It is stated, for instance, 
that through the action of thermo-electricity a diffuse perspiration will 
be produced at 90°, and that a higher temperature than this is never 
required in the bath on account of the potent effects of the “ combined 
influence ” of “ heat, electricity, and oxygen ” ! In a personal test of 
the bath we found that moisture appeared upon the body at a lower 
temperature than 90°, but this was wholly attributable to the con¬ 
densation of moisture produced by the contact of water from the 
shower with the hot plates in the bottom of the cabinet. The head, 
which was not confined in the bath, did not perspire in the slightest 
degree, and real perspiration did not begin until the temperature was 
raised and maintained for some time at 105°. The thermometer of 
the attendant very conveniently showed 92°, but a self-registering 
thermometer which we took with us into the bath showed at its con¬ 
clusion the temperature stated. We cannot resist the conclusion that 
this much-vaunted bath, when scientifically considered, is something of 
a humbug, since it does not accomplish what is claimed for it. We 
believe that all the effects produced by it are attributable to the hot 
air employed in connection with it. It is certainly an excellent hot¬ 
air bath, but that is all that can be said in its favor, except, perhaps, 
that it may have considerable potency in affecting the imagination of 
the patient. The bath previously described is vastly superior to it in 
every particular, as the electric current produced in connection with it 
is a sensible one and can be increased or diminished, as the necessities 
of the case require. 

Various Combinations of Electricity with Water.— Electricity 

may be combined with water in a variety of other ways. The electric 
pour is a very simple and efficient combination. It may be conven¬ 
iently administered by connecting the negative pole with some part of 
the patient’s body, as the feet, and the positive with a tin dipper. When 
the water is poured through the dipper upon any part of the body, the 
circuit will be completed and the patient will feel its effects. This is an 
excellent application to painful or swollen joints. It is also a favorite 
way of concluding the electric bath, the pour being administered to the 
back of the neck and to the spine. By the use of a metal nozzle or a cop¬ 
per wire with a coil at one end placed in the rubber tube, the hose douche 
may also be converted into an electric douche and advantageously used 
in the treatment of enlarged glands, hypertrophy and congestion of the 


/ 


SURGICAL USES OF ELECTRICITY. 70 :} 

liver and spleen, as well as for the other purposes for which the douche 
is applicable. Electricity used in this way in connection with the uter¬ 
ine douche is a very effective means of increasing the utility of that very 
valuable remedial agent. In fact, we consider this method the best of 
all for applying electricity to the uterus, as it is far less irritating than 
the contact of a metal electrode. Electricity may also be applied to the 
nose in the nasal douche in the same way, care being taken to keep the 
glass nozzle dry. It may be applied to the ear and eye by the same 
means. It is possible also to administer electricity through the medium 
of the spray, but the effects thus obtained are very slight. We have fre¬ 
quently combined electricity with the foot bath, cold compress, hot 
fomentations, and even packs, with excellent results. 

Other Electrical Appliances. —It has been found that two metals 
of whatever character, as zinc and copper or silver, when placed in con¬ 
tact with the skin, generate a slight current of electricity on account of 
the action of the perspiration upon the zinc. The quantity of electricity 
produced in this manner, however, is exceedingly small, and, consequently, 
it is very doubtful whether appliances of this sort can be made of any 
practical value in the treatment of disease. Quacks, however, have made 
great capital out of this mode of applying electricity, and have con¬ 
ducted a large business in this as well as in other countries in the man¬ 
ufacture of galvanic belts and various other appliances of the same sort, 
which are recommended to be worn by persons suffering from all forms 
of disease, these appliances being held out as a panacea for all the ills to 
which human flesh is heir. We have met many persons who had worn 
these belts for months without an appreciable effect. We have no 
hesitation in pronouncing them utterly worthless for most of the pur¬ 
poses for which they are recommended, and so slightly beneficial in any 
case as to be of little or no value as remedial agents. 

Sill •gical Uses of Electricity. —Electricity has come to be con¬ 
sidered as one of the most useful of surgical appliances. By means of 
numerous ingenious devices which arc now furnished with the batteries 
for use in surgery, it is possible to perform almost any operation which 
can be performed by all other surgical appliances combined, if we ex¬ 
cept the various forms of .splints and braces used in the treatment 
of deformities, although many of these may be replaced by some form 
of electric appliance. Through the well-known heating effects of elec- 
tricitv, parts may be rapidly and almost painlessly destroyed, the opera¬ 
tion being known as electro-cauterv. We have frequently employed 

O v 


704 


RATIONAL REMEDIES FOR DISEASE. 


this method in the removal of polypi, tumors, and other morbid growths 
which could not have been otherwise treated without great risk and 
even considerable danger to the patient. By means of electrolysis, or 
the decomposing power of electricity, nevi, aneurisms, cancers, and nu¬ 
merous other morbid growths and conditions, may be removed. Elec¬ 
trolysis furnishes the best known means of depilation, or removal of the 
hair, the method of which is fully described under the proper heading. 

MEDICAL GYMNASTICS, OR SWEDISH MOVEMENTS, 

The value of exercises of various sorts as a remedial measure has 
for ages been recognized by both barbarous and civilized nations. 
The Chinese, one of the oldest nations on the globe, together with the 
inhabitants of India, have long appreciated the value of exercise. Ac¬ 
cording to accounts which have been gathered from their writings, 
they have for the last two thousand years or more possessed a knowl¬ 
edge of the remedial value of exercise, and have employed it fre¬ 
quently in a more or less systematic manner. The ancient Greeks and 
Romans also employed exercises of various sorts, not only for devel¬ 
oping the body, but for relieving many diseased conditions. 

We might find it interesting to note more particularly some of the 
peculiar modes of treatment employed by the various nations men¬ 
tioned in ancient and modern times; but as our space is limited, we 
will confine our remarks entirely to what are known at the present 
time as “ Swedish Movements.” This system of medical gymnastics 
was chiefly developed by a Swede by the name of Ling, who was 
born about the middle of the last century. His system of exercise 
was put in practice in Stockholm, Sweden, about the year 1813. The 
results obtained were so remarkable and attracted such general atten¬ 
tion that Ling very soon secured the cooperation of the Swedish 
Government, which enabled him to found an institution under gov¬ 
ernmental patronage for the employment of his system for the treat¬ 
ment of chronic diseases of various sorts, which was so successful that 
it remains in existence to the present time, though its founder has 
been dead for more than forty years. At the present time many hun¬ 
dred patients are annually treated at this institution, and its success 
has encouraged the establishment of similar institutions in various 
parts, especially in this country, so that it is probable that at. 
the present time there are not less than fifty in active operation. 


TO REGULATE THE CIRCULATION. 


705 


THE REMEDIAL VALUE OF MOVEMENTS. 

The value of movements in the treatment of disease has become 
now so thoroughly established that it is not necessary for us to ad¬ 
duce other arguments than the results of their use to show their utility. 
For some years after the introduction of this mode of treatment, it 
was looked upon with suspicion by the better class of physicians gen¬ 
erally, and was left to be employed by quacks and charlatans. In 
many instances it has been employed by unscrupulous persons who 
sought to attract patronage by laying claim to the possession of skill¬ 
ful magnetic powers. There have been many cases in which patients 
were benefited by the treatment of these quacks, when in fact their 
success was wholly due to the results of the manipulations of various 
sorts which were invariably employed by the so-called “ magnetic 
doctors.” We will now briefly consider some of the principal remedial 
effects of the employment of medical gymnastics. 

1. To Regulate the Circulation. —It has long been recognized as 
an established physiological fact that the circulation of the blood 
is greatly influenced by the action of the muscles. By muscular ac¬ 
tion the blood is pressed along the veins, and thus its progress toward 
the heart is greatly accelerated. Whenever there is a deficiency of 
muscular activity, as in persons who are confined to their beds or who 
are unable to take a sufficient amount of daily exercise, the em¬ 
ployment of Swedish movements will often produce most marvelous 
results in restoring to a normal condition the unbalanced circulation. 
They are of special service as a derivative measure when applied to the 
hands and feet of any person suffering with habitual coldness of these 

* members. We are acquainted with no remedy which will so readily 
secure marked and permanent results in this direction as this. Ap¬ 
plied to the whole skin, it is an excellent means of relieving conges¬ 
tion of the head, spine, liver, and other organs. 

2. To Increase Secretion and Excretion. —Movements are of 
very great service in cases in which there is very giteat diminution of 
secretion and excretion. They are especially useful in cases of torpid¬ 
ity of the liver and inactivity of the skin, 

3. To Increase Respiratory Power. —No function may be so 
rapidly augmented and permanently increased by the aid of move¬ 
ments as that of respiration. We have known patients to double their 

45 


706 


RATIONAL REMEDIES FOR DISEASE. 


breathing capacity by a few weeks’ practice in the employment of 
lung gymnastics. 

4. To Increase Digestive Power. —In the great majority of 
chronic diseases of other organs, as well as in functional derangement 
of the stomach, deficient muscular power and activity of the stomach 
and intestinal canal is one of the principal morbid conditions, and one 
to which especial attention must be given in directing a successful 
mode of treatment. In many cases, movements applied to the abdo¬ 
men seem to meet these indications better than any other remedy 
which can be employed. We have been in the habit of prescribing 
this means of treatment in cases of this sort for a number of years, 
and are more and more thoroughly satisfied with the results obtained. 

5. To Increase Assimilation. —In not a small proportion of cases 
of chronic disease which come under the care of a physician, defective 
assimilation is one of the most serious obstacles which must be over¬ 
come in conducting the case toward a successful issue. It is not what 
a person eats, or even what he digests, that benefits him, but what he 
assimilates. There is no means by which assimilation may be so pow¬ 
erfully stimulated and encouraged as by the careful and skillful em¬ 
ployment of Swedish movements. This fact is now so thoroughly 
recognized by the leading physicians of all countries that this means 
of treatment is relied upon as almost the sole remedy in the treatment 
of a large class of cases. 

6. To Increase Yital Action. —The influence of movements in in¬ 
creasing vital action is shown not only by the rapidity with which pa¬ 
tients gain in flesh under their employment, but by the fact that the 
immediate effect of the application in the majority of cases is to produce 
marked rises of temperature which cannot be accounted for in any 
other way but that there has been a marked increase in vital action 
as a result of treatment. As the effect clearly suggests, the remedy is 
of great service in the treatment of cases of general debility and all 
other diseases in which there is general inactivity of the vital 
functions. 

7. To Regulate Muscular Action. —No remedy is of greater value 
in the treatment of that class of cases in which there is disordered 
muscular activity, as in various distortions of the spine, which result 
from unequal muscular action, in the great majority of cases of dis¬ 
placement of the womb, and various other diseases peculiar to women. 


DESCRIPTION OF VARIOUS MOVEMENTS. 


707 


In cases of paralysis no other remedy, unless it be electricity, will ac¬ 
complish so much as this, and if we were obliged to dispense with the' 
use of one of these two remedies we should certainly choose this as 
the one of greatest value. 

General Principles Governing the Application of Movements* 

—In the application of medical gymnastics it is important to give at¬ 
tention to the following points:— 

1. The kind of movements to be taken should be carefully and ac¬ 
curately adapted to the condition of the patient. 

2. If the movements to be taken are of such a character that the 
patient can administer them to himself, he should receive careful in¬ 
struction, as everything depends upon the proper application of the 
means employed; if they be given by another person, the attendant 
should be thoroughly trained, as much more harm than good will be 
done by an unskillful application of the remedy. 

3. Movements are best administered at about ten o’clock in the 
forenoon, or between three and four o’clock in the afternoon, unless 
there is some special reason w T hy they should be administered at some 
other time, as in cases of slow digestion. 

4. At the beginning of a course of treatment with movements, the 
first application should be gentle, so as to avoid the production of 
muscular soreness and nervous irritability, which will often appear 
when this precaution is disregarded. In case, however, the patient 
suffers with a slight soreness, or with an increase of nervous irritabil¬ 
ity, and other slightly unpleasant symptoms, his fears should be at 
once quieted by the assurance that both these symptoms will disappear 
in a few days, as they will be almost certain to do. 

5. In the application of movements, care should always be taken 
not to extend them sufficiently long to induce great fatigue. The pa¬ 
tient should always be made to take an hour or two of rest after the 
application. 

Description of Various Movements. —The various movements 
employed are divided into three general classes : Active, Passive, and 
Half-Active, or Active-Passive. In the first class of movements the 
exercise is obtained wholly from the individual effort of the patient; 
in the second, the exercise is applied by means of an attendant; in the 
third class there is a combination of the two, attendant and patient, 
cooperating, the two acting either alternately or at the same time,. 


708 


RATIONAL REMEDIES FOR DISEASE. 


each gently resisting the other’s efforts. In institutions in which this 
remedy is relied upon almost entirely it is common to give a great va¬ 
riety of movements of various sorts. We will not attempt to describe 
the whole list, but will give a brief description of a few of those which 
we have found the most useful, and which can be the most readily 
utilized. 

Movements to Develop the Muscles of the Trunk. —Figs. 232- 
245 represent movements which are especially designed to develop the 
muscles of the back, chest, and abdomen. 

an exercise to be taken in a door¬ 
posts of proper height. The po- 
vell shown in the cut. The ex- 
lg one foot and placing it for- 
at the same time throwing the 


Fig\ 234. 

body forward with energy. The forward motion being arrested sud¬ 
denly by the arms, a strong strain is brought upon the muscles of 
the front of the body, particularly those of the chest. After the for¬ 
ward movement, the foot is returned to its place beside the other. This 
movement is repeated eight or ten times with each foot. As in all other 
movements, the action should be deliberate, and energy and considerable 
muscular strength should be employed. This is a most excellent means 
for strengthening the chest. 

Fig. 233. Another admirable movement for developing the chest and 
the muscles of the trunk. The feet are thrown apart to brace the body, 
the hands being clasped over the head, and the trunk is oscillated from 




Fig. 232 represents 
way, or between two 
sition is sufficiently v 
e-rcise consists in raisir 
ward as in walking, ; 













/ 


TRUNK DEVELOPMENT. 


700 


side to side several times in succession ; then the same movement is ex¬ 
ecuted from before backward. 

Fig. 234. The weight of the body is partly sustained by the hand 
holding the top of a bed-post, or a ring fastened in a wall or post. The 
movement consists in swinging the body, making the points of support 
of the hands and feet the centers of motion. The movement may be 
varied by allowing the body to fall slowly toward the hands by bending 
the arms at the elbows, and then straightening the arms to restore the 
body to the first position again. The effect is to expand the chest and 
strengthen the muscles of the abdomen and back. 

Fig. 235. The body is placed in the kneeling posture, with a cushion 
under the knees, and the heels prevented from rising when the body 



Fig. 235. Fig. 236. Fig. 237. 


bends forward, as shown by the dotted line, by being placed under the edge 
of a sofa or some other convenient object. This movement affects not 
only the trunk but also the muscles of the calf and thigh. 

Fig. 236. The patient stands against a wall or 
post, and bends forward as far as possible with¬ 
out bending the knees. By the aid of an as¬ 
sistant, the head may be readily lowered to a level 
with the knees. 

Fig. 237. In this movement the patient’s head is 
thrown back as far as possible, and to prevent 
the patient from falling backward, the head is 
supported by the wall or a post. 

Fig. 238 represents essentially the same move¬ 
ment, its effect being intensified by bending the 
body backward nearly to a right angle. In tak- 





Fig. 233. 

























710 


RATIONAL REMEDIES FOR DISEASE. 


ing this movement it is necessary to have the hack supported by the 
hand of an assistant. 

Fig. 239. A movement calculated to increase the strength of the mus¬ 
cles of the back. The trunk is kept perfectly rigid, while the body is 
maintained in position for a few seconds, or until the muscles begin to 
show signs of fatigue. 



Fig. 240. The body 
is supported by the 
toes, which rest upon 
the floor, and the 
hands are placed upon 
a stool o r platform 
raised about a foot 
higher than the floor. 

o 

The effect of the move¬ 
ment is to increase 
the volume of the 
chest by throwing it 
forward. 

Fig. 241. This 
movement is some¬ 
what similar to the 
preceding, but its ac¬ 
tion is different, the 
tension being brought 

o o 


chiefly upon the ab¬ 
dominal muscles. Ex¬ 
cellent effects are ob¬ 
tained by its use in 
cases of prolapsus of 
the pelvic organs, rec¬ 
tum, etc. The body should be brought slowly into position, the feet 
being retained in position for a moment and allowed to fall again. 
After resting a minute or two the movement should be repeated, until 
the body has been elevated five or ten times. 

Fig. 242. In this movement the body is wholly supported by the 
head and heels, which rest upon platforms raised a few inches from the 
floor. This movement calls into vigorous action all the muscles of the 
neck, trunk, and legs. A little assistance will at first be required by 



























TRUNK DEVELOPMENT. 


711 


the patient in getting into position. The position should be main¬ 
tained for a few seconds, and then the body may be let down to the 
floor to rest. After three or four minutes the movement may be re¬ 
peated. The number of repetitions must depend, of course, entirely 



upon the strength of the patient. Care should be used not to strain 
the muscles too violently, which may easily be done in taking this 
movement, especially by beginners. 

Fig. 243. The trunk is supported upon a 
platform in such a way that the lower end of the 
spine just reaches to the end of the supporting 
surface. The limbs are held rigidly in the position 




seen in the cut. This is a powerful means of exercising the muscles of 
the abdomen and thighs. 

Fig. 244. In this movement the position is reversed, the legs being 
supported and held in position upon a platform by an attendant while 
the trunk is sustained in the air by the muscles of the abdomen and 
thighs. This movement should be used cautiously at first by those 
who are unaccustomed to such exercise. 

Fig. 245. This is a modification of the preceding, in which the 




























712 


RATIONAL REMEDIES FOR DISEASE. 


trunk is sustained with the face downward. In this movement the 
principal strain is upon the muscles of the back instead of the 
abdomen. 

Miscellaneous Movements. —Fig. 246, which represents toe-stand¬ 
ing, requires no explanation. It is an excellent means of increasing 
circulation in the lower extremities. The body should be slowly ele¬ 
vated into the position shown, the patient rising as high as possible 
upon the toes while slightly supporting the body by the finger placed 





against the wall or a post. The elevated position should be maintained 
as long as possible, and the body slowly lowered to its natural posi¬ 
tion. The movement, in order to be effective, must be executed very 
slowly, so as to give time for the desired changes in the blood-vessels. 

Fig. 247 represents an excellent exercise for the feet. The position 
of the feet is well shown in the cut. The exercise is produced by 
bending the knee and throwing the weight upon the forward limb. 
This movement should also be executed slowly, being repeated ten to 
twelve times with each foot. 

Fig. 248 represents a light form of exercise consisting of rotation of 
the limbs. The limbs may be twisted together, both in the same di¬ 
rection, or in alternate directions. 

A very great variety of other movements of a similar character 
might be given, but many of these are included under the head of 
gymnastic exercises, which are fully described elsewhere in this work. 

Passive and Active-Passive Movements. —This class of move¬ 
ments requires the assistance of a skilled attendant. Many of them 













PASSIVE AND ACTIVE-PASSIVE MOVEMENTS. 


TVS 


may be learned by almost any intelligent person, however, and their 
great utility warrants a brief description in this connection. 

Figs. 249 and 250 represent exercise of the arm, flexion and exten¬ 
sion. These movements, like most other passive movements, are appli- 



Figr. 251. 



cable to persons who are either too weak to take active exercise or are 
suffering from paralysis which renders them incapable of doing so. It 
is a most useful exercise in cases of rigidity of the joints as the result 
of fractures, sprains, or other accidents which require long inactivity. 




It should be employed in all such cases; and neglect of this impor¬ 
tant measure in cases requiring it has not infrequently resulted in ir¬ 
reparable injury to the affected joints. 

Fig. 251 illustrates flexion and extension of the hand at the wrist; 
to be used in the same cases as the preceding. 

Fig. 252 indicates the same kind of exercise applied to the lower 
extremities. 
















714 RATIONAL REMEDIES FOR DISEASE. 

Figs. 253 and 254 represent an attendant in the act of flexing 
and extending the foot of a paralytic patient. 

Fig. 255 shows the method of rotating the hand at the wrist, a means 
of treatment often found useful in cases in which there is deficient 
mobility of the joint. 

Fig. 256 illustrates the same movement applied to the foot. 




Fig. 255. 


Fig. 257 shows the position of the lower limbs and the hands of the 
attendant in applying the rotary movement to the hip-joint. 

Fulling Movement. —Fig. 258 illustrates a form of passive move¬ 
ment which has been appropriately designated as the “ fulling ” move¬ 
ment. The cut represents the movement as applied to the arm. It is 




Fig. 256. 


Fig 257. 


applied to the head, neck, trunk, and lower limbs in a similar manner. 
It is an excellent means for encouraging assimilation and relieving in¬ 
ternal congestion by increasing the circulation of the blood in the sur¬ 
face of the body. 

Kneading. —Fig. 259 illustrates a method of kneading the muscles 
of the arm. The muscles of the arm are grasped at its upper extrem- 






STROKING. 


715 


ity by the thumb and finger, being rubbed to and fro between them 
as the hand passes along the arm. In a similar manner the whole 
body may be kneaded. Kneading of the bowels applied in a manner 
similar to that in which a baker kneads bread, employing either one 
or both hands, is a most excellent means of relieving slow digestion 
and chronic constipation. 

Stroking .—Fig. 260 illustrates a movement known as stroking. 
The hands are applied to the part of the body to which the movement 



Fig-. 258. 


Fig. 259. 


Fig. 260. 


* is being applied, and are moved slowly from above downward at first, 
and then afterward in an opposite direction, in such a manner as to fol¬ 
low the course of the veins and thus encourage the venous circulation. 
The application may be a very gentle one, soothing in character, or 
may be sufficiently vigorous to secure a considerable degree of exer¬ 
cise. Applied to the head and spine, stroking is a very excellent sed¬ 
ative, often securing sleep in persons who are unable to sleep on ac¬ 
count of nervousness. Stroking the abdomen is an excellent means of 
increasing the activity of the bowels, and should be made to follow 
the course of the colon, so as to encourage the downward passage of 
the contents of the bowels. The hands should be applied low down 
on the right side and pressed upward to the ribs, across to the oppo¬ 
site side, and then downward to a point opposite the place of starting. 
Either one or both hands may be applied, and the movement may be 
made as gentle or as vigorous as the condition of the patient or the 
effect desired may require. At the outset of treatment it will often 
be found that great tenderness is present, so that the most gentle ma- 





716 


RATIONAL REMEDIES FOR DISEASE. 


nipulation must be employed ; but an experienced manipulator will at 
first avoid the tender points, gradually encroaching upon them more 
and more, until finally as great a degree of vigor may be employed as 
is desired. 

Clapping. —Fig. 261. This movement consists in alternate percus¬ 
sion of the surface with the palms of the hands. It is one of the most 
generally applicable of all the forms of movement, being usefully ap¬ 
plied after nearly all forms of water bath. Whenever it is necessary 




to excite activity of the surface it is an admirable measure. Its ef¬ 
fect is evidenced by the red color of the skin which almost invariably 
follows its application. 

Chopping. —Fig. 262. This movement is similar to the preceding, 
the only difference being that the edge of the hand, instead of the palm, 
is used in application. In both chopping and clapping, it is important 
that the movement of the hand should be wholly from the wrist, which 
should be kept perfectly flexible. When the wrists are rigid, the move¬ 
ment being made from the elbows, the effect produced is unpleasant, 
the patient feeling as though he were being pounded. In chopping, the 
blow should be quick and sharp, though little force should be employed. 

The surface should be struck with the fingers, which should be kept 
a little way apart, and held loosely, so that they will clap together with 
each stroke. The object of the movement is to secure by quick, short 
blows rapid contraction of the muscles. It is a most excellent means of 
passive exercise, and a most efficient promoter of assimilation. Chop- 







SAWING AND VIBRATION. 


717 


ping may be applied to the whole body. It should be executed 
systematically. 

Knocking. —This movement consists in gently striking some part 
of the body with the clenched hand, the force of the blow being received 
upon the palm of the hand. Fig. 2G3 shows a form of this movement 






U 

Fig-. 267. 


which is known as “ chine knocking.” The patient supports himself 
with one hand against the wall, and, leaning forward, strikes upon the 
lower part of the back with the other hand twenty or thirty smart 
blows. This movement is very effective in removing the dull, aching 
pain often felt in this region, and exciting activity of the lower bowels. 

Sawing. —Fig. 264 illustrates this simple movement, which may 
sometimes be employed with advantage. Its effects are similar to 
those of stroking, though it is a somewhat more vigorous movement. 

Yibration. —Fig. 265 illustrates the manner of vibrating the arm. 
The assistant takes the patient’s arm, holds it out straight, and vi¬ 
brates it as rapidly as possible for fully a minute. After a minute’s 
rest the same is repeated, until the vibration has been performed eight 
or ten times. The lower extremities are vibrated in a similar manner. 


















718 


RATIONAL REMEDIES FOR DISEASE. 


The vibration of the chest, abdomen, and other parts of the trunk, is 
performed by placing the palm of the hand upon the part to be exer¬ 
cised, and by a rapid quivering movement of the muscles of the arm 
producing the desired effect. 

Percussion. —Fig. 26G. This exercise consists in striking the sole 
of the foot, protected by a shoe or boot, with a flat-sided ferule or 
wooden rod for the purpose. This is an excellent means for warming 
cold feet, and has been recommended for chilblains. 




Massage. —This mode of treatment, which is at the present time 
becoming quite popular, especially in the treatment of cases of nervous 
debility, anemia, etc., is really nothing more nor less than a combina¬ 
tion of a number of the above-described forms of treatment. Treat¬ 
ment generally begins with the feet. The first movement applied is 
fulling of the skin of the part manipulated, which is followed by 
kneading. One part of the body after another is manipulated, until 
the treatment has been applied to the whole body, especial attention 
being given to the bowels and loins. Vibration, chopping, and strik- 





















MASSAGE. 


710 


ing are next applied, the treatment concluding with stroking of the 
head and spine. In many cases in which this^treatment is indicated, 
there is great tenderness of the spine or intercostal spaces, as in cases 
of spinal irritation, nervousness, etc. The attendant must take care 
not to exaggerate the suffering of the patient by rude handling of 
these parts, but by encroaching gently upon them from day to day 
gradually accustom them to touch and manipulation, until finally, in 



Fig-. 270. 



Fig-. 271. 


the great majority of cases, the tenderness may be made to wholly 
disappear. We have often observed cases in which a sensation of 
acute pain was produced by a very gentle touch, while firm and hard 
pressure gave no uneasiness whatever. For the class of cases men¬ 
tioned, together with the majority of cases of chronic dyspepsia ac¬ 
companied with great debility, consumption, uterine disorders, and, in 
fact, all diseases characterized by debility, massage is a most valuable 
mode of treatment. When the skin is dry and rough, and, in fact, in 
nearly all cases in which massage is indicated, the benefits of treat¬ 
ment will be greatly increased by the employment in connection with 
it of light inunction with refined cocoa-nut oil. Canton oil is the best 























720 


RATIONAL REMEDIES FOR DISEASE. 


of any sort we have used. The only objection to it is its tendency to 
become rancid. This difficulty can only be corrected by keeping it in 
a cool place and covered with lime-water. 

Muscle-Beating. —This is a method of treatment closely allied 
to Swedish Movements which has been recently approved and rec¬ 
ommended by C. Klemm,* a German 
physician of eminence. The instru¬ 
ment employed is represented in Fig. 
2G7. It consists of three rubber 
tubes, together with a handle to which 
they are fastened. Beaters of various 
sizes are employed to suit the various 
portions of the body to be treated. 
Figs. 2G8 to 272 illustrate the vari- 
ous modes of using this form of ex¬ 
ercise. In the figures referred to, the 
patient is represented as administer¬ 
ing treatment to himself. In the 
majority of cases, however, it is better 
that the remedy should be applied by 
an attendant. The only advantage 
which this method of treatment has 
over those described is that it is so 
simple that it can be applied byalmost 
any one, and hence requires less skill for its administration, so that it 
may be applied by the patient himself. It is certainly a most excel¬ 
lent means for securing an equable circulation in the extremities, and 
for producing a derivative effect by exciting increased circulation in 
the external portions of the body. The inventor claims for it results 
which are seemingly much out of proportion to the simplicity of the 
apparatus employed. Notwithstanding, we have no doubt that if 
thoroughly and perseveringly employed a very great amount of good 
may be accomplished by its use. 

Lung Gymnastics. —No part of the body is more susceptible of 
development by judicious and appropriate exercise than the lungs. 
The amount of air which passes to and fro in the respiratory process 
is ordinarily but about two-thirds of a pint; and in cases of disease is 
much less, often being reduced to less than a third of this amount. 



* Muscle-Beating ; by C. Klemm. M. L. Holbrook, New York. 

















RELATION OF MIND AND BODY. 


721 


By the daily exercise of the lungs in such a manner as to develop the 
chest, the breathing capacity may be very greatly increased. We have 
frequently seen the chest expanded three or four inches by a course of 
appropriate training. One of the best exercises for this purpose is 
forced respiration, which consists in breathing as deeply as possible, 
making strong efforts to fill the lungs, and emptying them as completely 
as possible. This exercise should be taken slowly from five to thirty 
minutes at a time, and should be repeated several times a day. 

MENTAL THERAPEUTICS, 

Whatever may be the ultimate relation of the mind to the body, its 

influence over the latter for good or evil, in disease as well as in health, 

is certainly too great to be ignored in the consideration of the various 

agents by which the human system may be affected. Indeed, under 

some circumstances, the influence of the mind upon the body surpasses 

that of all other agencies that are or can be brought to bear upon it. 

Without delaying to furnish evidence for the influence of the mind upon 

the body in health, as this fact is so well and generally recognized, we 

will call especial attention to the effect of the mind in producing disease 

and also as an agent in the successful treatment of various diseases. 

Medical literature furnishes us with almost innumerable instances in 

which crave disorders as well as trivial affections have been cured 
© 

through the influence of the emotions. 

Numerous cases have occurred in which apoplexy has resulted from 
a sudden fit of anger or fear as also from intense pleasurable emotions, 
as a transition from a state of despair or grief to that of joy. It is. 
stated that the man who invented the means for applying steam in nav¬ 
igation died suddenly of apoplexy upon learning that his invention had 
received favorable notice from a scientific committee to which it had 
been submitted. A mother fell in an apoplectic seizure upon meeting her 
daughter, for whom she was waiting at a railroad depot, but who she had 
reason to fear had been killed in an accident which had just occurred. 
History informs us that an ancient Grecian died of excessive joy from 
receiving his three sons returning crowned as victors in the Olympic 
games. 

Insanity has not infrequently resulted from intense mental em'otion, 
both pleasurable and the opposite. It is, however, well recognized that 
fear, grief, and other depressing agents, are far more apt to produce 
serious results than are those of a pleasurable character. 

It may not seem so remarkable that diseases of the nervous system 

46 


722 


EAT IONAL REMEDIES FOR DISEASE. 


should be produced in this manner, but instances are not wanting to 
show that mental influence may produce disease of almost every func¬ 
tion throughout the body. 

The phenomenon known as bloody sweating, which has by many been 
considered impossible, has been observed in several instances, in which 
the exciting cause was extreme rage or fear. For example, the case is 
reported of a sailor who was so affected by fright during a storm which 
threatened destruction to the ship and all on board, that he fell speech¬ 
less on the deck and broke out into a profuse perspiration of blood. 
When wiped away from his forehead it appeared again, oozing out from 
the skin like ordinary perspiration. Microscopical examination of the 
sweat in other cases has shown that it does not contain blood corpuscles 
but only the coloring matter of the blood. It seems that this phenom¬ 
enon occurs also in animals. A case is related of a hippopotamus, which, 
under confinement, manifested for hours the most intense rage. The 
whole skin became covered with a bloody perspiration. In this case a 
microscopical examination showed that blood corpuscles had actually ex¬ 
uded from the skin. 

Several cases are recorded in which jaundice has been produced by 
rage and fear. Medical students sometimes become very yellow in con¬ 
sequence of mental anxiety which they undergo in the suspense preced¬ 
ing examination when failure is feared. 

The effect of fear in- causing cholera during an epidemic of this dis¬ 
ease is so well known that it scarcely requires mention. Instances of 
this sort have been so numerous that there can be no doubt that during 
cholera times many persons have died of symptoms exactly resembling 
those of the disease, of which fear was the only cause. 

A case is recorded in which small-pox, or a case exactly resembling 
it, seems to have been produced by the same mental influence. It is 
.-stated that a woman who was begging, with her child, in an English 
•city, stopped a carriage containing two ladies, requesting alms, which 
being refused, she threw her child into the carriage declaring that 
it had the small-pox and would communicate it to the inmates, upon 
whom she showered the most horrible imprecations. There was no evi¬ 
dence that could be obtained that the child was suffering with disease 
of any sort, yet one of the ladies was taken with small-pox within 
twenty-four hours, and died. 

Chorea, or St. Vitus dance, hysteria, and other convulsive and hys¬ 
terical diseases, arc frequently produced from the influence of the imagi- 


MENTAL THERAPEUTICS. 


723 


nation, often as the effect of example. This fact has been observed in 
a number of instances in which diseases of this sort have actually be¬ 
come epidemic wholly through imitation. The effect of grief and disap¬ 
pointment in producing serious organic diseases, as consumption, is a 
fact too well known to need confirmation by examples. Every one is 
familiar with cases in which persons suffering some kind of disappoint¬ 
ment, or great bereavement, have gone into a decline, and died in a few 
months in spite of all that could be done for them. Both rheumatism 
and gout have been produced by mental influence, either through severe 
fright, the agony of suspense, or from fixing the mind oil a part of the 
body, as in the case of John Hunter, who is said to have produced gout 
in his great toe by the prolonged effort of the will. 

We might multiply to any extent instances in which diseases have 
been produced by the influence of the mind upon the body, but we will 
now call attention to some of the morbid conditions, of the cure of 
which through mental influence alone there have been well-authenti¬ 
cated instances. Everybody is familiar with the fact that toothache 
frequently disappears as the sufferer from this painful affection ap¬ 
proaches the dentist’s office. Numerous instances have occurred in 
which persons have visited the office of a dentist for the purpose of pro¬ 
curing an extraction, but have found themselves so wholly free from 
pain when they reached the office door that they returned home without 
suffering the loss of the offending member. Many years ago an Italian 
physician was very successful in treating toothache by having the pa¬ 
tient rub an insect between the fingers and apply them to the aching- 
tooth. He claimed to cure at least three-fourths of his patients by this 
means, in which the imagination was the only active agent. Cases of 
painful joints in which patients have suffered, .sometimes for many 
weeks, months, or even years, with gout or rheumatism, or purely hys¬ 
terical affections, have not infrequently been cured by the operation of 
some strong mental influence, as sudden fright from the burning of a 
house, the sudden approach of a mad-dog, or from some other cause. 

The case is related of a patient who, while suffering from an attack 
of colic, received a prescription, with instructions to “take it.’ He 
obeyed the order literally, taking the paper prescription instead of the 
compound, the making of which it directed. The medicine had such a 
magical effect that in a few hours he was entirely cured. It is said that 
the physicians in Tartary very frequently treat their patients in this 
way, writing the name of the medicine on a piece of paper, rolling it 


724 


RATIONAL REMEDIES FOR DISEASE. 


into a ball, and allowing the patient to swallow it whenever the drug 
which they desire to administer is not at hand. An English physician 
relates a case in which a lady patient of his, suffering with pain in the 
chest, or pleurodynia, was promptly relieved in a somewhat similar 
manner. He wrote a prescription for a plaster and handed it to her, 
giving directions to wear it, meaning, of course, the plaster. She, sup¬ 
posing that the paper prescription was the remedy intended to be worn, 
placed it over the painful part, with the effect of producing prompt 
relief. 

Hysteria and other convulsive diseases, and even epilepsy, have been 
cured by severe fright, intense grief, and by affecting the imagination. 
The French committee appointed to investigate the claims of Mesmer, 
the first magnetic doctor, when he was exhibiting in Paris in the latter 
part of the last century, stated in their report that in their Experiments 
they had succeeded both in causing and curing convulsive affections 
through the influence of the imagination. 

o o 

Almost every one is familiar with anecdotes concerning persons who 
have for years been bed-ridden with paralysis or other diseases, render¬ 
ing them unable to walk, who have been suddenly cured by severe 
fright, as from a sudden fire or other danger. Sir Humphrey Davy 
had a case of paralysis which was entirely cured by the application of a 
thermometer to the patient’s mouth. In taking the temperature of the 
patient prior to an administration of nitrous-oxide gas, he observed that 
the patient seemed to experience beneficial results. Indeed, the patient 
was quite enthusiastic over the effects of the new remedy, which was 
applied daily without the use of any other means, with the result of 
wholly curing the patient in a week, although he had been for some 
time affected with the disease. 

Herodotus tells the story of the sudden cure of a dumb person in the 
presence of great danger. He states that “ during the storming of Sar¬ 
dis, a Persian, meeting Croesus, was, through ignorance of his person, 
about to kill him. The king, overwhelmed by this calamity, took no 
care to avoid the blow, or escape death; but his dumb son, when he saw 
the violent designs of the Persian, overcome with astonishment and ter¬ 
ror, exclaimed aloud, ‘ O man, do not kill Croesus! ’ ” It is stated that 
the cure thus effected was permanent. 

Probably the most familiar and indeed one of the most remarkable, 
of all illustrations of the influence of the mind in effecting a cure of 
disease, is seen in the familiar method of removing warts by charms of 


MENTAL THERAPEUTICS. 


725 


various sorts. Plenty of instances might be cited in which persons 
having warts which had existed for years and had been treated by 
more tangible means without success, have had them quickly removed 
by the application of some such remedy as rubbing with a split bean, 
doing the bean up in paper and leaving it out in the road for some 
one to pick up; or rubbing them with a piece of fresh meat stolen 
from the butcher-shop, and then .throwing the meat away to decay, 
the wart being supposed to disappear with the decay of the meat. It 
is impossible to believe that in these cases the remedies employed can 
have any curative effect whatever. Whatever influence they may 
have must be attributed wholly to the imagination of the person em¬ 
ploying them. That warts are often cured in this way, however, there 
can be no doubt, as hundreds of the most intelligent people are ready 
to testify. An interesting illustration of the effect of the imagination 
in curing disease, occurred in the siege of Beda in 1G25, when large 
numbers of the soldiers were suffering extremely with the scurvy. 
The Prince of Orange announced that he would provide an invaluable 
remedy. Each physician was supplied with two or three small vials 
of balsam, a drop or two of which was stated to be sufficient to impart 
powerful medicinal properties to clear water. With this diluted med¬ 
icine the soldiers were treated, and with a success which was most ex¬ 
traordinary, and which was wholly due, of course, to its effect on the 
imagination. 

Gout has been promptly cured by fear. Abernetliy says on this 
point in his lectures, “ You may see a person with gout that is almost 
unable to move with pain; but produce a shock to the nervous system 
by telling him that the house is on fire and he will scamper about like 
a lamp-lighter.” 

Ague has in innumerable instances been cured through the opera¬ 
tion of the imagination of the patient. In this disease, as we shall 
elsewhere show, all that is necessary for a cure is to interrupt the reg¬ 
ular paroxysms of the disease. We have known instances in which 
persons were cured by such novel remedies as going down stairs head¬ 
foremost on all-fours, and other procedures incapable of producing any 
other than a mental effect. Without doubt, a large share of the re¬ 
sults obtained in the use of quack remedies arise from the faith of the 
patient in the remedy employed. There are numerous illustrations of 
the employment with great success of remedies which are inert or 
nearly so, and which attain great celebrity until their inert properties 


726 


RATIONAL REMEDIES FOR DISEASE. 


are discovered. Remedies of this sort are well represented by Hol¬ 
man’s Liver Pad, Galvanic Belts, the much lauded waters of many 
mineral springs, etc. The cures effected by “ magnetic doctors ” offer 
plenty of illustrations of the power of the mind—that of the patient, 
not of the doctor—over the body. As we have elsewhere shown, 
there is no probability whatever of the existence of any occult force 
which can be communicated from one person to another, as is claimed 
by believers in animal magnetism. All the results which have ever 
been obtained by this mode of treating disease may be fairly attrib¬ 
uted to the influence of the will and the imagination of the patient 
himself. The effects obtained from the so-called “ magnetic rubbing ” 
must be attributed, in part at least, to the effects of rubbing, independ¬ 
ent of the patient’s imagination. We have elsewhere in this work 
(see page 149) called attention to a series of observations which we 
made some years ago on the effect of the mind upon the body in the 
cure of diseases. We have since observed many more striking in¬ 
stances in which equally appreciable results have been obtained in the 
same way. 

IMPORTANCE OF EMPLOYING MENTAL THERAPEUTICS. 

We believe that mental therapeutics is a perfectly legitimate agent 
for use in the treatment of disease, and there is no reason why intelli¬ 
gent physicians should not employ it in the treatment of many disor¬ 
ders, at least those of a functional character. Every observing physi¬ 
cian is aware of the different results which occur according as the pa¬ 
tient’s mental condition is cheerful or depressed. It is the common 
experience of all physicians to see patients decline and die under the 
influence of maladies which might and should have been relieved by 
the remedial agents employed, but the beneficial effects of which were 
counteracted by the unhappy mental state of the patient. If the pa¬ 
tient’s mind can be brought into full harmony with the method of 
treatment employed and his faith and confidence fully secured, his 
chanced for recovery from any malady are increased tenfold. Many 
times have we seen patients to whom we could give no encouragement 
and whose recovery seemed to be wholly impossible, gradually im¬ 
prove under simple methods of treatment, and finally recover, as we 
firmly believe, more through the influence of their own hope and de¬ 
termination to recover than through any remedial agent applied. On 
the other hand, we have with equal frequency seen patients whose dis- 


MEDICAL DIETETICS. 


727 


orders were not of a serious character and who had sufficient natural 
vigor and sufficiently favorable conditions to secure recovery, appar¬ 
ently, at least, but who went down into the grave, as we have every 
reason to believe, simply because of a lack of force of character or of 
strength of will to bring the mind to co-operate with the treatment 
employed or to preserve such a mental state as would be conducive to 
recovery. Every physician, and, in fact, every person who has any¬ 
thing to do with the sick, should realize the importance of imparting 
courage, good cheer, and hope to them, as by that means they may 
in many cases do more than in any other way to secure their recovery. 
There are, no doubt, cases in which it is allowable for the physician to> 
bring to bear such means as fear and other powerful mental agents in 
the treatment. These cases must be rare-, and such means when resorted 
to should be used with the greatest caution, like doses of powerful poi¬ 
son. A mental remedy which may be used, however, with much success 
in many cases is the directing of the patient’s attention to the part 
under treatment, at the same time inspiring the most perfect confidence 
that the cure will certainly be effected. It has been shown by numer¬ 
ous experiments that concentrating the attention upon any part induces 
changes in its circulation and nervous supply, and that attention can 
thus be used as a means of curing the disease. In using it as a cura- 
tive measure it is of course essential, as before remarked, that the pa¬ 
tient should be thoroughly convinced that the result desired will cer¬ 
tainly be secured by the means employed. In a large share of cases, 
at least, the expected result will be obtained, although the remedy em¬ 
ployed may he wholly inert. The remarkable effects often obtained 
by the use of highly potentized remedies must be attributed to this- 
cause. 

In conclusion, we again urge that physicians pay more attention 
to the employment of mental therapeutics. We do not doubt that if 
remedies were more often applied to the mind and much less to the 
stomach, the practice of medicine would be attended with much more- 
successful results. 

MEDICAL DIETETICS, 

We have already called attention, in considering the hygiene of 
food, to the important relations of food to the maintenance of 
health and the prevention of disease, but another phase of the subject 
of dietetics of almost equal importance still remains for consideration 


728 


RATIONAL REMEDIES FOR DISEASE. 


namely, the relation of food to the system in a state of disease. It has 
long been known that the use of various articles of food produces dif¬ 
ferent effects upon the system in disease from their use in health, many 
food substances which are taken apparently without detriment in 
health becoming causes of serious difficulty when taken while the sys¬ 
tem is suffering with disease. In consequence of this fact, intelligent 
physicians in all ages have taken care to interdict special articles of 
food in certain diseases, in which they had been found to produce a 
pernicious effect. It has also been observed that certain articles of 
food when received into the system while it is suffering under the 
morbid influence of special diseases, seem to exercise a favorable in¬ 
fluence upon the progress of the disease, hastening recovery or miti¬ 
gating symptoms, if not exerting a still more powerful remedial influ¬ 
ence on the disease. This has given rise to what has been termed the 
“ diet cure,” sometimes also called the “ nutritive cure,” different phases 
of which are known as the “ milk cure,” the “ whey cure,” the “ butter¬ 
milk cure,” the “ grape cure,” the “ starvation cure,” and similar 
terms. While it is not probable that in any of the so-called diet-cures 
the article of food upon which chief reliance is placed fills so impor¬ 
tant a part by any means in the cure of the disease to which it is said 
to be adapted as has been supposed, it is, nevertheless, probable 
that in most cases, at least, the use of the particular article recom¬ 
mended is to secure more favorable conditions for the curative opera¬ 
tions of the vital force than might otherwise have existed. This may 
be attributed either to the superior virtues of the food employed, or, 
as is in most cases undoubtedly true, to the. absence of articles of a 
damaging character. The object of this section is to call attention to 
the relations of articles of food to diseased conditions, pointing out 
particularly the morbid conditions and diseases in which some partic¬ 
ular articles of food are inadmissible, and also the conditions in which 
the same articles are specially indicated. First, we will notice— 

Meat, or Flesli-Food. —As has been shown elsewhere, meat in the 
condition in which it is almost always eaten contains a large propor¬ 
tion of excrementitious or waste products, which exist in the tissues 
of animals at the moment of death. Poisonous substances are ordi¬ 
narily eliminated from the system with sufficient readiness to prevent 
any immediate serious effects; but when the system is laboring under 
disease, the ability to dispose of this surplus of waste and poisonous 
matter is so greatly lessened that much harm may result from its use. 


MEAT, OB FLESH-FOOD. 


720 


This is especially true in cases in which the liver and kidneys,—two of 
the most important eliminative organs,—are affected, as in Bright’s 
disease, acute albuminaria, scarlatina, diphtheria, incontinence of urine, 
inflammation of the liver, gall-stones, and diabetes insipidis; and in 
general diseases, accompanied by fever of any degree of intensity, as 
typhoid fever, scarlatina, diphtheria, malarial fevers, measles, small¬ 
pox, and other febrile diseases, including acute and chronic rheuma¬ 
tism, gout, pleurisy, pneumonia, and pericarditis; together with diar¬ 
rhea, dysentery, and the other bowel-diseases incident to warm weather, 
including cholera; various forms of nervous disease, particularly those 
which occur in sedentary people, insomnia, or sleeplessness, some forms 
of neuralgia, chorea, epilepsy, and some disorders of the stomach, as in 
chronic gastritis, weak digestion, accompanied with tenderness at the 
pit of the stomach, and that form of dyspepsia usually termed bilious¬ 
ness, or bilious attacks. Persons who have suffered from apoplexy, 
especially when the attack has been recent, and those suffering with 
valvular disease of the heart, require an unstimulating diet, and hence 
the less animal food taken the better, although it need not be wholly 
interdicted, except in recent cases of apoplexy. Both of these dis¬ 
eases require that the amount of animal food used should be exceed¬ 
ingly limited. 

In the treatment of drunkenness, it is important to bear in mind 
that the stimulating influence of meat has the effect to excite the desire 
for alcohol, and hence its use should be very limited if allowed at all. 
Mr. Napier, of England, has recently shown that one of the best means, 
of destroying the appetite is to cause the drunkard to abstain from 
the use of flesh-food; and our own experience in the treatment of in¬ 
ebriates has abundantly confirmed the same observations. 

Children often suffer much with nervousness and other obscure 
troubles which may be directly traced to the use of flesh-food. When 
allowed at all, it should never be taken until the teeth are sufficiently 
well developed to allow of its thorough mastication. 

In nearly all of the diseases mentioned in the preceding paragraphs 
it is of tlie greatest importance that the use of meat should be 
interdicted, at least while the patient is under treatment and foi 
a sufficient length of time after the cure has been effected to preclude 
the possibility of its having any influence to cause a recurrence of the 
disorder. In many cases this would require abstinence from meat for 
a long time, and in a majority of cases this would be found beneficial 


730 


RATIONAL REMEDIES FOR DISEASE. 


rather than otherwise. It has been frequently observed that patients 
who have been cured of rheumatism while abstaining from the use of 
animal food have an almost immediate relapse, with swelling of the 
joints, and high fever, upon resuming the use of animal food. Re¬ 
lapses of typhoid fever are often similarly caused by the use of meat 
before the stomach has acquired power to digest it. Inflammation of 
the stomach is often produced in fever-patients during convalescence 
by the use of meat. It should he recollected that in withdrawing 
meat a sufficient quantity of some other form of nitrogenous food 
should be supplied. Oatmeal and wheat-meal furnish the required 
elements in a form in which they can be easily assimilated, and never 
produce any of the serious results which follow the use of meat, in the 
diseases and conditions named. In most cases, also, milk and eggs 
may be used to a considerable extent, especially the first-mentioned 
article, either by itself or in combination with such farinaceous foods 
as oatmeal gruel, barley gruel, rice, and farina. 

Meat may often be used with very great benefit, sometimes as an 
almost exclusive article of diet for a short time, in cases of great de¬ 
bility, anemia, farinaceous or flatulent dyspepsia, and acid dyspepsia. 
The special reason for its use in debility is, that, on account of the 
readiness with which it is digested, the nitrogenous tissues which are 
suffering for need of repair may be more rapidly built up than by 
vegetable food ; the system also requires a larger proportion of nitrog¬ 
enous elements than is found in a natural state. If in any of these 
cases, however, the use of meat is contra-indicated on account of other 
conditions, its place may be supplied by such food as gluten flour 
which contains a large proportion of nitrogenous elements, but a very 
small share of the carbonaceous. Meat is particularly useful in the 
forms of dyspepsia mentioned on account of its being digested in the 
stomach and not undergoing fermentation, and thus giving rise to 
acidity. It is quite the custom nowadays to use the meat in these 
cases in a raw state, a practice of which we cannot approve, however, 
as it exposes the patient to the liability of contracting diseases more 
serious than those he possesses. Reference has already been made to 
the fact recently demonstrated by Dr. Leidy, of Philadelphia, that tape¬ 
worm in America is most frequently derived from beef which has been 
eaten in a raw or slightly cooked state. In any case in which it seems 
necessary to administer meat in a raw condition, it should be inspected 
with the greatest care to insure its absolute freedom from parasitical 


FATS AND MILK. 


731 


infection. If small white specks are observed, it should be at once 
discarded. It is, however, often difficult to detect the embryos of 
the tape-worm in beef by the unaided eye, and hence absolute safety 
would require the inspection of every portion of the meat with the 
microscope. 

Fats. —These are of all articles the most difficult to digest. A piece 
of fat pork will remain in the stomach five or six times as long as a ripe 
apple, and two or three times as long as a portion of rice or well-cooked 
grain. When fats are added to food in cooking, it becomes much more 
difficult of digestion. Fried food, pie-crust, and similar articles are ab¬ 
solutely indigestible by a weak stomach. Fat also interferes with the 
digestion of other food, as we have previously shown, and also diminishes 
the secretion of bile by producing an inactive and congested state of the 
liver. On this account, fat meats and the different fats should be wholly 
interdicted in most cases of dyspepsia, torpid condition of the liver, gall¬ 
stones, jaundice, and in that somewhat indefinable but very common 
condition known as biliousness. For all these reasons, they should be 
forbidden in obesity also. 

Fat in the form of cream, and such nuts as almonds, chestnuts, and 
filberts, may be used freely with benefit by very thin people whose di¬ 
gestion is not greatly impaired, and especially in the emaciation incident 
to consumption, diabetes, and other wasting diseases. In many of these 
eases, the use of a small quantity of cream in connection with other 
food seems to have a favorable influence upon nutrition by increasing 
the assimilation. 

Milk.—Milk is one of the few articles of food which contains all the 
elements of nutrition in a form easily digested and assimilated; hence it 
is rarely to be forbidden altogether. However, there are many persons 
whose experience seems to show that it has a clogging effect upon the 
liver, at least in particular cases, occasioning headache, “ biliousness,” and 
other unpleasant symptoms. Such, of course, should avoid its use. 
There are also certain classes of dyspepsia, such as acid and bilious dys¬ 
pepsia, which do not tolerate the use of milk. Many persons will find, 
however, that they are able to use milk without any inconvenience, if it 
is taken in the proper manner, being eaten rather than drank, and 
taken in limited quantities. Such persons should avoid the use of sugar 
and fruits, especially acid fruits, in conjunction with milk. Milk must 
be forbidden in cases of gall-stones and j aundice. 

Milk is sometimes found almost indispensable as an article of food in 


732 


RATIONAL REMEDIES FOR DISEASE. 


the treatment of fevers, especially in the cases of children, in the treat¬ 
ment of certain classes of nervous disease, particularly those dependent on 
defective nutrition and accompanied with impaired digestion. The free 
use of milk in some cases as an almost exclusive article of diet, has been 
found to be very advantageous. We have frequently succeeded in cur¬ 
ing cases of this sort by a milk diet in conjunction with other hygienic 
measures, after all other known remedies had failed. The use of skim- 
milk is an excellent means of combating obesity. 

Yegetables. —Vegetables are objectionable in some diseases and 
morbid conditions, first, on account of the large amount of woody matter 
which they contain, which renders them difficult of digestion and liable 
to produce irritation of the membranes in different parts of the aliment¬ 
ary canal; second, on account of the large proportion of starch which 
most of them contain in the form which is more difficult of digestion 
than the starch grains, and is hence more liable to undergo fermenta¬ 
tion, developing injurious acids and troublesome gases. The diseases and 
morbid conditions in which vegetables should be wholly interdicted, or 
restricted to a very small amount, are as follows:— 

Painful and flatulent dyspepsia, also in many cases of acid dyspepsia, 
gastric ulcer, cancer of the stomach, dilatation of the stomach, and pain¬ 
ful hiccough. Vegetables containing a large proportion of starch must 
also be interdicted in diabetes. Bright’s disease requires that the patient 
should abstain* from the use of asparagus, turnips, cabbage, carrots, 
beans, peas, and all other vegetables which contain a large amount of 
woody fibre. In very obstinate and long-standing torpidity of the liver 
it is wise for the patient to refrain for some time from the use of coarse 
and starchy vegetables as potatoes, also from grains composed chiefly 
of starch, as rice and starchy preparations, such as sago, farina, etc. 

In a large share of the diseased conditions of the stomach it is nec¬ 
essary for the patient to abstain from the use of vegetables in conjunc¬ 
tion with fruits or meats. They may be taken alone or with grains 
when they may not be tolerated with other classes of food. 

Tomatoes, ordinarily wholesome, are thought to be injurious in dia¬ 
betes incipitis, and asparagus is by many physicians interdicted in rheu¬ 
matism; asparagus and beans are also to be abstained from in this 
disease when they produce pain in the region of the kidneys with de¬ 
posit in the urine. 

The free use of vegetables is especially indicated in constipation of 
the bowels, in scurvy, and in many cases in which patients have for a 
long time been deprived of them. 


GRAINS AND FRUITS. 


733 


Grains. —Grains when properly prepared are almost always well 
received by the system in disease as well as in health. About the only 
condition in which they may not be taken is diabetes melitis, in which 
they are objectionable on account of the large proportion of starch 
which they contain. Even in this disease, however, grains deprived of 
their starchy constituents are among the most essential articles of food. 
There are also conditions of the digestive organs which do not admit of 
any but the finer portions of the grains, as in painful dyspepsia and 
gastric ulcer. It is also of the greatest importance in these cases that 
food should be very thoroughly cooked. 

The free use of grains is especially indicated in neurasthenia, nervous 
debility, anemia, consumption, and constipation. The object of their use 
in these cases is twofold: first, to supply an abundance of nitrogenous 
elements and nutritive salts in a condition in which they can be easily 
assimilated, as in consumption and all diseases characterized by exhaus¬ 
tion of the nervous system; second, to supply the necessary degree of 
bulk in the digestive organs, and enable the stomach and bowels to per¬ 
form their functions properly, as in constipation, a very frequent cause 
of which is the use of too concentrated food. 

Fruits. —Fruits afford a very small proportion of nutriment 
and yet are very useful in various diseased conditions as additions to 
other foods. About the only conditions in which their use must be in¬ 
terdicted are acid and flatulent dyspepsia, and sweet fruits in diabetes. 
Fruits, especially apples and lemons, are particularly useful as curatives 
of biliousness and constipation. The use of grapes in typhoid fever has 
been very highly extolled; to such an extent, in fact, that in some places 
this disease has been treated by what was termed the grape cure, which 
consists in confining the patient almost exclusively to the use of grapes. 
Grapes have also been used in relieving other diseases. The idea that 
fruit should not be used in bowel diseases is an unfortunate error, as 
many people have been led to abstain from the use of this wholesome 
article of food in cholera times, and during the “ heated term,” when 
bowel diseases are most common. There is plenty of evidence to show 
any one that good ripe fruit is one of the most efficacious preventives of 
bowel diseases of all kinds, and that the use of such fruits as grapes, 
without the seeds, ripe apples, and the other better kinds of fruit, is of 
value as a means of curing some forms of bowel trouble. Many fruits, 
particularly apples, and those fruits containing a considerable proportion 
of water, seem to increase the activity of the kidneys, and hence are use¬ 
ful when those organs are functionally inactive. 


734 


RATIONAL REMEDIES FOR DISEASE. 


Sugar. —There are no conditions of the system for which sugar 
is to he especially recommended, since it is always eaten in abundance 
in the form of starch, which, it is well known, is wholly converted 
into sugar in the system, and in case of an insufficient supply from 
other sources, the liver will rapidly produce it, even from the nitrog¬ 
enous constituents of the food. There are, however, numerous condi¬ 
tions in which its use is very injurious and should be wholly inter¬ 
dicted. Some of the more important of these are diabetes, gall-stones, 
acid and flatulent dyspepsia, and also inactivity of the liver, and 
that very common morbid condition known as biliousness. 

Salt.— As previously pointed out, the dietetic value of salt is by 
no means so thoroughly established as many seem to suppose. What¬ 
ever may be its relation to the system in health, there is the best of 
evidence to show that in some diseases, at least, its use should be re¬ 
stricted as much as possible, and in some cases discontinued altogether. 
This is particularly true of gout and inflammation of the kidneys. 
Persons who are liable to attacks of gout, often find themselves en¬ 
tirely free from their painful enemy when abstaining wholly from 
salt, but suffer a relapse immediately when chloride of sodium or any 
other of the sodium salts is taken into the system. Very little salt 
should be taken in fevers; the former custom was to interdict its use 
altogether. It is probable, however, that with persons accustomed to 
its use, a small quantity may be advantageous in preventing the ap¬ 
petite from failing altogether, especially when the fever is prolonged. 
It is evident, however, that when the eliminative organs are so greatly 
overtaxed as they always are during a febrile attack, very little of this 
or of any other element which will increase their labor should be 
taken. To restrict the use of salt is almost as useful in rheumatism 
as in gout. In diabetes, when the tendency of the patient is always 
to drink more water than is best for him, and when the blood is al¬ 
ready rendered too thick or of too high specific gravity by the excess¬ 
ive quantities of sugar in it, a limited use of salt is evidently indi¬ 
cated. 

Condiments.— After what has been said of the use of condiments 
in health, we need scarcely add that their use should be wholly inter¬ 
dicted in disease. They are responsible for a large number of diseases, 
and there is no diseased condition which is not increased by their 
employment. 


ABSTINENCE FROM FOOD. 


i So 

Drinks. —The regular amount of fluid received into the system is a 
very important matter in many diseases. In some forms of dyspepsia 
the use of dry food and almost total abstinence from drinks, especially 
near the time of meals, is absolutely essential to recovery. This is em¬ 
phatically true of the particular kind of dyspepsia in which, on account 
of the inactivity of the absorbent vessels of the stomach and intestines, 
fluids are taken up slowly and remain for a long time near the alimen¬ 
tary canal. This condition has sometimes been called the “ indigestibil¬ 
ity of fluids.” We have also confirmed an observation made by an em¬ 
inent English physician, that in many cases of organic disease of the 
heart, fluids are tolerated only in very small quantities at a time, and 
scarcely at all in connection with food. This is due also to the inactivity 
of the absorbents, which results from the congestion of the vessels of the 
stomach due to the mechanical obstruction of the circulation in the heart. 
It should also be remarked that in cases of dilatation of the stomach the 
less fluid taken with the food the better, as there is such an inactive 
state of the absorbent vessels of the mucous membrane of the stomach 
in this condition that fluids are retained a long time. 

With these few exceptions, drinks may be properly used with great 
advantage in nearly all diseases, particularly in those which require in¬ 
creased elimination ; hence they are especially indicated in all types and 
varieties of fevers, in cases of defective nutrition, in inflammation of the 
liver, inactivity of the liver, biliousness, acute and chronic diseases of the 
kidneys, constipation of the bowels, inactivity of the skin, rheumatism, 
gout, and cholera. In the latter disease the copious drinking of cold 
water has been found to be one of the most efficacious of all known rem¬ 
edies, as the absorbents of the intestinal tract in this disease will scarcely 
act at all. Fluids taken pass rapidly through the stomach and intes¬ 
tinal tract, thus washing out the bowels, carrying away the poisonous 
elements of disea.se, and aiding nature in her efforts to effect a cure. The 
restriction of drink is a common practice in both forms of diabetes, and 
is frequently carried to too great an extreme. A demand for fluids is as 
much an expression of want on the part of the system as want felt in 
any other condition, and hence it should be regarded and acceded to, at 
least in sufficient degree to prevent the patient from too great suffering. 

Abstinence from Food. —All physicians recognize the fact that in 
many diseases, especially those of an acute character accompanied with 
fever, the use of food should be restricted, to a considerable degree. By 
entire abstinence from food for one or two days, together with active 


736 ‘ 


RATIONAL REMEDIES FOR DISEASE 


eliminative treatment, many febrile diseases may be checked at the out¬ 
set. In bowel diseases caused by taking indigestible food, total absti¬ 
nence from food for a day or two, or the use of a very small quantity 
of light food once or twice a day, is particularly advantageous. Attacks 
of asthma when occurring in persons addicted to high living may often 
be promptly cut short by prohibiting any but the very lightest articles 
of food for a day or two. In pericarditis and inflammation of the lin¬ 
ing membrane of the heart, or endocarditis, a very restricted diet should 
be employed, especially in those who have previously been overfed. 

Digestibility of Foods .—For the benefit of persons whose digest¬ 
ive organs are weak, or who desire to preserve them in health by avoid¬ 
ing articles of food which are difficult of digestion, we have prepared 
the following tables, which are based upon careful observation and the 
experiments of Beaumont upon the stomach of Alexis St. Martin. 

Articles Easy of Digestion.— The following articles are readily 
digested by a healthy stomach, and can be digested with comparative 
ease by most dyspeptics :— 


ANIMAL 

Raw white of egg, beaten to a froth. 

Beef tea, free from fat. 

Raw whole egg, beaten. 

Milk, fresh and warm. 

Fresh eggs, soft boiled. 

Mutton, broiled. 


FOODS. 

Yenison steak, broiled. 

Chicken, especially the white parts. 
Rabbit. 

Fresh trout, and most fresh fish which 
are not oily. 


VEGETABLE FOODS. 


Stale bread. 

Graham rolls, made without yeast or 
soda. 

Rice, well boiled or steamed. 

Tapioca, sago, corn-starch. 

Oatmeal porridge, eaten with dry toast. 
Graham mush or crushed wheat. 


Cauliflower, 

Asparagus, if very tender. 
French beans. 

Baked sweet or subacid apples. 
Strawberries and whortleberries. 
Grapes, without skins or seeds. 
Oranges and bananas. 


Articles Not Easy of Digestion. —The following list includes the 
common articles of food which require a considerable degree of vigor on 
the part of the digestive organs, and must be avoided by all b$d dys¬ 
peptics :— 

ANIMAL FOODS. 


Animal soups of all sorts. 
Beef. 

Lamb. 

Turkey, duck, pigeon. 


Codfish. 

Oysters, raw. 

Butter. 

All sorts of roast meats. 





DIGESTIBILITY OF FOODS. 


i 61 


VEGETABLE FOODS. 


Potatoes. 

Carrots. 

Turnips. 

Spinach. 

Cabbage. 

Parsnips. 

Tomatoes. 

Vegetable soups. 

Peas. 

Corn-meal preparations. 

Beans. 

Salads of all sorts. 

Raisins and most dried fruits. 

Currants. 

Apples. 

Gooseberries. 

Peaches. 

Raspberries. 

Plums. 

Blackberries. 

Cherries. 

Rhubarb. 

Pineapple. 

Jelly. 

Beets. 



Indigestible Articles. —The following articles, while they may be 
digested by a vigorous stomach, impair the digestive powers and induce 
indigestion, and to the dyspeptic are more of the character of poisons 
than of foods :— 


ANIMAL 

Pork. 

Veal. 

Goose. 

Liver. 

Kidney. 

Heart. 

Sausage. 

Hard-boiled eggs. 

Scrambled eggs. 

Cheese. 


FOODS. 

Hashed and stewed meats. 

Salt and smoked meats. 

Melted butter, and all animal fats. 
Mackerel, and all oily fish. 

Salt fish. 

Dried and smoked fish. 

Sardines, and other fish preserved in oil. 
Lobster, crabs, etc. 

Cooked oysters and clams. 

Fried meats of all sorts. 


VEGETABLE FOODS. 


Warm bread, especially when taken 
with butter. 

Muffins. 

Buttered toast. 

Pies, cakes, and all sorts of pastry. 
Pancakes. 

Fried bread and vegetables. 

Nuts of all kinds. 


Onions. 

Mushrooms. 

Pickles. 

Tea, coffee, cocoa, chocolate. 

Mustard, pepper, spices, and other con¬ 
diments. 

Sugar, preserves, and all saccharine 
foods. 


Nutritive Injections. —In certain diseases of the stomach, as in gas¬ 
tric ulcer, inflammation of the stomach, chronic gastritis, enlargement of 

47 





738 


RATIONAL REMEDIES FOR DISEASE. 


the stomach, and the vomiting of pregnancy, it is often necessary to allow 
the stomach to rest for days, and in some cases even for weeks, no food 
being taken in the usual way. In these cases it is of greatest impor¬ 
tance that the proper nutritive injections, or enemata, should be employed. 
The idea that soups, beef tea, milk, or other undigested food, may be 
digested iu the rectum and absorbed, thus nourishing the system, is with¬ 
out foundation. But, as elsewhere remarked, recent discoveries have given 
grounds for the supposition that food injected into the rectum is carried 
up into the small intestine, where it may undergo digestion in the reg¬ 
ular way. When possible, however, on account of the weakened condi¬ 
tion of the digestion and the possibility that the undigested food may not 
be carried into the small intestine, the food should be artificially digested, 
at least in part, or should be so prepared that it will undergo digestion 
after introduction into the bowels. There are several methods of prepar¬ 
ing food for this purpose, all of which are highly recommended. The 
value of the following preparations for use as nutritive enemata we have 
frequently and thoroughly proven by experience in the treatment of 
cases in which they were required, having kept patients for weeks on 
little else than the nutritive enemata. We are acquainted with cases in 
which life has been well sustained for months in this way. 

Heat Solution. —Take two pounds of lean beef, cut into small 
pieces and put into a pint of blood-warm water. Add twenty-five 
■drops of pure hydrochloric acid and half a teaspoonful of pepsin. 
Keep it at a temperature of about 100° F. for six hours, or until the 
meat becomes disintegrated, stirring frequently; then strain and add 
half a teaspoonful of bi-carbonate of soda to neutralize the acidity. 
This highly nutritious fluid should be administered in quantities of 
not more than two or three ounces, and repeated once in three or four 
hours. The bowels should be emptied by a copious enema an hour 
before administering the injection. This rule applies to all forms of 
rectal feeding. 

Pancreas and Meat Solution. —Take fresh beef pancreas, care¬ 
fully remove all fat, cut two ounces, about two heaping tablespoonfuls, 
into very small pieces. Take of finely scraped or ground beef, also 
free from fat and sinew, double the quantity of pancreas. Mix with 
two-thirds of a teacupful of warm—not hot—water. Stir until well 
broken up. Inject into the rectum through a large tube. About half 
.should be injected at once, and the injection should be made slowly, so 


USEFUL DIETETIC RECIPES. 


739 


as to prevent its discharge before absorption has taken place. If 
necessary, a napkin should be held against the anus until the disposi¬ 
tion to move ceases. 

Pancreas and Cream. —Chop very fine three ounces of fresh beef 
pancreas. Add two tablespoonfuls of warm water and a teacupful of 
sweet cream. Mix thoroughly in a small pail. Cover and place in a 
pan of water blood-warm. Keep at this temperature for from one- 
half to three-quarters of an hour, stirring frequently. At the end of 
this time strain through a coarse colander, rubbing through as much 
as possible of the pancreas, and inject into the rectum. If the patient 
will not retain all at first, use half the quantity, keeping the balance 
in a refrigerator until needed for use. Then warm to the proper 
temperature and inject as before. 

Beef Tea and Egg.—Beat lightly one egg with four tablespoon¬ 
fuls of strong beef tea. Inject as directed before. This is the most 
nourishing of any preparation which can be employed for this purpose, 
and as it is easily prepared should be resorted to whenever a patient 
cannot be nourished by the stomach. 

USEFUL DIETETIC RECIPES. 

Milk and Lime-Water. —In many cases in which milk is indi¬ 
cated as an important article of diet, indeed, as the most important of 
all foods, as in young infants, it cannot be taken without distress on 
account of the large, tough curds which it forms in the stomach. For 
cases of this sort, ordinary cow’s milk may be mixed with lime-water 
in the proportion of a large teaspoonful of lime-water to a tumblerful 
of milk. If the difficulty still continues, the lime-water may be used 
in the proportion of one part to two of milk. Barley-water will in 
most cases answer as well as lime-water. 

Brail Tea. —Soak a teacupful of bran in cold water over night in 
a cool place. Simmer for half an hour, and strain through a cloth. 
A soothing drink, said to encourage activity of the bowels. We have 
not much confidence in its laxative properties. It is a good wash for 
irritated surfaces. 

Brail or Wheat CofFee. —Mix bran and molasses to a stiff paste, 
spread on a tin and brown in the oven. Brown wheat in the same 
way. Be careful not to allow the heat to be sufficient to burn or 


740 


RATIONAL REMEDIES FOR DISEASE. 


scorch. Use as other coffee, for which it is a good and unstimulating 
substitute. Wheat coffee is sometimes sold at the stores in packages. 

Acorn Coffee. —Select plump, round acorns. Shell, and brown in 
an oven. Grind in a coffee-mill, and use as ordinary coffee. A good 
drink for children suffering with diarrhea, on account of the tannin 
which it contains. It is also recommended for scrofulous persons. 

Water Gruel. —Over a dessert-spoonful of finely ground oatmeal, 
mixed with a tablespoonful of cold water, pour a pint of boiling water; 
let it settle two or three minutes, then pour off the water carefully, 
leaving the coarser part of the meal. Boil ten or fifteen minutes, stir¬ 
ring frequently. 

Milk Gruel. —Into a pint of scalding milk stir two tablespoonfuls 
of fine oatmeal. Add a pint of boiling water and boil until the meal 
is thoroughly cooked. 

Oatmeal Gruel. —Stir two tablespoonfuls of coarse oatmeal into a 
quart of boiling water, and let it simmer at least two hours. Strain 
if preferred. 

Rice Gruel. —Soak two tablespoonfuls of fine rice for half an hour 
in cold water. Pour off the water; add a pint of milk and let it sim¬ 
mer until the rice is tender. Press through a sieve and then dilute 
with milk. Heat again for a few moments; pour off to cool, and 
flavor with a little salt or sugar. 

Milk Porridge. —Place over the fire equal parts of milk and water. 
Just before it boils, add a small quantity (a tablespoonful to a pint of 
water) of graham flour or corn meal, previously mixed with w T ater, 
and boil a minute longer. 

Rice and Apple. —Stew two or three large, ripe apples to a pulp 
and sweeten with a little white sugar. Then boil a half teacupful of 
rice in milk until it is quite tender. Put the rice round a plate with 
the apples in the center and serve. A dish which most invalids, 
unless bad dyspeptics, will readily digest. Excellent for fever 
convalescents. 

Rice Blanc-Mange. —Heat one quart of milk to near boiling ; then 
stir into it one-fourth of a pound of finely ground rice previously 
mixed to a smooth batter with a little milk. Add two spoonfuls of 
white sugar and let it boil until thick enough to mold, stirring it all 
the time. Flavor, while boiling, with a little lemon or pine-apple. 
Serve cold. 


USEFUL DIETETIC RECIPES. 


741 


Arrow-Root Blanc-Mange.— Bring a pint of milk to boiling point, 
add a batter made by mixing two tablespoonfuls of arrow-root with 
, a little milk, and let it boil. Sweeten and flavor to the taste, stirrino- 
, assiduously until it thickens sufficiently to mold. Corn-starch blanc¬ 
mange may be made by this same recipe by using the above propor¬ 
tion of corn-starch instead of arrow-root. 

Egg-Nog. —Beat one egg and a teaspoonful of refined sugar to a 
stiff froth ; add a teaspoonful of lemon-juice ; pour in a glass, and fill 
up with water. 

White of Egg ami Milk .—The white of an egg beaten to a stiff 
froth and stirred very quickly into a glass of milk is a very nourish¬ 
ing food for persons whose digestion is weak, also for children who 
cannot digest clear milk. The white of egg has a tendency to prevent 
the formation of hard curds in the stomach. 

White of Egg. —Stir the white of an egg into a tumblerful of 
cool water, or water warm as it can be without coagulating the egg. 
Give to infants suffering from extreme disorder of digestion and un¬ 
able to take milk. This simple mixture has saved many an infant’s 
life. 

Beef Tea. —For every quart of beef tea desired, use one pound 01 
fresh beef from which all fat, bones, and sinews, have been carefully 
removed. Cut the beef into pieces a quarter of an inch square, or 
grind in a sausage-grinder, and soak over night in a small quantity of 
water (a pint will do). Take the beef out and let it simmer gently in 
a larger quantity of water for two or three hours, replacing from time 
to time the water lost by evaporation. Afterward pour together the 
boiling liquor and the cold liquid in which the beef was soaked. 

Another Method. —Take a pound of fresh beef prepared as above, 
and mix with a pint of cold water. Let it stand an hour; then pour 
into a glass fruit-can, or large-mouthed stone jar, and place in a vessel 
of water; let it heat on the stove another hour, being careful not to 
allow it to boil. Strain through a fine cloth or filter before using. 

Flaxseed Tea. —Take an ounce of whole flaxseed, half an ounce 
of crushed licorice root, an ounce of refined sugar, and four tablespoon¬ 
fuls of lemon juice. Pour over these ingredients a quart of boiling 
water; let this stand near the fire for four hours, and then strain off 
the liquid. The flaxseed should not be crushed, as the mucilage is in 
the outer part of the kernel and if bruised the boiling water will ex- 


742 


RATIONAL REMEDIES FOR DISEASE. 


tract the oil of the seed and render the decoction nauseous. The tea 
should be made fresh daily. 

Barley-Water. —Take half a teacupful of good pearl barley. First 
wash it thoroughly; then boil five or ten minutes in fresh water. 
Drain off this water and pour on two quarts of boiling water and boil 
down to one quart. Flavor if desired with a little lemon or sugar. 
Thin to required consistency with boiling water. 

Currant-Jelly W ater. —A tablespoonful of currant jelly stirred 
into a glass of cold water makes a pleasant beverage for fever patients. 

Apple Water. —Wipe two or three ripe, tart apples, and slice, 
without paring, into a dish and pour over them a quart of scalding 
water. Let stand until cool; then turn off water and sweeten. 

Toast Water. —Brown a slice of stale bread or crust thoroughly, 
but do not allow it to blacken or burn. Break the toast into small 
pieces and put into an earthen dish or jug; pour over the pieces a 
quart of boiling water; cover the dish tightly, and let the mixture re¬ 
main until cold. When strained it will be ready for use. 

Lemonade. —Mix the slices and the juice of two lemons with three 
spoonfuls of refined sugar and add a pint of cold or iced water. 

Hot Lemonade. —Take two thin slices and the juice of one lemon ; 
mix with it two teaspoonfuls of white granulated sugar, and add one 
half pint of boiling water. A very useful drink for a person when 
exhausted. A splendid substitute for tea and coffee. 

Sago Jelly.— Simmer gently in a pint of water two tablespoon¬ 
fuls of sago until it thickens, frequently stirring. A little sugar may 
be added if desired. 

Bread Jelly. —Pour boiling water over bread crumbs; place the 
mixture on the fire and let it boil till it is perfectly smooth. Take it 
off, and after pouring off the water, flavor with something agreeable, as 
a little raspberry or currant jelly water. Pour into a mold until re- 
quired for use. 

Tapioca Jelly. —Take two tablespoonfuls of tapioca and one pint 
of water; let it simmer until it becomes thick like jelly. A little 
lemon juice and sugar may be added. 

Gum-Arabic W ater. —Put an ounce of choice gum arabic into a 
jar with two ounces of refined sugar and a pint of water. Place the 
jar in a sauce-pan of warm water and stir until dissolved. Add a lit¬ 
tle lemon to flavor. This is a good drink for consumptives. 


MISCELLANEOUS REMEDIES. 


743 


Diabetic Dread. —No. 1. Take a sufficient quantity (say a quart) 
of wheat bran, boil it in two successive waters for a quarter of an hour, 
each time straining it through a sieve, then wash it well with cold water 
(on the sieve) until the water runs off perfectly clear; squeeze the bran, 
in a cloth as dry as possible, then spread it thinly on a dish and place 
it in a slow oven ; if put in at night let it remain until the morning,, 
when, if perfectly dry and crisp, it will be fit for grinding. The bran 
thus prepared must be ground in a fine mill and sifted through a wire 
sieve of such fineness as to require the use of a brush to pass it through. 
That which remains in the sieve must be ground again until it becomes, 
quite soft and fine. Take of this bran powder three ounces (some pa¬ 
tients use four ounces), three eggs, and about half a pint of cream ; mix 
the egg with a little of the cream and warm the other portion; then 
stir the whole well together, adding a little nutmeg or cinnamon, or 
any other agreeable spice. Bake in small tins, which must be well 
buttered, in a rather quick oven for about half an hour. The cakes, 
when baked, should be a little thicker than a sea-biscuit. They may 
be eaten with meat, milk, curd, or buttermilk. 

Diabetic Bread.— No. 2. Reduce to a fine powder in a mortar, a 

quarter of a pound of blanched almonds. Tie up in a bag and throw 

into boiling water which has been acidulated with lemon for fifteen 
© 

minutes. Then beat to a froth and add the whites of three eggs. 

MEDICINAL AGENTS AND MISCELLANEOUS REMEDIES, 

Under this head we shall consider briefly the principal drugs em¬ 
ployed in medicine, together with miscellaneous remedies not included, 
under any of the preceding heads. We have purposely omitted giving 
the doses of the majority of medicinal agents mentioned, believing, as- 
previously remarked, that the administration of drugs capable of pro¬ 
ducing injurious or poisonous effects should be discouraged, to accom¬ 
plish which is, indeed, one of the objects of this work, for which rea¬ 
son we have devoted so much space to a consideration of hygienic or 
non-medicinal remedies. In a great majority of cases in which drugs 
may be usefully employed in the treatment of disease, the services 
of an intelligent physician are required, and the regulation of the doses- 
may be properly left to him. Indeed, there can be no absolute ruie as to 
the proper doses of medicines, so different is their action, so-called, un¬ 
der different circumstances, in different conditions of the system and hr 


741 


RATIONAL REMEDIES FOR DISEASE. 


different individuals. Any one who wishes to obtain more precise and 
extended information regarding the various medicinal agents men¬ 
tioned may readily do so by referring to almost any one of the nu¬ 
merous excellent works on materia medica and therapeutics which ex¬ 
ist at the present time. With reference to the so-called “ action ” of 
drugs, we need but remind the reader of our previous discussion of the 
subject, in which we have endeavored to show that what is termed the 
action of the medicinal property of the drug is really simply a mode 
of expressing the manner in which the vital, organism acts upon it. 
Further remarks will be made on this subject in connection with the 
different classes of medicine which will be referred to. 

In our consideration of the various classes of medicine we have 
closely followed the order of classification adopted by Dr. H. C. Wood, 
in the last edition of his “ Therapeutics, Materia Medica, and Toxi¬ 
cology.” 

Tonics.— Tonics are drugs which are supposed to increase vital 
strength, and hence they are chiefly used in diseases and conditions 
characterized by debility. Numerous theories have been advanced to 
explain their supposed action, but none which seems to us more satisfac¬ 
tory or more capable of logical proof than that of Dr. Guy, of London, 
who asserts that their effects ai’e produced in precisely the same manner 
in which the effects of stimulants are produced. As we have already 
seen, stimulants seem to produce an increase of strength simply by ir¬ 
ritation, by means of which the forces of the system are developed re¬ 
ally in antagonism to the influence of the drug, though sometimes in¬ 
cidentally to some useful purpose also. The effects occasioned by ton¬ 
ics are much less marked than those of stimulants, but it cannot be 
shown that they are in any way different except in degree. There 
are, doubtless, cases in which the use of tonics occasions more good 
than harm, yet we firmly believe that an immense amount of harm has 
been done by a false reliance upon tonics to accomplish what can only 
be effected through the medium of good food, pure air, sunshine, and 
obedience to all the laws of hygiene. We are also thoroughly con¬ 
vinced from observation and treatment of hundreds of cases of debil¬ 
ity in all its various forms and stages, that far greater benefit is to be 
derived from the invigorating influence of such agents as sunshine, 
and an abundance of pure air, together with the proper application of 
message, water, electricity, and other hygienic remedial agents, than 
from all the medicinal tonics that can be brought to bear in such cases. 


MISCELLANEOUS REMEDIES. 


745 


We have, in fact, by these means restored to health many persons who 
had tried in vain the whole list of medicinal tonics afforded by what 
an eminent physician is pleased to call the “ polypharmacy of the text¬ 
books.” 

The principal drugs employed for supposed tonic effects are clas¬ 
sified as bitters, aromatics, and mineral tonics. 

Some of the more commonly employed of the first class are quassia, 
gentian, columbo, boneset, gold-thread, salicin, wild-cherry bark, cin¬ 
chona, quinine, and other preparations from Peruvian bark, strych¬ 
nia, chamomile, and Virginia snake root. 

The second class is chiefly composed of the various substances em¬ 
ployed as condiments, including cinnamon, cloves, allspice, black pep¬ 
per, red pepper, cardamoms, etc. 

Under the head of mineral tonics are included all the different prep¬ 
arations of iron, sulphuric acid, nitric acid, muriatic acid, nitro- 
muriatic acid, lactic acid, and phosphorus. 

Of the above-mentioned drugs we will notice but a very few. The 
whole class of bitters may be represented by the chief of them,— quinine. 
The rational view of their tonic effects we have already explained, but 
they possess another curious property to which we shall call attention; 
namely, the power to destroy the regularity of the paroxysms in peri¬ 
odic diseases, as ague and remittent fever, from which they are called 
antiperiodics. Quinine is about the only one, however, which is em¬ 
ployed for antiperiodic purposes, as this property is too feeble in most of 
the other bitters to be of much practical account. Just how quinine 
will interrupt the progress of a malarial fever has been an interesting 
subject for discussion ever since this peculiar property of the drug was 
discovered. That it will do so, there is no chance to question. How 
the effect is produced, is not so clear. Various theories have been pro¬ 
pounded, all of which have, however, seemed to us to be erroneous, since 
they are all based on the supposition that the drug is, the active agent, 
and the system the recipient of some action performed upon it. 

Dr. Headland in his work on the action of medicines proposes an in¬ 
genious theory that quinine is a natural constituent of the blood, and 
that in persons suffering with malarial disease, this element is lacking, 
and that, consequently, quinine is beneficial by restoring to the blood an 
important element which is in these cases deficient. Unfortunately for 
this theory, however, it can produce no well-ascertained facts in its sup¬ 
port. Quinine has never yet been found in the blood, and when we 


74G 


RATIONAL REMEDIES FOR DISEASE. 


consider the source of this alkaloid, it being obtained from the bark of a 
South American tree, it seems wholly improbable that any such discov¬ 
ery will be made. Even if it should be proven that quinine were a nat¬ 
ural constituent of the blood, it would still remain to be shown that it is 
deficient in persons suffering with malarial diseases, and that the admin¬ 
istration of the druof in the form in which it is used in medicine could 
supply the deficiency. 

Our own theory, which our experience with the use of the drug in 
antiperiodic diseases has seemed to confirm, is that its utility is wholly 
due to a sort of substitutive action. In other words, we believe that 
when quinine is administered to a person suffering with malarial disease 
of any form with the result of causing a cessation of morbid symptoms 
the result produced is brought about in this way : The symptoms of 
malarial disease are undoubtedly produced by the resistance of the vital 
organism to the encroachments of a morbid poison of some sort, probably 
of organic germs. When quinine is introduced into the system in suffi¬ 
cient doses, a new morbid action is set up in the resistance of the system 
to the quinine, or its efforts to expel it from the vital domain, and thus 
the attention of the organism is distracted from its efforts against the 
malarial poison, and so the symptoms peculiar to that kind of morbid 
action cease. In other words, the malarial disease is cured. 

There is no doubt, however, that the cause of the disease—malarial 
germs or other specific poison—remains in the system, since, as is well 
known, the disorder when broken up in this way is very apt to return 
again. The use of quinine is successful in curing ague, simply because 
it interrupts the paroxysms which occur in this disease. Any agent 
which will effect the same result, that is, the interruption of the par¬ 
oxysm, will cure the disease, as we shall elsewhere show more fully in 
considering the treatment of ague and remittent fever. 

We do not wish to be understood as arguing against the use of qui¬ 
nine as an antiperiodic, as we believe it to be one of the most useful of 
all medicinal agents on account of its efficiency in interrupting the par¬ 
oxysms of malarial disease. It is but fair to add, however, that the 
same result may be accomplished by numerous other agents, as well as 
quinine. We have cured many cases of malarial disease in which the 
symptoms were well marked, without the use of a single grain of qui¬ 
nine, or, in fact, of drugs of any kind. Directions for the use of quinine 
in malarial disorders will be given in connection with the treatment of 
those diseases. 



MINERAL TONICS. 


747 


Strychnia is looked upon as one of the most powerful of all the tonics 
employed in medicine. It is one of the most violent and certainly fatal 
poisons known. 11 has been much used in paralysis and some forms of 
dyspepsia, and in nervous debility. When administered even in very 
minute doses it seems to call forth the most powerful resistance on the 
part of the system, causing, in any but the smallest doses, violent tetanic 
convulsions. No certain antidote for its effects is known, and severe 
cases of poisoning by it are almost certainly fatal. From experiments 
which have been made, we are strongly inclined to believe that the use 
of apparatus for the inhalation of compressed, and exhalation into it of 
rarefied air, would be found to be of benefit. 

Mineral Tonics. —Of the mineral tonics, by far the most largely 
used is iron, of which a very large number of preparations are employed. 
As this is the chief of all the mineral tonics we will confine our observa¬ 
tions to it alone. 

Many years ago, Prof. Liebig, a noted German chemist, made a 
chemical analysis of the blood, and found iron in it. He claimed to 
prove by his experiments that the color of the red corpuscles of the blood 
was due to the presence in them of the oxide of iron, which was sup¬ 
posed to play a very important part in the transmission of oxygen from 
the lungs to the tissues, and the removal of carbon di-oxide (commonly 
called carbonic acid) from the system. 

Since these supposed discoveries were made it has been taught that 
iron constitutes an essential part of the coloring matter of the blood. 
The name applied to this peculiar compound is ham at os in. Whenever 
a person is found to be deficient in red blood corpuscles, as is the case in 
most invalids, especially dyspeptics, iron is administered, either in its me¬ 
tallic state or in combination with some acid. In this way it has 
been supposed that red blood corpuscles could be increased in a person’s 
blood, and the theory has given rise to numberless quack medicines 
which are sold under the various names, “blood tonics,” “iron tonics,” 
“ iron bitters,” etc. Unfortunately for this theory, it has been proved, 
according to the Popular Science Monthly, by the experiments of Mal- 
der and Van Gondovcr, two distinguished chemists, that the coloring 
matter of the blood contains no iron. If these experiments are reliable, 
and we have no reason to believe that they are not, the practice of ad¬ 
ministering iron to improve the color of the blood is left without 
foundation. 

It seems, also, that eminent medical savants are beginning to take the 


748 


RATIONAL REMEDIES FOR DISEASE. 


same view respecting this drug. According to the Boston Medical and 
Surgical Journal, M. Dujardin-Beaumetz is not a believer in the ther¬ 
apeutical virtues of iron in anemia and chlorosis. Notwithstanding the 
existence of a lessened quantity of iron in the blood of anemic and 
chlorotic patients, he says that this diminution is of very little conse¬ 
quence, being ten to twenty centigrammes, at the most, of the total 
amount of two grammes of iron in five litres of the blood of an average¬ 
sized adult. Now, according to Boussingault, the daily food introduces 
into the body more than this quantity of iron ; consequently, the loss 
of iron may be made up by the food alone. 

When a student at college, we were particularly struck by the re¬ 
marks of our professor of materia medica on the value of iron as a tonic. 
He stated with great emphasis that his experience with the drug had 
been that patients suffering with anemia might be dosed with any 
amount of iron but no effect would be obtained unless they were sent 
out to exercise in the fresh air and sunshine, when good results would 
be at once observed. The query arose in our mind at the time, for 
which we have never found any but an affirmative answer, whether it 
would not be equally well for the patient to send him out into the fresh 
air and sunshine without plying his stomach with doses of iron. In 
cases in which we have used the iron for tonic purposes, depending upon 
it alone so as to be able to judge accurately of its effects, we have never 
observed any benefit whatever. We are aware that statements of this 
kind will be considered very rash and bold, but we feel less hesitancy in 
making them since we are able to cite the testimony of so eminent a 
physician as Dr. Dujardin-Beaumetz in favor of the same position. 
Having had quite extended opportunities of testing other methods of 
treatment in the cases in which iron is usually prescribed and after it 
had been thoroughly and faithfully used for a long time, we may per¬ 
haps be pardoned for being exceedingly skeptical as to its beneficial 
effects. 

Heart Stimulants.—The drugs enumerated under this head are 
ammonia and its compounds, alcohol in all its forms, turpentine , and 
digitalis. 

Ammonia, the first-mentioned of these, is a colorless, irrespirable, 
highly irritant gas, of a strong alkaline reaction, and very soluble in 
water. Aqua ammonia, or ammonia water, is simply water which 
has been impregnated with ammonia gas. Applied to the skin, ammonia 
is a powerful irritant; and when inhaled, causes irritation of the air- 


HEART SEDATIVES. 


749 


passages, and even inflammation. One of the most common uses of am¬ 
monia is to prevent syncope, or fainting, when strong symptoms tending- 
in that direction are manifested. Bv its irritating effects it excites the 
lungs and heart to increased activity. It acts, in fact, like a whip upon 
a tired horse. It gives no strength, but simply compels the organs which 
recognize it to use the force which they already have. 

Alcohol and its relations to the human organism, in disease as well 
as in health, have been dwelt upon at so great length elsewhere that we 
need nox give the subject further notice here. 

Digitalis is often prescribed in organic disease of the heart, but its 
use is attended with considerable danger, as it is a powerful poison, and 
not infrequently the effects of the first dose are not fully felt until three 
or four doses have been given, when the effects of the accumulated quan¬ 
tity received are experienced together, and sometimes with fatal results. 
As a means of increasing the heart’s impulse in organic diseases of this 
organ, we have found it vastly inferior to galvanism applied to the 
pneumogastric and sympathetic nerves. 

Heart Sedatives. —The principal drugs included in this class are 
antimony and its preparations, arnica, veratrum viricle, aconite, hydro¬ 
cyanic acid, cyanide of 'potassium, and vegetable acids. With the 
exception of the vegetable acids, all the drugs included in this list are 
powerful poisons. Their effects, whether administered in health or dis¬ 
ease, are essentially those of poisoning, the principal effect being a great 
decrease in the activity of the heart’s action. 

Antimony, in the form of tartar emetic, is so named from the fact 
that its discoverer experimented with it as medicine upon several Spanish 
monks, who died from its effects. From this it was called antimony, 
which is derived from two Spanish words meaning “ anti-monk.” Three- 
quarters of a grain in a child and two grains in an adult, in the form of 
tartar emetic, has produced death. 

The vegetable acids can hardly be considered as drugs, since when 
taken in their natural form they are really foods, being taken and di¬ 
gested by the system. When taken in large doses they sometimes pro¬ 
duce symptoms resembling those of the other poisonous substances men¬ 
tioned under this head, whence they have been put in this class. 

Citric Acid in the form of lemon juice is a very valuable agent in 
the treatment of several diseases. Its value in scurvy has long been 
known, and is now so well recognized that whaling ships and othei 


750 


RATIONAL REMEDIES FOR DISEASE. 


vessels going- on long voyages in which it will be impossible to obtain 
an abundant supply of fresh fruits and vegetables, always take with 
them a supply of preserved lemon juice as a preventive against the oc¬ 
currence of scurvy. The free use of lemon juice is also to be recom¬ 
mended in acute rheumatism, in jaundice due to a catarrhal condition of 
the biliary ducts, in chronic inactivity of the liver, and in some forms of 
constipation of the bowels. Lemonade is also a very valuable drink in 
fevers, on account of its cooling properties. The free use of lemons in 
malarial fevers sometimes appears to have a decided influence in cutting 
short the disease. 

Arnica, another member of this class of drugs, has been much used 
as a liniment in bruises and wounds of various kinds. Frequently, how¬ 
ever, it has been observed that decided effects of poisoning have followed 
its use in this way, and many physicians have recently abandoned its 
use on this account. Quite a number of eminent English physicians 
condemn its use in the strongest terms as a poison which should never 
be employed under any circumstances. When used as a liniment it very 
frequently causes serious skin eruptions which are a long time in healing. 
It has no effect whatever to hasten the healing of wounds, its only influ¬ 
ence being to diminish pain by its paralyzing effect upon the sensitive 
nerves with which it is brought in contact. As the same result can be 
accomplished by other means which are not open to the objections that 
are justly urged against this, we heartily agree with those who con¬ 
demn its use. 

Prussic Acid, like arnica and antimony, is a powerful poison. In¬ 
deed, it is without doubt the most rapidly fatal drug in use. It is never 
kept in a pure state, as its vapor alone is sufficiently poisonous to produce 
fatal effects. It is frequently used in combination with 'potassium as 
cyanide of potassium, which almost equals it in poisonous properties. 
The poisonous character of cyanide of potassium should be kept in mind, 
as this drug is frequently used in the household for removing nitrate-of- 
silver stains from the fingers and from linen. Since this can be accom¬ 
plished by other means it is best that the drug should not be kept about 
the house, as it produces death so quickly that there is little hope of sav¬ 
ing the life of a person who has taken a dose of it, by the use of any an¬ 
tidotal means. It should be further remarked in this connection that 
the peculiar flavor of bitter almonds and of the kernel of the peach seed 
is due to the presence of this poison. The use of bitter almonds for fla¬ 
voring purposes Is worthy of strong condemnation. Though the amount 


ANTISPASMODICS. 


751 


of the drug thus employed might be very small, it could not possibly be 
of benefit. 

Antispasmodics. —This class includes musk, castor, valerian, assa- 
fetida, camphor, hops, lactucarium, coffee, etc. 

These drugs are called antispasmodics because used in those condi¬ 
tions of the nervous system included under the head of nervousness, 
together with exaggerated forms of the same conditions, such as hys¬ 
teria, and various other convulsive disorders. How the effects of these 
drugs in relieving nervousness and interrupting convulsions are pro¬ 
duced, our works on materia medica and therapeutics do not explain. 
There can be no doubt, however, that their apparent action, as is the 
case with other drugs, is wholly due to the reactions of the various 
parts of the system against them as foreign elements in the vital do¬ 
main. Several members of this class are violent poisons. Assafetida, 
a drug very frequently used for the relief of hysteria and nervous¬ 
ness, is in some Eastern countries used in very small quantities as a 
condiment. It has a very offensive taste and odor, and it is exceed¬ 
ingly strange that it should ever have acquired a use of this sort. 

The medicinal properties of hops are due to a substance which they 
contain called lupulin. People frequently find their insomnia re¬ 
lieved by the use of hop pillows. The soothing effect of a hop poul¬ 
tice when applied to painful parts is well known. It is, perhaps, one 
of the mildest narcotics which is used in this way. The poultice may 
be made by simply pouring hot water on the hops contained in a 
. gauze bag of the right size and shape, which is applied to the pain¬ 
ful part, or by mixing the hops with Indian meal and making a 
poultice with hot water. 

Lactucarium is a medicinal substance obtained from lettuce. It 
is said to have narcotic effects, but these are so slight that even the 
most concentrated preparation has been taken in very large quantity 
without producing any effect whatever. It is probable that it may 
have some slight effects. 

Coffee is still classed among other drugs as a medicine. It properly 
belongs with medicinal agents, and is, consequently, wholly unfit for 
daily use as an article of diet. Ordinary tea, Paraguay tea, and all 
other substances which contain caffeine, possess essentially the same 
properties as coffee. Strong coffee has been found to be a valuable 
means of counteracting the effects of poisoning by opium. This is 


752 . 


RATIONAL REMEDIES FOR DISEASE. 


about the only good tiling we can say of this almost universally 
abused drug. 

Anodynes. —This term is applied to drugs which are used for the 
relief of pain. AVe shall mention under this head only opium, mor¬ 
phia, Indian hemp, belladonna, and hyoscyamus. 

These drugs are all characterized by their power to relieve pain, an 
effect which is due to their benumbing influence upon the brain, the 
seat of sensibility. They are more largely used, perhaps, than any 
other class of drugs employed in medicine. This is especially true of 
opium, the chief of all agents for the relief of neuralgia and many 
other painful affections. 

Morphia has a still more powerful effect than opium, being a 
concentrated extract from the crude drug. While these agents are of 
the greatest service in affording relief from pain and suffering which 
is beyond the hope of cure or cannot be reached, they are abused to an 
extent which is fearful to contemplate. Sufficient has perhaps been 
said with reference to the employment of opium in the opium habit, 
and we shall not repeat our previous observations on this subject. 
We will, however, simply revert to the fact that it is the medicinal 
use of the drug which in the majority of cases leads to its habitual 
employment. We cannot but regard the reckless manner in which 
opium and other anodynes are used by many, perhaps the larger share 
of physicians, as in the highest degree worthy of condemnation. Phy¬ 
sicians often forget that the relief of the prominent symptoms of a case 
is but a small part of the work which must be done if a cure is to be 
effected. The relief of symptoms we regard, indeed, as but a small 
part of the physician’s duty. His first work should be to find out the 
cause of the suffering, and then he should set to work to remove this 
cause at the earliest possible moment. If it can be quickly removed, 
no other means for removing the pain need be employed, as the re¬ 
moval of the cause will itself bring relief. If, however, the cause is 
found to be of such a nature that it cannot be removed at once, but 
considerable time must elapse before relief can be obtained in this 
way, it is often the duty of the physician to employ such other means 
as may be necessary to mitigate the sufferings of his patient suffi¬ 
ciently to secure for him the greatest degree of comfort compatible 
with his best interests. By the employment of ingenuity and the 
proper degree of painstaking it will be found possible in a very large 
proportion of cases in which opium and other anodynes are commonly 


MORPHIA AMD OPIUM. 


753 


employed, to obtain relief without resorting to remedies of this class, 
and we regard it as the solemn duty of every physician to give such 
remedies only in cases of actual necessity. All physicians who have 
observed carefully the effects of their prescriptions, are aware that 
anodynes benumb and depress the activity of the organic nerve cells 
of the nerves of sensibility, and consequently under their influence the 
various processes necessary to nutrition and the other organic func¬ 
tions cannot be so well performed as when the system is not under the 
influence of paralyzing drugs. Consequently it is evident that recov¬ 
ery must in some degree be impeded by the use of anodyne rem¬ 
edies. Electricity, when properly used, will be found in many cases 
to be a perfect substitute for anodyne drugs, and it is never attended 
with any of the unpleasant effects which follow the use of such reme¬ 
dies as opium, morphia, and other drugs of that class. The sleep af¬ 
forded by the narcotic effects of opium is by no means so refreshing as 
natural sleep. Indeed, we fully indorse the statement made by an emi¬ 
nent physician at the International Medical Convention, held at Phil¬ 
adelphia in 1876 , that one hour of natural sleep is equal to three or 
four hours of narcotic insensibility. In many cases the use of ano¬ 
dynes can be avoided by urging the patient to bear with fortitude his 
sufferings, which may be quite too slight to require the use of such 
powerful remedies as must be applied to secure entire insensibility to 
pain. 

In the case of habitual opium-eaters we have found the greatest 
obstacle to recovery to be the entire loss of fortitude to endure even 
a very slight degree of pain, which condition had doubtless been 
brought about by the habit of taking the narcotic for the relief of 
every unpleasant sensation. We have no sympathy with the class of 
medical fanatics who would allow a patient to die from sheer exhaus¬ 
tion from pain rather than administer a narcotic. We frequently find 
it necessary in practice to employ opium, morphia, belladonna, and in 
fact, the whole list of anodyne remedies; but we restrict the use of 
these drugs as much as possible, and exhaust every other means of 
relieving pain before resorting to them. This is the practice which we 
heartily commend to every physician, and which ought to be insisted 
upon by all intelligent persons so far as their influence may extend. 
The common and almost unrestricted use of opium by physicians has 
made the common people so familiar with the drug that its poisonous 
properties are seldom thought of. It is regarded as a great boon for 

48 


RATIONAL REMEDIES FOR DISEASE. 


754 

the relief of pain, as it is, and so is resorted to on any and every 
occasion when discomfort is experienced which cannot he relieved oth¬ 
erwise. This ignorance or apathy respecting the injurious properties 
of the drug undoubtedly lies at the bottom of that most pernicious 
practice,—the use of anodynes in the form of paregoric, Mrs. Wins¬ 
low’s Soothing Syrup, and other narcotic or anodyne mixtures for the 
purpose of quieting restless or troublesome infants. Thousands of in¬ 
fants die annually in consequence of this pernicious practice, and we 
cannot help believing, in view of this terrible sacrifice of human life, 
that it would be a boon, to the rising generation at least, if narcotics 
and anodynes of every sort were blotted out of existence. The treat¬ 
ment of opium poisoning and the opium habit are fully considered in 
other connections. 

Belladonna, another prominent member of this group of drugs, is 
also very largely used as an anodyne, although to a far less extent 
than opium, in its various preparations. One of the most character¬ 
istic effects of belladonna is its power to dilate the pupil of the eye. 
This was one of its first observed effects, and the drug has been very 
largely used by ladies for this purpose in order to give to the eye an 
increased brilliancy. In certain diseases of the eye in which inflam¬ 
mation of the structures about the pupil occasion danger to the sight 
by causing adhesion of the iris to the cornea or lens in such a posi¬ 
tion as to prevent the admission of light into the eye, belladonna has 
an exceedingly useful effect to produce dilatation of the pupil, thus 
withdrawing the iris from the seat of danger until the inflammation 
has been subdued by the proper means. We have seen many eyes 
saved by this means which would otherwise undoubtedly have been 
sacrificed. Belladonna is also of great service to the oculist by en¬ 
abling him to dilate the pupil to such an extent as to admit of a thor¬ 
ough examination of the whole interior of the eye by means of an 
ophthalmoscope. This drug has also been found to be a physiological 
antidote for opium-poisoning. 

Hyoscyamus and stramonium produce an effect upon the eye sim¬ 
ilar to that of belladonna, though in a much less degree. 

Anesthetics. —This is a class of drugs which occasion the loss of 
consciousness by the inhalation of their vapor. Their effects are very 
largely due to their exceeding volatility, by means of which they are 
taken into the system very rapidly. Various theories have been proposed 
to account for their effects. The most probable is that their so-called 


CHLOROFORM. 


i o •> 


action is anti-vital; that is, wholly due to the reaction of the system 
against them. The principal anesthetics are chloroform, ether, bi¬ 
chloride of methyl, and nitrous oxide. 

Chloroform is produced by the action of chlorine upon alcohol. It 
has a hot and sweetish taste, and a fragrant and peculiar odor. It is 
heavier than water, and sinks when dropped into it. AVhen placed 
upon the skin and covered with a cloth, it will cause a blister; and 
when taken into the mouth or stomach, produces a burning sensation. 
When inhaled, it causes first a feeling of excitement or exhilaration 
accompanied by roaring in the ears, with strange and peculiar sensa¬ 
tions. The patient generally has a feeling as though the objects im¬ 
mediately about him were a long distance off. This gradually fades 
into semi-unconsciousness, which is accompanied with visions and illu¬ 
sions. During this stage, patients weep, laugh, talk, pray, rave, or be¬ 
come violently obnoxious. This stage usually lasts but a few min¬ 
utes, and gradually passes off, when the patient sinks into complete 
unconsciousness. The first stage very closely resembles that of alco¬ 
holic intoxication. In the second stage the patient is unconscious, and 
lies perfectly quiet. It is during this condition that surgical opera¬ 
tions are performed. If the inhalation of vapor is continued, the third 
stage is produced, which is one of narcotic poisoning accompanied by 
stertorous breathing and complete relaxation of the muscles. It is one 
of great danger, and should be carefully avoided in the administration 
of chloroform. In the first stage the pulse is very greatly quickened 
in the second stage it should be about normal; in the third stage it 
becomes very weak and frequent. Chloroform has a very depressing^ 
influence upon the heart. In cases of death from its use, the result is 
generally due to paralysis of the heart. Of the two most largely used 
anesthetics, chloroform and ether, chloroform is without doubt by far 
the most dangerous. It has been shown by carefully collated statis¬ 
tics that it produces death on an average in about one case in 3,000 
inhalations. The treatment for threatened death during chloroform 
inhalation is given under the head of “Artificial Respiration.” 

The danger in the use of chloroform is now generally conceded by 
experienced surgeons to be so great as to render its use unjustifiable 
except in cases where ether cannot be well employed. Although its 
inhalation is much pleasanter for the patient, and its greater potency 
as an anesthetic renders the use of a smaller quantity sufficient to 
produce the desired result, these advantages are overbalanced by the 


756 


RATIONAL REMEDIES FOR DISEASE. 


greater danger to life entailed by its use. Experiments made at the 
Philadelphia Hospital have shown that persons may be anesthetized 
with chloroform in sound sleep without being awakened, and there is 
some evidence to show that the drug has sometimes been employed in 
this way by burglars for aiding them in their operations. Persons 
who are sleeping lightly, however, will be awakened by the strong- 
odor and irritating effects of the gas. 

Ether is a colorless, volatile liquid obtained by treating alcohol with 
sulphuric acid. It is very inflammable. Its vapor is two and one- 
half times heavier than air. It has a very strong, peculiar odor and 
taste. When inhaled, its effects are similar to those of chloroform. 
It produces in addition unpleasant choking sensations, which fre¬ 
quently cause great discomfort to the patient. The effect of ether is 
different from that of chloroform, also, in producing, a short time af¬ 
ter the giving of the inhalation, a brief period of at least partial un¬ 
consciousness and insensibility sufficient to allow the performance of 
short, even though painful, operations. In the performance of such 
surgical operations as the removal of the toe-nail, circumcision, and 
similar operations requiring but a few minutes for their completion, 
we always endeavor to take advantage of this short period of insensi¬ 
bility to pain, and thus avoid the necessity for the inhalation of so 
large a quantity of this drug as is usually necessary to produce pro¬ 
found anesthesia. We have in some instances performed quite severe 
operations in this manner while the patient was entirely conscious, 
though insensible to pain. When death occurs from the inhalation of 
ether it is the result of arrested respiration rather than its effect upon 
the heart, which is shown by the fact.that the pulse will continue for 
some time after respiration has been wholly arrested. Its effects upon 
respiration are produced slowly and are wholly observable, so that 
there is more warning than is the case with chloroform. On this ac¬ 
count, ether is a much safer anesthetic, and is rapidly replacing chlo¬ 
roform for this purpose. 

It is important to recollect that both ether and its vapor are highly 
combustible, as also that, being heavier than air, it will sink to the 
floor. A light held two or three feet above a sponge saturated with 
ether will not occasion any very great degree of danger, while the op¬ 
posite would be the case if it were held below. In an atmosphere 
highly impregnated with the vapor of ether, a flame will sometimes 
flash to a sponge lying several feet from the lamp or gas-jet. 


NITROUS OXIDE. 


757 


Some years ago, a dentist who was operating upon the mouth of 
a patient was suddenly horrified at seeing the patient’s breath take 
fire. The flames were soon extinguished, but not without some in¬ 
jury to the face and mouth of the patient. 

Dr. B. W. Richardson has called attention to the astonishing 1 fact 
that in various parts of Ireland, particularly in Dublin, Cork, Belfast, 
and several other cities, together with a number of small villages in the 
“ Mountains of the North,” ether has been substituted for alcohol as an 
intoxicant. In one small place, known as Draperstown, ether is regularly 
sold in groceries and other small retail stores. The effects of ether-drink¬ 
ing are similar to those of alcoholic intoxication except that the effects 
are much more evanescent, a person becoming sober in an hour or 
two after having been hi a state of intoxication which, if induced by 
alcohol, would have required several hours to recover from. The 
quantity usually taken is from half an ounce to three ounces. The 
breath of those who employ ether as a drink is for some time so heavily 
charged with the vapor as to be inflammable. The story is related, on 
reliable authority, of a man who, after drinking ether, lighted his pipe 
to smoke, and in doing so also set fire to his breath, a volume of flame 
issuing from his mouth. He would certainly have died had it not been 
for the assistance of a friend who quickly threw him down and by pour¬ 
ing water into his mouth extinguished the flames before any fatal injury 
had been inflicted. 

Nitrous Oxide is a colorless, almost odorless, gas of sweetish taste. 
It is made by the distillation of nitrate of ammonia. Its use as an 
anesthetic exceeds that of any and all other anesthetics together, as it 
has for a number of years been employed very largely by dentists in the 
extraction of teeth. It is only fit for use in such minor operations as 
tooth extraction, the opening of felons and abscesses, and similar opera¬ 
tions. Its anesthetic effects have, by recent experiments, been found 
to be wholly due to depriving the bipod of oxygen, since similar anes¬ 
thetic effects are produced by the inhalation of pure nitrogen, hydrogen, 
or any other gas which will not support respiration. The exciting and 
exhilarating effects which frequently accompany its use are thought to 
be due to a specific influence of the gas. There is some evidence, how¬ 
ever, that these effects may also be simply the result of the deprivation 
of oxygen. Its anesthetic effects are produced very rapidly, and are 
equally transient in duration, no unpleasant effects following its admin¬ 
istration. Its use is generally considered perfectly safe; but that this 


RATIONAL REMEDIES FOR DISEASE. 


758 

is not the <’jiso is indicated by tlie fact that several deaths from its use 
have been recorded. The infrequency of deatli from its use is probably 
due to the short time required for the operations in which it is generally 
employed. Large quantities of this gas, and water impregnated with it, 
are sold under the name of “compound oxygen,” from which the most 
marvelous effects are said to be obtained. From information recently 
received we are satisfied that little good is accomplished by this agent. 

Bi-chloride of methyl is closely allied to chloroform in character, as 
its use is attended with the same danger. It has been little employed, 
and probably will never come into general use. 

Depresso-Jlotors, —The drugs of this class are so called because 
they lessen the activity of the spinal cord. The principal drugs which 
have this effect are calabar bean, bromides of 'potassium, sodium, am¬ 
monium, and lithium, chloral and bromal hydrates, nitrate of amyl, 
lobelia, gelsemium, tobacco, and couium. 

Calabar bea u contains an alkaloid called physostigma, to which its 
j»oisonous properties are due. In fatal doses it produces death by paraly- 
is of respiration, which is undoubtedly due to its poisonous effect on 
the nerve-centers. One of its most peculiar effects is to cause contrac¬ 
tion of tin; pupil, for which reason it is frequently useful in the treat¬ 
ment of affections of the eye and to counteract the dilating effect of 
b<4Uulonna. 

The bromides of potash, sodium, ammonium, and lithium, have 
also a depressing effect on the spinal cord, on which account they are 
very largely used in the treatment of nervous diseases, particularly epi¬ 
lepsy. IVobably there is no drug which has so powerful an influence 
upon the disease mentioned as bromide of potassium. It will undoubt¬ 
edly check tin; epileptic convulsions, and numerous cases are recorded in 
which the occurrence of convulsions has ceased after the long-continued 
use of this drug. We have used it in quite a number of cases of this 
disease, but our experience has been that, employed alone, it is a very un¬ 
satisfactory remedy, and will rarely secure anything more than tempo¬ 
rary relief. In addition to this it must be said that it is a powerful irri¬ 
tant to the stomach, often occasioning serious disturbances of the dmes- 
tion, and so operating directly against those measures which must be the 
most permanently useful in securing recovery from the disease. As we 
shall show elsewhere, epilepsy may be successfully treated without the 
use of bromide of potassium, which, when employed in such a manner as 
to occasion irritation of the stomach, really does more harm than good. 


HYDRATE Of 1 CHLORAL. 


750 


The drug may be sometimes useful in interrupting the paroxysms of the 
disease, but it should not be depended upon as a curative agent, since a 
cure can only be brought about by improving the nutrition and re¬ 
inforcing the vital energies of the system ; and the almost universal con- 
nection of some degree of impairment of the digestion with epilepsy is a 
strong argument against the very common use of bromides. 

Hydrate of Chloral is a drug which has come to be used within the 
last three years, and has been most extensively abused. Like the other 
drugs of this class it has a powerfully depressing influence upon the cen¬ 
tral nervous system, by means of which it produces a tendency to sleep. 
Sleep under the influence of chloral, however, is by no means identical 
with natural sleep. In the latter condition the brain contains very little 
blood, being pale and anemic, as a result of which there is complete rest, 
at least of the cerebrum and higher nerve-centers of the brain, while in 
the sleep under the influence of chloral the blood-vessels of the brain, as 
well as of other parts of the nervous system, are dilated and gorged 
with blood, a condition similar to that produced by alcohol in nar¬ 
cotic doses. So great an amount of harm has been done by the use 
of this drug that we think the world would have been better off 
had it never been discovered. Dr. Richardson, as well as other ob¬ 
servers, has shown that its employment for its narcotic effects since its 
discovery, scarcely ten years ago, has become very extensive. There 
are now, especially in large cities, many persons who take chloral in 
enormous doses as habitually as alcohol and opium are taken. Its 
effects on the system are in the highest degree pernicious. It produces 
changes in the blood similar to those which are found in scurvy, produ¬ 
cing, in fact, nearly all the other symptoms of that disease. The long- 
continued use of chloral as a medicine produces effects not dissimilar to 
those occasioned by its non-medicinal habitual use. We regard it as a 
poisonous drug which could very well be dispensed with. We have 
rarely found any occasion for its use, being usually able to substitute 
some better remedy in cases in which it is supposed to be indicated. 

As a local application, however, we have frequently found it useful 
where the object is to cause the absorption of morbid tissue and to lessen 
too profuse secretion, as in some cases of inflammation of the pharynx. 
Its use as a gargle has also been highly recommended in diphtheria. 

Nitrite of Amyl is a volatile liquid with a peculiar odor. It is pre¬ 
pared from fusel-oil. On account of its great volatility it is chiefly used 
in inhalation. Its effect is to produce great fullness and distension of the 


760 


RATIONAL REMEDIES FOR DISEASE. 


blood-vessels of the head, accompanied with severe pain, flushing of the 
face, and difficult respiration, with violent action of the heart when any¬ 
thing more than very small doses are inhaled. It also has the peculiar 
effect to cause surrounding objects to look yellow to a person under its 
influence. One of the most marked effects of this drug is to destroy the 
power of the blood corpuscles to absorb oxygen. On this account its in¬ 
halation produces a distinct feeling of threatened suffocation. The only 
cases in which we have found the drug of any use has been in relieving 
the paroxysms of obstinate cases of asthma until the effects of other rem¬ 
edies could be secured, and in preventing epileptic convulsions. It should 
be taken with very great care, only a few drops being placed on a hand¬ 
kerchief and inhaled for a minute or two. It should be remarked that 
the full effects are not felt until a minute or two after it has been with¬ 
drawn. It is certainly sometimes very useful in interrupting the con¬ 
tinued convulsions present in what is termed the status epilepticus, in 
which the paroxysms often follow each other in rapid succession. We 
have had patients under treatment who carried a small vial of the drug 
constantly with them, and whenever they felt the premonitory symp¬ 
toms of the paroxysm, by holding the bottle to the nose and taking a few 
deep inspirations, were enabled to prevent the occurrence of any further 
symptoms. It, of course, has no curative value, but it must be acknowl¬ 
edged to be of some real service in such cases. In all cases which were 
relieved in this way which we have had under treatment, resort to the 
drug was found unnecessary after the first two or three weeks. 

Lobelia. —This common drug, made familiar by its almost universal 
employment, by Thompsonian doctors and physio-medical physicians, 
produces in both man and animals the most intense prostration, which 
is usually indicated by feeble pulse, cold sweats, great relaxation of the 
muscles, and emesis. Many cases of fatal poisoning have been produced 
by it. Its general effects are, in fact, almost identical with those of to¬ 
bacco. It was formerly much employed for its relaxing effects in 
whooping-cough, epilepsy, and tetanus, but it has been generally aban¬ 
doned in the treatment of those affections, as much less dangerous rem¬ 
edies have been found to be equally, or more, efficient. 

Tobacco. —The effects of tobacco upon the human system have al¬ 
ready been so fully described that we do not need to notice this drug at 
length in this connection except to say that its poisonous effects are so 
rapid and powerful, that, although formerly much employed, it is now 
very seldom used. About the only useful service which it can perform 


ALTERATIVES. 


7G1 


is in the destruction of vermin, but its use for this purpose must be con¬ 
demned, since numerous cases of fatal poisoning have occurred even from 
its employment in this manner. 

Gelscmium. —This is an alkaloid whose poisonous character has 
been well shown by its fatal effects, as small a quantity as one-sixth 
of a grain having proved fatal to a man. When taken in anything 
more than the smallest doses, it produces dilatation of the pupil, dizziness, 
great weakness, and frequently double vision. Death, in poisoning, is 
produced by paralysis of the circulation. 

Alteratives. —This term is applied to drugs which, when taken into 
the system, occasion a change in the functions of various vital organs, 
by means of which the processes of nutrition are modified. In other 
words, they are supposed to alter the vital actions taking place in the 
body. The various medicines which are supposed to purify the blood, 
belong in this class. It is, however, in the highest degree probable that 
by their use, the opposite, rather than purification, takes place. It seems 
to us to be clearly evident that the so-called action of these drugs is 
wholly due to a modification of the vital processes occasioned by the ef¬ 
forts of the system to rid itself of the poisonous elements of which it can 
make no use. The principal drugs employed for alterative purposes are 
arsenic and its preparations, mercury in numerous forms, iodine in 
various combinations, cod-liver oil, phosphoric acid and phosphates, 
colchicum, sarsaparilla, sassafras, and dandelion. Most of these 
drugs are so largely used that it will be worth while for us to give each 
some attention. 

Arsenic. —The drug known by this name is a compound of metallic 
arsenic, or arsenicum, with oxygen, called white arsenic, or arsenious 
acid. When thrown upon hot iron, it volatilizes with a peculiar, gar¬ 
licky odor. It is an exceedingly active poison, and even when largely 
diluted with water it is a severe irritant. When swallowed in consider¬ 
able quantities, it produces intense inflammation of the digestive organs, 
and speedy death. When smaller doses are taken, death may not occur 
for two or three days. If the body is examined after death in the latter 
class of cases, in addition to the irritating effects of the poison upon the 
mucous membrane, with which it comes in contact, it is found that 
great changes have taken place in nearly all the tissues of the body, the 
muscles, liver, kidneys, and various other tissues having undergone what 
is termed fatty degeneration. When taken even in medicinal doses for 


702 


RATIONAL REMEDIES FOR DISEASE. 


skin diseases and other affections, for which it is usually prescribed, for 
a long time some of the same poisonous symptoms are occasioned, the 
more common of which are puffiness under the eyes, and sometimes 
dropsy, together with the appearance of albumen in the urine and casts, 
the well-known sign of acute inflammation of the kidneys. The especial 
effects upon the kidneys are probably due to the fact that the poison is 
chiefly eliminated by these organs, as it can be detected in the urine in a 
very short time after its administration. The most common uses of 
arsenic are in obstinate cases of ague, inveterate skin diseases, dyspepsia, 
and nervous disorders. In view of its* exceedingly poisonous effects, 
even when taken in medicinal doses for some time, it seems to us that 
its use as a medicine is quite unjustifiable. . There are many eminent 
physicians who do not recognize its supposed utility as a remedy for skin 
diseases. In the treatment of nervous diseases it certainly cannot in any 
degree compare with electricity, which is wholly devoid of the dangers 
attendant upon the misuse, or even the use, of this drug. 

Mercury. —This drug, once known as the “ Samson ” of the materia 
medica, is now much less used than formerly. It is a powerful mineral 
poison in all its combinations, being most rapidly fatal even in small 
doses in the form known as corrosive sublimate. The first symptoms 
of mercurial poisoning, when it has been taken into the system, are 
seen in the mouth, consisting of a fetor in the breath, and soreness of 
the teeth. Very soon the patient discovers a metallic taste, the gums 
become swollen and soft, and bleed profusely on very slight abrasion, 
accompanied with a profuse flow of saliva. If the use of the drug 
is persisted in, the gums become swollen and inflamed, and marked by a 
red line at the junction of the teeth. The tongue also becomes swollen, 
sometimes enormously, protruding from the mouth so as to prevent its 
closing. The teeth become loosened in their sockets. The saliva is in¬ 
creased in quantity, becomes ropy and viscid, and pours out over the 
swollen and lacerated lips. The whole system is feverish. This condition 
of things often becomes worse, so that the teeth fall out of their sockets. 
Large portions of the gums and cheeks slough away, leaving the patient 
scarred and disfigured for life. The jaw-bones undergo necrosis, large 
portions separating and coming away after long periods of suppuration. 
The blood becomes thin and deficient in red corpuscles, and contains 
large quantities of fetid fatty matter. Epilepsy, insanity, scurvy, pa¬ 
ralysis, resembling that from lead-poisoning, and necrosis of the bones in 
various parts of the body, are the well-known results of the use of 
mercury. 


MERCURY. 


763 


The old-fashioned treatment of fevers by mercury has been almost 
wholly abandoned, and there seems to be an increasing and wholesome 
inclination to substitute for it less harmful remedies. The experiments 
of Dr. Bennett in Edinburgh, and of a number of other careful ob¬ 
servers, have shown that the belief in the efficacy of mercury as a 
cholagogue, or liver stimulant, has been entirely a mistake; in fact, the 
results of a large number of experiments show that instead of increasing 
the amount of bile secreted by the liver, the quantity is actually de¬ 
creased when mercury is taken. It is true that a large dose of mercury 
will occasion the appearance in the bowel discharges of a considerable 
quantity of bile; but as Dr. Chambers very pertinently remarks in ex¬ 
planation of this phenomenon, this is simply due to the fact that the bile 
has been so poisoned by the mercury administered that it cannot be 
absorbed and used in the system, and hence is discharged. 

It should be borne in mind that the bile is a secretion as well as 
an excretion, and that the larger share of this fluid secreted is taken 
up with the food, the absorption of which it greatly promotes, and is 
used in the system, only the waste and excrementitious products being 
allowed to escape with the detritus of the food. The effect of the 
mercury is to so change the composition or qualities of the bile as to 
render it useless and unfit for absorption, consequently that which 
should be taken up in the system is lost and carried away with the 
useless elements of the food. In view of these facts we are forced to 
the conclusion that the use of mercury to relieve congestion and tor¬ 
pidity of the liver, or conditions which have often been termed “ bil¬ 
iousness,” has been a great mistake. Facts indeed show that mercury 
is one of the most active agents in producing torpid and inactive livers. 
Indeed, it is our candid opinion that the liver of a person who has been 
salivated a few times is maimed for life. One of the peculiarities of 
mercury is that when taken into the system it is very frequently de¬ 
posited in various tissues, and there retained for a long series of years. 
It is probable that the liver thus contains a considerable proportion of 
the mercury which is received into the system, partly since it first re¬ 
ceives the drug through the medium of the portal vein, after it has 
been absorbed, partly on account of the well-known fact that it pos¬ 
sesses the peculiar property of retaining within its tissues various me¬ 
tallic substances, such as lead, copper, and arsenic, as well as mercury. 
It is for this reason that the chemist, in searching for evidences of 
death from metallic poisoning, is anxious to secure the liver for 


TGI 


RATIONAL REMEDIES FOR DISEASE. 


examination, particularly if there is suspicion that the poisoning has 
been effected by a slow and somewhat long-continued process. It 
is also stated by authority which we have good reason to consider re¬ 
liable, that mercury has in some instances been found in the bones in 
a metallic state. It is said that an Italian professor once astonished 
his students by striking his lecture-desk with the bone of a human 
being and thereby causing countless numbers of minute globules of 
mercury to roll out upon the table. During life the patient had taken 
considerable quantities of mercury for a long time, and it seems that 
the metallic element had been stored up in the bones in such quanti¬ 
ties that it could be shaken out in a metallic state after death. The 
fact that mercury has some particular affinity for the bones may be 
inferred from the statement of Prof. Gross, in his great work on sur¬ 
gery, in which, in speaking of syphilis as a cause of necrosis, he states 
that “ the history of this disease has shown that the osteitis growing 
out of it is more apt to occasion death of the bone when the patient 
has been subjected to three courses of mercury for his cure than when 
the malady has been treated on general antiphlogistic principles.” 

The quotation from Prof. Gross also brings to light another fact of 
very great importance, namely, that in syphilis, one of the diseases in 
which mercury has been considered by many as a real specific and ab¬ 
solutely essential to recovery, it is by no means so useful or harmless as 
its advocates have generally supposed. It is an omen of good that at 
the present time numerous physicians, many of much eminence, are 
beginning to entertain serious doubts of the efficacy of mercury in the 
treatment of these diseases also ; and we should not be at all surprised 
if within the next ten years this, the so-called “ Samson ” of the ma¬ 
teria medica, should be reduced in the eyes of practitioners, at least, to 
the proportions of a dwarf, if it is not annihilated altogether, which in 
our opinion would not be a serious detriment to the world, since all 
possible advantages sacrificed would be much more than counterbal¬ 
anced by the damage which would be obviated. Dr. Wood has stated on 
this point, “ There has arisen a school of syphilographers [physicians 
devoted to the treatment of syphilis] who assert that the drug is not 
only not necessary, but is in all stages and all cases of the disease 
most injurious; that the worst symptoms of the disease are due, not 
to the constitutional affection, but to the remedy given for its relief.” 
Although never having made a specialty of the disease in question, we 
have treated a sufficient number of cases to demonstrate to our satis- 


MERCURY. 


765 


faction that the views entertained by the class of specialists referred 
to are entirely correct. We were glad to notice not long since an able 
article in the British Medical Journal, the author of which maintained 
that syphilis could be much more successfully treated without mer¬ 
cury than with. The opinions of the author are entitled to some con¬ 
sideration, for his position is Surgeon of Militia in the Medical Corps 
of the British army, and Assistant Professor of Pathology in the Army 
and Medical School at Netly. The article referred to was an abstract 
of a paper read by him before the meeting of the British Medical As¬ 
sociation in 1878. He cites hundreds of cases of syphilis successfully 
treated by him in all stages of the disease wholly without the use of 
mercury. He says distinctly, “ The practice which in the main guided 
me in the treatment of syphilis was the practice of avoiding mercury 
as much as possible. My sheet-anchor has in all cases been the fre¬ 
quent employment of hot-water baths.” He suggests to those “ who 
hold that the specific action of mercury is absolutely necessary for the 
eradication of syphilis from the organism, to consult the works of 
Hughes, Bennet, Lancereaux, etc., for a list of observers, committees, 
or councils, that have declared in favor of the same treatment of syph¬ 
ilis.” The facts as shown by a large and increasing number of ob¬ 
servers with reference to this disease have proven that the use of mer¬ 
cury simply checks or obscures the symptoms of the disease. What 
is needed to effect a cure of this terrible malady, so far as a cure can 
be effected, is to aid nature in the process of eliminating the virile poi¬ 
son with which the system of those suffering from the disease is contam¬ 
inated. A drug which exercises upon the system such a powerfully 
depressing and poisonous influence as mercury can certainly render no 
assistance in this process. In fact, it diverts the attention of the life 
forces from the syphilitic poison to the mercurial poison, and in so do¬ 
ing checks the remedial process which nature sets up, and thus while 
checking the manifestations and symptoms of the disease, and so af¬ 
fording a false feeling of security on the part of the sufferer, only hides 
the malady, and postpones to a later period the terrible punishment 
which these sufferers must almost certainly undergo, and renders al¬ 
most certain its subsequent outbreak with greatly increased virulency, 
if not in the life of the individual himself, in that of his posterity. 
As we have elsewhere shown that there is a much more rational 
method of treating this disease, we need not delay further on the sub¬ 
ject in this connection. Before leaving the subject of mercury we 


700 


RATIONAL REMEDIES FOR DISEASE. 


should mention another fact which ought to he generally known, 
though we think it is not mentioned in works on poisons, that calomel, 
one of the mildest forms in which mercury is administered, if taken 
into the stomach in connection with chloride of sodium, or common 
salt, may, through chemical reaction with the salt, be converted into 
corrosive sublimate, a much more powerful poison, and may produce 
serious and fatal consequences. 

Iodine. —Iodine in its pure state occurs in crystalline scales, with 
a bluish metallic lustre. It is quite volatile, having an odor similar to 
. that of chlorine, and a very hot and acrid taste. At a temperature a 
little above that of boiling water it melts, and is converted into a beau¬ 
tiful purple or violet vapor. It has the peculiar property of turning 
starch blue, which effect Is made of practical utility as a test for this 
drug. That iodine is a powerful poison is shown by the fact that 
when given in any but very small doses it produces the effects of 
poisoning, such as ringing in the ears, salivation, vomiting, diarrhea, 
cutaneous eruptions, and palpitation of the heart, with great loss of 
flesh, sleeplessness, hypochondria, etc. When its use is continued a long 
time, though in small quantities, it produces atrophy, or wasting, of 
certain glands of the body, such as the breasts in the female and the 
testicles in the male. On account of its effect in producing absorption 
of tissue, it is often used for the treatment of abnormally enlarged 
glands and other growths, sometimes with the effect to occasion their 
disappearance. Iodine is much used in the later forms of syphilis, in 
which disease immense doses of the drug are sometimes taken. We 
have seen persons who were taking an ounce of the drug a day. This 
usually produces a skin eruption, but certainly has the effect to stop 
the progress of the morbid action, as when rapid ulceration is taking 
place, as in ulceration of the throat and the internal structures of the 
nose. We believe the drug to be of real service in some of these cases, 
as well as in certain cases in which morbid growths of a syphilitic 
character have taken place in the brain and produced serious inter¬ 
ference with the functions of that organ. In numerous cases it has 
been shown that through the administration of iodide of potassium 
marked cases of this sort have been cured, and it has thus been the 
means of saving life. When taken internally to cause the absorption 
of such growths as goiter, it produces absorption of the other glands 
mentioned as well as of the abnormal growth. It generally happens, 
also, that after the use of the remedy is discontinued the growth re- 


PHOSPHORIC ACID. 


707 


turns, but the natural glands which have been affected by it do not 
gain in size. Iodine is also of service in the treatment of some 
surgical cases, as hydrocele, cases of pleurisy in which effusion has 
taken place, and for injections into cavities from which pus has been 
drawn, to prevent its re-formation. 

Iodide of potash is said to be useful in chronic rheumatism and 
gout, but we have never seen any good from its use, and believe that 
these diseases can be treated far more successfully without it, as we 
have proven in numerous instances. 

Iodoform, a drug which is prepared by the action of iodine upon 
chloroform, has recently come into use to some extent, and from the 
opportunity we have had of testing it we think it to be a very useful 
agent. When sprinkled upon foul ulcers it has the effect to cleanse 
them, and so modifies their action as to enable healthy granulations to 
form and healing to take place. In cancer of the uterus, chronic 
uterine inflammation, and some other affections occurring in this region 
in females, we have found it very useful in relieving pain, correcting 
fetor, and apparently inducing a healthy action. We have found it 
useful also in relieving painful maladies where the patient was not 
willing to submit to an operation for a radical cure. 

Cod-Liver Oil also has been much praised as an alterative, but there 
is a great difference of opinion respecting its virtues. To the majority 
of persons it is nauseating, is frequently ejected from the stomach, and 
often causes indigestion together with looseness of the bowels. It is 
disposed of by the digestive organs with great difficulty, which ac¬ 
counts for these effects. We prefer to prescribe for persons who re¬ 
quire fatty matter in addition to what they receive with their food, 
sweet cream, which is the most easily assimilated of all forms of fat. 
Cod-liver oil has received much praise as a remedy for consumption 
on account of its supposed alterative effects, but it seems to us to be 
clearly proven that any other fat that can be easily assimilated can 
take its place without detriment whenever fatty elements are needed. 

Phosphoric Acid is a product which results from the burning of 
phosphorus in the air. It has also been much praised as an altera¬ 
tive. It is sometimes used in solution in the pure state, but more often 
in the form of what are termed phosphates, particularly phosphate of 
calcium. Many preparations of phosphates are offered for sale 
by druggists under a great variety of names, as “ chemical food,” 


70S RATIOXAL REMEDIES EOP. DISEASE. 

~compound syrup of phosphates, "phosphate of lime/' etc. There 
- -t> been much discussion as to the possibility of the ass India- 
tion of the thosphate of lime and other phosphates artificially pre¬ 
pared. Some very eminent physicians express the decided opinion 
that verr little if any <;f the preparations of phosphorus artificially 
ma ie are assimilate! when taken into the stomach. Ha.jar, an emi¬ 
nent German physician, claims to have shown this to be the case with 
rhosphate :t calcium, which is considered the most important and is 
the mist freely employed of all Applying the well-known principle 
of physiology, that animals can assimilate only organized matter, the 
assimila tion t m manic matter heint: c: tinned wholly to vegetables, 
there would seem to he no Ilthcnlty in settling the question of the 
asshmilati :n of artificially prepared phosphates. There are many per¬ 
sons however, who claim that the phosphates of lime. iron, and a few 
other mineral substances are exceptions to the general rule, though 
they offer no proof that snch is the case. The arguments against this 
theory are very strong, and. in ieed. they seem to us to be unanswera- 
"tle. mav - snmmtrim- . -as t— 

1. The fait that in ah of those cases in which phosphates are sup¬ 
pose! to re nee lei. the urine is loaded with phosphates, shows very 
clearly that the dim unity is not a deficiency in the supply of phos- 
7 hates in the system, but a deficient assimilation or continued loss of 
these elements. 

2 An a nr iart supply of phosphates is furnished in the food, and 
in a condition of such intimate combination with the other elements 
of food that absorption must take place with readiness. The amount 
of phosphates administered in the conditions supposed to require them 
is wholly made rate to supply the requirements of the system. In¬ 
deed. when compared with the amount fumishei in ordinary food, it 
is entirely insignificant. The most liberal prescription of phosphates 
would not exceed thirty or forty grains a day. while the amount of 
the salts taken in the food in a single dav is about ten times as much. 
If the diet consisted entirely of oatmeah 340 grains of the salts would 
be taken in one day. A proportionate uantity of meat would con¬ 
tain 37-i grains of the salts, while an e .uivalent amount of potatoes 
would fumish to the system 434 grains.—more than ten times the 
maximum amount of phosphates ever administered. But Dr Birger, 
of London, asserts that not more than three to six grains of the arti¬ 
ficial iy tt-tarei lime salts can be absorbed in twenty-four hours. 








PHOSPHORIC ACID. 


769 


consequently, the greater share of what ls administered in ordinary 
medicinal doses is wasted, and the comparison between the amount 
which can be received into the system as medicine, and the amount 
which can be received as food, becomes still more striking, the pro¬ 
portion being, according to this statement, one part of the artificial 

salts to from fiftv to one hundred and fiftv of the organic salts found 

• * ^ 

in the food. This view of the case certainly puts the matter in a 
somewhat ridiculous light, for it could not l*e considered any possible 
advantage to administer as a food, with a view to supplying a special 
want of the system, a substance which was already leing received in 
quantities more than one hundred times as great. 

3. Experiments which have teen made with the use of these salts 
furnish evidence that even so small an amount as that stated by Dr. 
Banger is not absorbed. The principal evidence is that the amount of 
phosphates discharged in the urine is not at all increased by their ad¬ 
ministration. even though larse quantities are given This observa¬ 
tion still further confirms the supposition that in cases in which the 
phosphates are wanting in the tissues the difficulty is faulty assimila¬ 
tion rather than a deficient supply, at lea^t in a great majority of 
cases. It may be further objected to the common use of phosphates 
that they are injurious on account of their interference with the func¬ 
tions of -digestion. This serious influence of phosphates upjn digestion 
is so well recognized that eminent writers upon therapeutics give 
warning against their too frequent use. It should l:e also stated that 
when used in the large quantities in which they are frequently taken 
they sometimes form concretions in the lowed. and so occasion seldom 
injury. 

The only argument in favor of the use of phosphates is that their 
use seems to be followed in many cases by improvement in the condi¬ 
tions for which they are administered, whether they are remedial or 
not. It may be said in answer to this argument, in this case as in the 
case of many other drugs, that it must be very difficult to decide- 
whether the improvement observed as the result of the phosphates is 
independent of them, or is in spite of them. Those who contend that 
phosphates are not absorbed in the blood at all or in so small a degree 
as to produce wholly inappreciable effects, ascribe the benefit which 
>eems to follow their Use to the improved hyinene which is, or at least 
should be. in all cases prescribed with them. In the experiments of 
French physiologists it was found that animals died when fed upon 
food which had been deprived of its natural salt'. 

49 





770 


RATIONAL REMEDIES FOR DISEASE. 


Colcllicum. —This drug is obtained from the roots and seeds of the 
meadow saffron, a small plant growing in Europe. The preparation 
usually employed is what is known as the wine of colchicum, prepared 
from the root. This drug is usually considered to be a specific for 
.gout, for which it is more used than for any other purpose. There is 
no doubt that when taken by persons suffering with attacks of gout it 
will frequently relieve painful symptoms in a very short time. That 
it does not cure gout, however, is sufficiently evidenced by the fact 
that thousands of people continue to suffer from it notwithstanding 
their continued use of colchicum. If it were a specific, it should effect 
a cure instead of mere palliation. It was formerly supposed that 
colchicum afforded relief from the gout by exciting the kidneys to in¬ 
creased elimination of uric acid. There have been, however, so many 
observations by competent observers showing that the drug has no 
such effect, rather diminishing than increasing the amount of uric acid 
contained in the urine, that the so-called action of the drug can no 
longer be explained by this theory. Dr. Ringer, in his celebrated work 
on therapeutics, says that colchicum does not in any way affect the 
condition on which gout depends, and hence “ is merely a palliative, re¬ 
moving for the time the patient’s suffering, but, as experience abun¬ 
dantly proves, in no way protecting him from a recurrence of the at¬ 
tack ; for it is on all hands accepted that colchicum is inoperative to 
prevent the return of the attack; nay, many who suffer from it are 
of the opinion that while the medicine removes altogether the existing 
attack it insures the speedy return of another. Hence, gout-ridden 
people generally advise their fellow-sufferers to abstain from the use of 
colchicum.” 

It is a very irritating drug, and when taken in any but small 
quantities, produces the most violent irritation of the mucous mem¬ 
brane. It has been used in rheumatism as well as gout, especially in 
the chronic form, but there is still less evidence of its utility in this 
disease than in gout. We see no reason for its employment when 
there are other remedies, the superior efficacy of which is so well ad¬ 
mitted, as elsewhere shown. 

Sarsaparilla. —This much-used drug is the root of smilax, a little 
vine native of Mexico and northern portions of South America. It 
has been long and widely used as a “ blood-purifier ” in scrofula, syph¬ 
ilis, and other diseases in which the blood has been supposed to require 
purification. It also at one time enjoyed great reputation as a remedy 


LOCAL REMEDIES. 


771 


for cancer. Very extensive investigations respecting its effect upon 
the system have shown, however, that its medical properties are very 
slight indeed, if it is not entirely neutral. The only effects which fol¬ 
low very large doses of a decoction of the root are slight disturbances 
of the stomach. It has been supposed to excite the action of the kid¬ 
neys and skin, but experiments show that this is not the case; and, so 
far as scientific evidence goes, the probability seems to be that it is 
wholly destitute of medicinal properties. It is claimed, however, not¬ 
withstanding the negative results obtained by experiment, that its use 
in the treatment of such diseases as chronic syphilis and scrofula in¬ 
dicates that in some mysterious way it favorably affects the system in 
these morbid conditions. But from all that we have been able to 
learn of its effects even in these diseases, it seems to us very prob¬ 
able that the beneficial results obtained when it has been employed 
alone, in such a way as to afford an opportunity of judging of its ef¬ 
fects, have been due either to the absence of powerful and depressing 
drugs, to improved hygiene, or to the vis medicatrix naturae. 

Sassafras, Taraxacum, etc. —The bark from the root of the sassa¬ 
fras tree, the root of the common dandelion, and quite a number of 
other common barks and roots, are popularly supposed to possess al¬ 
terative properties. For this purpose they are very largely used. 
The evidence of any such fact is, however, of an exceedingly doubt¬ 
ful character. Prof. Wood, of Philadelphia, in his “ Materia Medica,” 
says with reference to dandelion that “ no effect is to be witnessed 
from a single dose of the drug however large, other at least than some 
nausea.” With reference to the diuretic properties which this drug is 
popularly supposed to possess, he says, “ The only evidence brought for¬ 
ward to establish this is the vulgar name which the plant bears both 
in English and in French.” Perhaps the best that can be said of these 
drugs is that they would not be likely to do any very great harm, al¬ 
though only an equal amount of benefit can be expected from them. 

LOCAL REMEDIES. 

The drugs thus far mentioned are those which are supposed to oc¬ 
casion systemic effects. We will now consider in a somewhat brief 
manner the particular drugs to which are attributed local effects. 

Astringents. —Astringents are of two classes,—vegetable and min¬ 
eral. Vegetable astringents comprise ta,nnic and gallic acids, oak 


RATIONAL REMEDIES FOR DISEASE. 


772 

bark, rose, geranium, blackberry root, persimmon, etc. Mineral as¬ 
tringents comprise the alums, sulphate of aluminum, various com¬ 
pounds of lead, bismuth and its preparations, zinc and its compounds, 
cadmium, copper, silver, and other preparations. 

These drugs are called astringents because when applied to living 
tissues they occasion contraction. This has by some been supposed to 
be due to the coagulation of albumen ; by others, to the contraction of 
the muscular fibres; but facts do not seem to support either theory. 
No doubt the real truth is, in this case as in the case of the other 
drugs, the action of which we have examined, that whatever action is 
exerted takes place upon the part of the living tissues and not upon 
the part of the agent employed to produce the action, the peculiar 
character of the action in different cases being wholly due to the dif¬ 
ferent ways in which various agents are recognized by the tissues. 
The essential element in all vegetable astringents is tannic acid. It 
occurs as a light, feathery powder of a light yellowish color and some¬ 
what bitter taste. When absolutely pure, however, it is colorless and 
free from all odor and taste other than that of astringency. It 
dissolves readily in water, but is still more freely soluble in glycerine. 
It combines with various vegetable alkaloids, which makes it a very 
useful agent in cases of poisoning from morphia, strychnia, and all the 
other poisonous alkaloids. When combined with iron it forms a black 
compound, to which is due its utility in the manufacture of ink. It 
coagulates white of egg, or albumen in any other form, on account of 
which it cannot be absorbed into the blood in any appreciable 
quantity. 

As the effects of tannic and gallic acids, and various substances 
which contain them, are entirely local, they are very useful agents in 
treating a variety of morbid conditions. For example, they may be 
used to cause contraction of the tissues in spongy gums, in hemorrhoids, 
in chronic sore throat, or pharyngitis, in which the tissues are very much 
relaxed and the blood-vessels dilated. Tannic acid is also useful in the 
treatment of hemorrhage when the source of bleeding cannot be reached, 
as in hematemesis, or bloody vomiting, hemorrhage from the bowels, etc. 
It is used to diminish morbid secretions, as in diarrhea, chronic looseness 
of the bowels, excessive sweating, and various diseases of the skin. It is 
also very properly used, often with marked benefit, for the purpose of 
hardening parts which are exposed to friction or pressure, as the under 
parts of the body in patients who are long confined in bed and unable 


to move themselves. It is very largely and usefully employed in the 
treatment of many local diseases peculiar to women. 

Tannic acid is one of the best remedies for poisoning with tartar 
emetic, as it forms with the antimony an insoluble compound. When 
it is to be administered internally it should be given in doses of from 
three to five grains, either in pills or in capsules. When its astringent 
properties are desired to act on the intestines, or when given for hem¬ 
orrhage from the stomach, it should be*in a powder in doses of from ten 
to twenty grains. For external application the best preparation is a so¬ 
lution of tannin in glycerine, in the proportion of one part of tannin to 
four of glycerine. This may be applied as required for the purpose of 
lessening seci*etion, as in leuchorrhea and chronic ulcers. A decoction of 
the bark of the white and black oaks is often used as an astringent for 

O 

external local applications, but their efficacy is wholly due to the tannic 

acid which thev contain. 

%/ 

Alum. —There are two varieties of alum used in medicine, potash 
alum, and ammonia alum. The latter, being cheaper, is the most com¬ 
mon. Their properties are identical. What is known as burnt alum is 
the white powder obtained by heating the drug until the water of 
crystallization which it contains is driven off. It is soluble in either 
form in very cold water. When applied to the tissues it acts as a 
very powerful astringent and irritant. This property is illustrated by 
its effect upon the mucous membrane of the mouth, with which every 
one is familiar. It may be used with good effect to arrest slight hem¬ 
orrhage when the seat of the hemorrhage can be reached. In cases of 
bleeding from the lungs, a saturated solution should be inhaled by means 
of an atomizer. It is very frequently used for mouth-washes and for 
gargles for sore throat, but it should never be thus employed, as it has a 
very destructive action on the teeth. Sponging with alum-water is a 
very useful means of arresting the night-sweats of consumptives. It 
may also be usefully employed in the treatment of chronic ulcers. 
In the form of burnt alum it is particularly beneficial in those cases in 
which granulations are exuberant. It is also a good antidote in lead 
poisoning before the lead salt has been formed, as it precipitates the lead 
in an insoluble form. 

Sulphate of aluminum has similar properties to those of alum. 

Lead.—The soluble compounds of lead in weak solution are quite 
powerful astringents, and hence they may be usefully employed as ex¬ 
ternal applications, if better means are not at hand. All the soluble 


774 


RATIONAL REMEDIES FOR DISEASE. 


compounds of lead are, however, exceedingly poisonous in character, and 
poisoning from their reception into the system is the most common of 
all forms of poisoning. Lead poisoning occurs most frequently in those 
whose occupation exposes them to its influence, as persons engaged in 
the manufacture of white lead, painters, and other laborers w T ho employ 
it largely in their work. Poisoning also occurs very frequently through 
the medium of water which is contaminated by passing through lead 
pipes, or by standing in lead-lined tanks. Food is also frequently con¬ 
taminated in the same manner by cooking in tin-lined vessels, in which 
the tin is adulterated with lead, or by standing in vessels made of the 
same kind of tin, as in the case of milk. There is good evidence for be¬ 
lieving, also, that poisoning not infrequently occurs from the use of 
fruits and vegetables which have been put up in tin cans made of lead 
tin. Cases have been observed, also, in which lead poisoning has oc¬ 
curred from cooking in certain kinds of enameled vessels, in which lead 
was used in the enamel. The effects of lead poisoning are not infre¬ 
quently seen as the result of the use of cosmetics and hair-dyes, which 
very frequently contain the salts of this metal. We have met several 
instances of this sort in which the effects were very severe. The symp¬ 
toms of lead poisoning and its proper treatment will be described 
elsewhere. 

The symptoms of chronic lead poisoning are generally as follows: 
The patient first has slight colicky pains, which after some days increase 
in intensity, being sometimes dull, at other times sharp. They are gen¬ 
erally located around the umbilicus, often accompanied with severe retch¬ 
ing and vomiting. The bowels are costive, the tongue has a white coat, 
there is great thirst, and usually no appetite. Sometimes there is also 
severe headache with delirium and occasionally convulsions, similar to 
those noticed in epilepsy. One of the most common effects on the nervous 
system is paralysis of the extensor muscles of the fore-arm which allows 
the wrist to drop, whence it is known as “ wrist-drop.” Persons some¬ 
times become cross-eyed under the influence of the drug, from paralysis 
of the external rectus muscle of the eye. One of the most characteristic 
symptoms, and one which is always looked for, is a blue line on the edge 
of the gums where they join the teeth, which is almost invariably found 
in cases of lead poisoning. The best remedies for lead poisoning with 
which we are acquainted are the Turkish and electro-thermal baths, the 
latter of which is found to be particularly advantageous, especially 
when the primary or galvanic current is employed. By means of elec- 


EMETICS. 


(to 


tricity, all of the indications for treatment are met: First, the poison is 
eliminated from the system by the eliminative effect of the warm bath, 
and the electrolytic effect of the electricity; second, the paralysis result¬ 
ing from the disease is relieved, and most successfully treated, by this 
means, as the exhausted vital forces of the patient are re-invigorated by 
this powerful tonic. 

Nitrate of lead is an excellent disinfectant. 

Bismuth, by which is understood the sub-nitrate or sub-carbonate,, 
is much used in vomiting due to an irritable condition of the stomach 
in neuralgia and cancer of the stomach, in pyrosis, or water-brash, in 
acute and chronic diarrhea, and in various other complaints. Though 
often used in very large doses with apparently no injurious effect, the 
use of this drug is sometimes followed by the most poisonous and even 
fatal results, which are supposed to be due to the compounds of arsenic 
which it is very apt to contain. 

Of the other metallic astringents, sulphate of copper and nitrate of 

silver are the most useful. They may frequently be employed with 

signal service in the treatment of chronic and obstinate ulcerated sur- 
© 

faces. 

Emetics. —This class includes all substances which, when admin¬ 
istered by the stomach or otherwise, induce vomiting. The mechanism 

of vomiting has been elsewhere described. 

© 

The principal drugs employed for the purpose of inducing vomit¬ 
ing are ipecacuanha, apomorphia. mustard flour, tartar emetic, sul¬ 
phate of zinc, and common salt. 

Ipecacuanha. —The ordinary dose of ipecacuanha is from five to 
thirty grains every fifteen to thirty minutes, administered in a powder. 
A smaller dose should be used for children. The most pleasant form 
for administration is the syrup, of which an emetic dose for a child is 
from one to two teaspoonfuls. 

Apomorphia is a drug prepared from morphia. This drug has 
the curious property of producing vomiting by the injection of an ex¬ 
ceedingly small quantity under the skin. The dose required is from 
one-fifteenth to one-tenth of a grain. 

Mustard Flour also is used as an emetic, especially in emergencies 
from narcotic poisoning. The required dose is a heaping dessert spoon¬ 
ful in half a pint of warm water repeated every ten or fifteen minutes, 
if vomiting does not occur. 


776 


RATIONAL REMEDIES FOR DISEASE. 


Tartar Emetic has been much used to produce nausea and vomit¬ 
ing. It is a very powerful drug, as the nausea produced by it remains 
for a long time and the vomiting is often violent. Its use is rarely, if 
ever, really necessary. 

Sulphate of Ziuc is much milder in its effects, as it occasions but 
little irritation. It may be given in doses of from twenty to thirty 
grains in cases of narcotic jDoisoning. 

Salt .—A teaspoonful of salt in a pint of warm water, followed by 
copious warm water drinking and tickling of the throat, is an excellent 
means of exciting vomiting. Copious warm water drinking and tick¬ 
ling of the throat with a feather or the linger will also aid the effect 
of other emetics and secure the desired result with smaller doses than 
would otherwise be required. We have known of several instances in 
which physicians have given one emetic after another without effect 
until nearly the whole list of emetic substances had been swallowed, 
relief being obtained only when the patient was directed to take copi¬ 
ous draughts of warm water. 

O 

Cathartics. —All drugs which occasion an increased activity of the 
bowels are termed cathartics, or purgatives. The effect produced by 
them is called purgation, or catharsis. The mode of action of cathar¬ 
tics has been the subject of much discussion. However their effects 
may be produced, they are in all cases due to the effort of the system 
to rid itself of the irritating and obnoxious substance employed. Pur¬ 
gative medicines are classified as follows: First, laxatives, which simply 
unload the bowels; second, purges, which produce active purgation 
but do not act as poisons even in large quantities ; third, hydragogues, 
which cause large watery discharges without producing irritation even 
in large doses; fourth, drastics, which cause great irritation of the 
intestinal mucous membrane, and in large doses are violent poisons. 
‘The principal laxatives employed are the following:— 

Laxative Food. —Bulky food, that is, that which contains a con¬ 
siderable proportion of innutritious matter in the form of cellular or 
woody tissue, produces free and loose discharges from the bowels, while 
■concentrated food produces constipation. It is well known that car¬ 
nivorous animals, whose food is concentrated, are nearly always consti¬ 
pated, while the opposite is the case with herbivorous animals. So, 
also, line wheat flour, meats, and other concentrated articles of diet, 
produce constipation in man, while cracked wheat, graham flour, oat- 


CATHARTICS. 


777 


meal, Indian meal, and, in fact, the unbolted meal of all the grains, oc¬ 
casion a loose condition of the bowels. The same may be said of most 
acid fruits, as apples, pears, lemons, and particularly dried fruits. 
Milk is one of the most constipating of all articles of diet, a fact which 
renders it for some people an unwholesome article of food. 

Manna, the juice of the European ash, is a very gentle laxative 
when taken in large doses. It has a sweetish taste and is closely allied 
in its composition to sugar. For an adult, a dose of from half an 
ounce to two ounces is required to produce a laxative effect. For a 
child, four drachms should be taken in water. 

Carbonate of Magnesia is another very mild laxative. It is fre¬ 
quently employed by persons who habitually suffer with acid dyspep¬ 
sia, and is used as much to relieve acidity as for its laxative effects. 
It is taken in large doses of from half a drachm to half an ounce. This 
use of the drug, however, is often very injurious, since it not infre¬ 
quently accumulates in the intestines, causing large concreted masses. 

Sulphur is also very frequently used as a laxative, but it is much 
more commonly employed in certain skin diseases, particularly para¬ 
sitical diseases. It is a well-known remedy for scabies, the disease com¬ 
monly known as the “ itch.” It is also frequently used in the form of 
sulphur vapor, both in chronic rheumatism and other diseases in which 
it is thought to have an alterative effect. Not infrequently, however, 
when applied to the skin in the form of ointments it produces eruptions. 

By the above-named remedies a gentle action of the bowels may be 
induced, which is not usually followed by any unpleasant effects; but 
when any vigorous action is desired, castor oil, rhubarb, senna, sulphate 
of magnesia, or Epsom salts, sulphate of sodium, Rochelle salt, jalap, 
colocynth, podophyllum, elaterium, gamboge, Croton oil, and a few 
other substances may be employed. Some of these produce a very 
violent action of the bowels with copious discharges, as is the case 
with Croton oil, while others operate much less severely. We give no 
directions for the use of these more powerful cathartics, since the in¬ 
jury which may result from their use is so great that the risk should 
never be incurred by non-professional persons. 

In our opinion, few classes of drugs are more abused than this. 
While there are cases in which the speedy and thorough action obtain¬ 
able by the use of cathartics is very useful, yet the habitual employ¬ 
ment of these powerful irritants to the digestive organs is attended 


RATIONAL REMEDIES FOR DISEASE. 


O 

/ /» 

with the most disastrous results. When employed in the treatment of 
constipation they almost invariably aggravate the very condition 
which they are employed to remedy. When long continued, they with 
almost equal certainty produce serious impairment of the digestive or¬ 
gans. The very common practice of taking a dose of salts whenever 
there is irregularity of the bowels or a condition usually termed “ bil¬ 
iousness,” supposed to be due to the inactive condition of the liver, 
has a most pernicious effect. It will not be denied that in many cases 
the operation of the remedy is followed by apparent relief, and yet the 
relief is of the most temporary character and is generally obtained at 
the expense of the exaggeration of the very conditions which gave rise 
to the unpleasant symptoms in the first place. 

The popular supposition, common among physicians as well as non¬ 
professional persons, that cathartics give relief by increasing the activity 
of the liver, seems to be wholly without foundation, since it has been 
shown by a committee appointed to investigate the subject, with the em¬ 
inent Dr. Bennett of Edinburgh at its head, that cathartics have no in¬ 
fluence whatever to increase the activity of the liver, but, on the con¬ 
trary, diminish the amount of bile secreted. They undoubtedly often 
occasion an increased appearance of bile in the discharges, but this ap¬ 
pearance has been proven to be deceptive, and it has been clearly shown 
that the amount of bile secreted in twenty-four hours while the system 
is under the influence of a cathartic is actually less than is produced at 
other times. The only apology which can now be offered for the use of 
cathartics is that they produce a necessary depletion, which simply means 
that they destroy a portion of the person’s vitality, a fact which cannot 
be desirable under any circumstances, since what is needed in the treat¬ 
ment of disease and morbid conditions is the economizing and saving of 
vitality rather than its reckless waste. 

Fatal injury has often been done in the employment of cathartics for 
the relaxation of the bowels when intussusception or some other form of 
mechanical obstruction has been mistaken for simple constipation of the 
bowels. There is no doubt whatever but that violent cathartics may be 
wholly dispensed with in the treatment of disease, provided that the 
numerous other means of securing activity of the bowels are made use 
of, such as massage, copious water-drinking, the use of electricity, Swed¬ 
ish Movements, revulsive applications to the abdomen, stimulant applica¬ 
tions to the spine, etc. 


DIURETICS. 


77 D 

The Enema. —For at least nineteen-twentieths of all ,the cases in 
which cathartics arc employed, warm-water enemata would fulfill all 
the conditions much better. With reference to the use of cathartics, Dr. 
Wood says that “ it cannot be doubted that the use of purgatives in such 
diseases as fevers and cholera, with the idea of eliminating some of the 
materies morbi, rests simply upon a crude, unproven, and probably false, 
pathology.’’ The same reasoning may be applied to the common use of 
cathartics as a means of purifying the blood. Perhaps the most useful 
service which can be derived from cathartic drugs is the removal of in¬ 
testinal parasites, particularly tape-worm and round-worms. For tape¬ 
worm they are useful by producing such violent contractions of the 
intestinal walls as to loosen the grasp of the worm, or, after it has been 
induced, to let go its hold, through the action of some other drug, to ex¬ 
pel it from the intestine before it has had time to renew its grasp upon 
the mucous membrane. Directions for their use for this purpose will be 
found under the head of “ Anthelmintics.” 

Diuretics. —The principal drugs represented to be useful for this 
purpose are squills, digitalis, sweet spirits of nitre, potash and its prep¬ 
arations, buchu, uva ursi, turpentine, cubebs, and cantharides. 

When taken into the system, these drugs are recognized by the kid¬ 
neys as elements which cannot be used and are likely to do harm, and 
so are removed by them as quickly as possible, by which means the 
amount of urine is largely increased. Incidentally, of course, urea and 
the other excrementitious principles found in the urine are also elimi¬ 
nated, but the principal object of the increased elimination of urine seems 
to be to get rid of the diuretic itself. Diuretics are used for five dis- 
tinct purposes :— 

First, in cases of functional inactivity of the kidneys, to stimulate 
thoseorgans to increased action for the purpose of eliminating urea and 
other poisonous elements which are naturally removed by the kidneys; 
second, to remove superabundant fluids from the body, as in dropsy; 
third, to diminish the irritating effects of morbid urine upon the bladder 
and other urinary organs, by increasing the quantity of urine by dilu¬ 
tion ; fourth, to apply medicines of supposed specific virtues to the blad¬ 
der and urinary passages in certain diseases of those parts; fifth, to 
change the character of the urine in such a way as to prevent the 
formation of calculi. 

That all of these effects can be produced by the action of diuretics is 
unquestioned, since if it were not the case their use would have been 


780 


RATIONAL REMEDIES FOR DISEASE. 


abandoned loner aero. However, in connection with each one of these 
uses of diuretics there are several considerations of importance to which 
we invite attention. 

First, we will notice their effect in maintaining the action of the 
kidneys. The results obtained by the use of diuretics for this purpose 
are very uncertain. For instance, when the secretion of the kidneys is 
checked on account of intense congestion, it is evident that the adminis¬ 
tration of diuretics can be of no use. The kidneys already contain too 
much blood and have more work imposed upon them than they are able 
to perform, and to administer diuretics is to put upon them a still heav¬ 
ier burden and to render them still more incapable of performing their 
proper functions. The same remarks apply to the condition of the kid¬ 
neys found in acute inflammation. The delicate tubules with which 
these organs are filled, the purpose of which is to convey away the excre¬ 
tion, are in inflammation filled with the results of the inflammatory 
process so that the urine which is formed is dammed backed, and the 
organs thus become clogged. To increase the irritating qualities of the 
urine under these circumstances by the use of diuretics, cannot be other¬ 
wise than harmful. Yet, strangely enough, it is under these very con¬ 
ditions that diuretics are most often employed and persistently applied. 
The futility of such efforts has not infrequently been shown by the 
rapid improvement of the patient when the agents mentioned are dis¬ 
continued. Dr. Austin Flint, Sr., president of the Academy of Medicine 
in New York, reported to that body, a few years ago, a case of inflam¬ 
mation of the kidneys which occurred at Bellevue Hospital, in which, 
after the failure of all other means to produce a free evacuation of urine 
and when the case had been virtually abandoned, the patient was al¬ 
lowed to satisfy his desire for fluids by drinking as freely as he chose, 
with the result of producing immediate improvement in the symptoms. 
By a continuance of the same measure, which was encouraged when its 
good effects were seen, ultimate recovery was secured. 

Second, diuretics are much used for the purpose of causing absorp¬ 
tion of the liquid which has been accumulating in the tissues or in va¬ 
rious cavities of the body, as in abdominal dropsy, dropsy of the chest, 
and anasarca, or general dropsy. While temporary benefit is not in¬ 
frequently obtained in this way, the measure cannot be considered in 
any way curative, since it does not reach the cause of the malady, and 
must, in some degree at least, lessen the chances for recovery by low¬ 
ering the vitality of the patient and especially by impairing the func- 


THE USE OF DIURETICS. 


781 


tions, at least when long continued, of so important organs as the kid¬ 
neys. Abdominal dropsy is very often the result of disease of the 
liver in which the function of this organ is very greatly impaired. 
This, of course, very naturally imposes an extra degree of labor on the 
kidneys, which are obliged to act, in some degree at least, vicariously 
for the disabled organ. If in this state of things the kidneys are 
overstimulated by diuretics, it is evident that the result in the long 
run must be disastrous, since from continued stimulation the kidneys 
will greatly lose their natural tone, and so become less able to perform 
the extra labor which is demanded of them. 

It seems to us that the most rational method, both in this class of 
cases and the preceding, is to facilitate the function of the kidneys 
rather than to compel them to do more work without increasing their 
facility for performing their peculiar functions. In the first class of 
cases, as already intimated, this may be best accomplished by increas¬ 
ing the amount of fluid in the blood and thus largely diluting the poi¬ 
sonous elements which it is the function of the kidneys to separate 
from the blood, and so rendering the work of elimination easier. In 
the second class of cases, where superabundant fluid is to be gotten rid 
of, our experience has been that the work can be much better accom¬ 
plished, and with far less injury to the system, by increasing the activ¬ 
ity of the skin than by overstimulating the kidneys. This may be 
easily done by the use of hot-air baths, Turkish baths, packs, and a 
great variety of other means of producing increased perspiration. By 
this means a large portion of the urea which the kidneys usually elim¬ 
inate will be removed through the skin, and the kidneys will then be 
able to render the liver much greater aid in the elimination of the poi¬ 
sons which are usually eliminated by it, but which may also be sepa¬ 
rated from the blood by the kidneys, and in a slight degree by the skin. 

Third, in the use of diuretics for the purpose of soothing and di¬ 
minishing the irritation of the urinary and genital organs, the desired 
effect is usually obtained almost wholly, if not entirely, from the sim¬ 
ple dilution of the urine, as already shown. This can be effected bet¬ 
ter by the copious drinking of water than by any other means, espe¬ 
cially of very cold water, as elsewhere shown. It ought perhaps to be 
mentioned also that in cases where the irritation is due to abnormal 
acidity of the urine this condition may be removed by the regulation 
of the diet. 

Fourth, the application of drugs to the genito-urinary organs 


782 


RATIONAL REMEDIES FOR DISEASE. 


through the urine is certainly a very roundabout method of medica¬ 
tion. We have never found difficulty in accomplishing all that was 
required in the way of local medication by applying the remedies indi¬ 
cated directly to the organs themselves rather than medicating the 
whole system before reaching them. 

Fifth, although great claims have been made for the efficacy of cer¬ 
tain drugs in preventing the formation of urinary calculi or in dissolving 
the calculi after they are formed, no satisfactory evidence has yet been 
offered that any drug possesses properties of this sort. We may per¬ 
haps make an exception in the case of uric acid deposits, which are, in 
some degree at least, restricted by the use of potash. Experiments 
which we have made in cases in which there was a very abundant de¬ 
posit of uric acid with the use of diet in meeting this condition satisfy 
us that we can with safety say at least that the use of diuretics is not 
the only means of accomplishing this result. The conclusion of the 
whole matter seems to be that of all diuretics pure water is pre-emi¬ 
nently the most useful, and that by its use, together with the proper 
regulation of the diet, most of the indications for the use of diuretics 
can be fulfilled. We have met with many cases in which great harm 
had resulted from the long-continued use of diuretics, and we are con¬ 
vinced from observation that the amount of injury thus done is much 
greater than is generally supposed. Indeed, it is possible that the 
very extensive employment of diuretics may be one of the causes of the 
notorious frequency of kidney diseases among the American people. 

Diaphoretics. —The drugs known by this name are those which 
excite an increased activity of the skin. In addition to nauseating 
and refrigerating diaphoretics, the principal employed are jaborandi, 
spirit of mindererus, siveet spirit of nitre, and alcohol. . 

Diaphoretics are supposed to produce their effects in four different 
ways:— 

First, by relaxation of the blood-vessels of the skin, as from the 
use of nauseating remedies, such as tartar emetic and ipecacuanha. 
This result is undoubtedly obtained from the effects of these sub¬ 
stances upon the nervous system. Any drug which produces nausea 
may have this result. Relaxation of the circulation in the skin may 
also be produced in a most effective manner by the employment of 
either dry or moist heat, as in the hot-air, vapor, Russian, and Turkish 
baths, together with the warm-water bath and the wet-sheet pack. 

Second, by diminishing the rapidity of the circulation and thus de- 


OBJECT OF DIAPHORETICS. 


creasing the amount of blood passing through the skin. In fever the 
skin is often so congested that the activity of the perspiratory glands 
is interfered with, as in congestion of the liver, kidneys, and other 
excreting organs. Certain drugs, by diminishing the amount of 
blood circulating in the skin, cause perspiration. These are called re¬ 
frigerant diaphoretics. Those commonly employed are aconite, vera- 
trum viride, and the other drugs which have been mentioned as 
cardiac sedatives. Citrate of potash is often used for this purpose. 

Third, by directly exciting the action of the perspiratory glands. 
This is accomplished by means of drugs which are chiefly eliminated 
by these glands. The action of the perspiratory glands is also power¬ 
fully excited by means of moist or dry heat as applied by the means 
already mentioned. 

Fourth, the activity of the skin may be increased by the copious 
drinking of pure water or beverages in which it is the chief constitu¬ 
ent. The diaphoretic effects are best induced by means of warm or 
hot water. In order to secure free perspiration it is best for the pa¬ 
tient, after drinking freely, to be covered up warm in bed. 

The objects to be secured in the use of diaphoretics are, according 
to the best authorities, substantially as follows:— 

First, to arrest diseases not very serious in character when just be¬ 
ginning. This is probably accomplished by causing a flow of blood to 
the surface, and so relieving internal congestion. The results of 
checked perspiration and of exposure to cold, such as a general “ cold,” 
muscular rheumatism, suppressed menstruation, and similar affections, 
may often be readily relieved in this way. We would suggest that 
no other means of producing diaphoresis for this purpose is so effect¬ 
ive as heat combined with copious water-drinking 

Second, diaphoretics are useful to produce absorption. For this pur¬ 
pose they are especially employed in dropsy. With reference to the em¬ 
ployment of diaphoretics. Dr. Wood very truthfully remarks as follows : 
<r None of the medicinal diaphoretics are of sufficient power to he relied 
upon in dropsy: in order to reduce the effusion, the Turkish, Russian, 
or hot-water bath must be vigorously employed.” By this remark it is 
clearly seen that the remedies mentioned are pre-eminent above all others 
as diaphoretics. 

Third, diaphoretics are very serviceable in hastening the subsidence 
of diseases which naturally pass off with a sweat. For this purpose they 
are chiefly employed in malarial fevers, especially in ague in those cases 


784 


RATIONAL REMEDIES FOR DISEASE. 


in which the sweating stage is not wholly developed. In these cases the 
wet-sheet pack is, on the whole, far superior to any other agent with 
which we are acquainted. It is stated that pilo-carpine, a drug recently 
introduced into practice, will, in many cases, when injected under 
the skin, interrupt the paroxysm, if administered after the chill is be¬ 
gun, by exciting profuse diaphoresis. Cold sponging is also exceedingly 
useful in the fever stage of the ague paroxysm, hastening diaphoresis by 
relieving the intense congestion of the skin. 

Fourth, diaphoretics are useful in aiding the elimination of poisonous 
elements from the blood. There is no doubt, that, by exciting the action 
of the skin, retained secretions may be rapidly eliminated. By this means 
the blood may be purified from waste products which are frequently a 
cause of disease. This mode of treatment is especially advantageous in 
cases in which there is great inactivity of the kidneys and liver. The 
amount of urea excreted by the skin when the kidneys are inactive has 
been shown to be very great. So large a quantity has been secreted in 
some cases that it has appeared upon the skin as a crystalline powder. 
A case has also been reported in which uric acid has appeared upon the 
beard in such abundance as to give it a frosty appearance. It has also 
been shown that in cases of jaundice the excrementitious elements of the 
bile are contained in the perspiration. This fact points very clearly to 
the great importance of employing the most effective diaphoretic meas¬ 
ures in all cases in which there Is marked inactivity of the liver or kid¬ 
neys or a generally inactive condition of all the excretory functions. It 
should always be recollected that profuse diaphoresis usually leaves the 
skin in a relaxed condition, which renders the person liable to contract 
cold on account of the diminished tone of the superficial blood-vessels. 
This danger may be in a large degree obviated by anointing the skin 
with almond oil, vaseline, or any other fine unguent. 

Expectorants. —These are medicines which are supposed to modify 
the secretions of the mucous membranes of the lungs and respiratory 
passages. There are chiefly two classes, known as nauseating expecto¬ 
rants and stimulating expectorants, the effects of which are quite oppo¬ 
site in character. 

Nauseating expectorants are commonly employed in acute stages 
of inflammation of the air-passages in which the activity of the blood¬ 
vessels is so great as to prevent secretion, thus giving rise to very un¬ 
pleasant dryness and irritation, the result of which is generally violent 
but ineffectual coughing. By the administration of ipecac, tartar 
emetic, or lobelia, the three nauseating expectorants commonly em- 


EXPECTORANTS. 


785 


ployed, the action of the blood-vessels will be so depressed, from their 
influence upon the nervous system, that secretion may take place, and 
thus the suffering of the patient will be palliated. 

Stimulating expectorants produce varying effects. Some of them in¬ 
crease the secretion of the respiratory mucous membrane, while others 
lessen a too profuse secretion. The stimulating expectorants commonly 
employed are chloride of ammonium, seneka, ammoniac, balsam of 
Peru, balsam of Tolu, benzoin, squill, and tar. 

The use of nauseating expectorants, as might be readily supposed, 
produces a very profound effect upon the general system, and is conse¬ 
quently a very depressing mode of treatment. We have seen cases in 
which we were satisfied that the patient’s life had been sacrificed by the 
use of tartar emetic and ipecac. In our opinion, these remedies can be 
dispensed with without diminishing the number of useful remedies, since 
there are other modes of removing congestion of the respiratory tract 
which are far more effective, such, for instance, as the warm-blanket 
pack, which in the acute capillary bronchitis of children produces such 
magic effects as to be considered almost a specific. We know it to be 
a fact that many eminent physicians are dependent on this remedy al¬ 
most altogether in the treatment of this disease, which of all others would 
seem to require prompt relief of the congestion of the mucous membrane. 
Fomentations to the chest and the prolonged chest compress are agents 
of no small value. We have frequently employed, in relieving the con¬ 
dition for which nauseating expectorants are commonly prescribed, hot. 
applications to the chest combined with cold applications to the spine be¬ 
tween the shoulders, and have, by this means, often secured almost, 
marvelous results. Indeed, we have never been disappointed in its use 
in congestion of the pulmonary mucous membrane. All the good results 
which can be obtained from the use of the stimulating diaphoretics men¬ 
tioned can be secured much more promptly, and in a much greater de¬ 
gree, by local applications to the diseased membranes by means of inhala¬ 
tion in the form of atomized spray. The most useful for this purpose 
are chloride of ammonium, benzoin, balsam of Peru, balsam of Tolu, 
tar, creosote, carbolic acid, and pure water. In many cases in which 
nauseating diaphoretics are employed, inhalation of pure water in an at¬ 
omized state will frequently afford the greatest relief. For the use of 
various stimulating diaphoretics by inhalation, the reader may consult 
the article on inhalations. 

50 


78(3 RATIONAL REMEDIES FOR DISEASE. 

Emmenagogues. —These are drugs which are used to promote the 
menstrual flow. The principal drugs employed are myrrh, aloes, black 
hellebore, savine, rue, parsley, cantharides, guaiac. 

The effects which follow their use are produced in some cases by in¬ 
creased circulation of the blood in the uterus, as well as the other abdom¬ 
inal viscera, by excitement of the nerve centers which control the circu¬ 
lation in the uterine organs. Several of the drugs mentioned are fre¬ 
quently used for the purpose of producing abortion. When thus used 
they are exceedingly dangerous to life, from their poisonous effects as 
well as from the dangers attending abortion. 

Oxytocics. —These are drugs which occasion increased contraction 
of the uterus, for which purpose they have been frequently employed 
during labor or immediately afterward. The chief of the class is ergot. 
Until recently, this drug was employed very extensively as a means 
of increasing the activity of labor pains and hastening the termination of 
labor. It has been conclusively shown, however, that this practice has 
been an exceedingly injurious one, and that numerous and most serious 
accidents in connection with labor, both to the mother and child, must 
be attributed to its use. Consequently, the former mode of using this 
drug is now being abandoned by the intelligent part of the profession. 
There are, undoubtedly, cases in which it is useful, as in preventing hem¬ 
orrhage after delivery, but it should be employed with the greatest cir¬ 
cumspection, and never unless its use is absolutely and distinctly indi¬ 
cated. It should also be recollected that even in these cases it can gener¬ 
ally be very well replaced by other means of producing uterine contrac¬ 
tion, as the employment of cold, the hot douche, and electricity. Ergot has 
also been successfully used in the treatment of tumors within the cavity of 
the uterus by its administration in small doses continued for a long time. 
Continuous uterine contraction has been shown, by quite a large number 
of successful cases, to promote recovery by gradually forcing the tumor 
out of the uterine cavity, and so bringing it within reach of the operator 
and making its removal possible. These effects are supposed to be pro¬ 
duced through its influence upon the nerve centers which control the 
action of the uterus. 

Epispastics and Rubefacients. —Under these heads are included 
the various drugs which are used for the purpose of counter-irritation 
Cantharides is about the only epispastic now in common use. It is 
usually employed in producing blisters. Ammonia may be used in 


CO UNTER-IRRITA TION. 


787 


the same way. The principal rubefacients are mustard, cayenne pep¬ 
per, and Canada pitch. 

Counter-irritation is a remedy which lias been employed for ages 
in the treatment of local inflammations. It is now much less used 
than formerly, many practitioners having lost confidence in its efficacy 
for the purposes for which it lias been so long employed. This skep¬ 
ticism respecting the value of counter-irritation as a remedial agent, 
has arisen from two sources : first, the observations of frequent and 
extensive injury from its use; and second, the impossibility of ex¬ 
plaining on rational principles how benefit could be derived from 
its use. While there is no doubt that an immense amount of harm 
has been done by the use of counter-irritation in the treatment of 
numerous diseases, some facts in experience which cannot be ques¬ 
tioned seem to show that in some cases some degree of benefit is de¬ 
rived from its use. It has been clearly shown that the old theory of 
the derivative effect produced by blisters and other counter-irritants, 
is wholly inadequate to account for any such results, since in a ma¬ 
jority of cases in which benefit is supposed to be derived, there is no 
direct connection between the diseased part and the part to which the 
blister is applied; as, for instance, when a blister is applied for the 
relief of pneumonia it is impossible that benefit should be obtained 
by the withdrawing of the blood from the diseased organ to the sur¬ 
face, since the blood supply of the lungs and that of the chest wall 
are entirely independent. It is possible that whatever beneficial re¬ 
sults are produced by any form of counter-irritation, are produced 
through the agency of reflex nervous action. The blister is one of 
the severest forms of counter-irritation. It is usually produced by the 
application of cantharides or Spanish flies to the skin, the drug being 
kept in contact with the skin until the desired amount of irritation is 
produced. Ammonia also will produce a blister if confined for ten or 
fifteen minutes in contact with the skin. It has the local effect to 
produce much more serious inflammation than cantharides, and on 
that account is seldom employed. 

The rubefacients are much milder in their effects, not producing 
vesication unless retained in contact with the skin for some time. 
Hot fomentations may be considered as the mildest form of counter¬ 
irritation. The degree of irritation produced may be modified at will 
by varying the temperature at which the application is made to the 
skin. By placing a moist cloth upon the skin, and applying a hot 


788 


RATIONAL REMEDIES FOR DISEASE. 


flat-iron over it, the effect is fully as severe as that from cantharides. 
We have little faith, however, in counter-irritation, believing that all 
the good results which can be secured at all by this means can 
be obtained by repeated and prolonged irritation in a moderate de¬ 
gree, as from the application of mustard plasters, or, still better, moist 
or dry heat. Since it is through the reflex action occasioned by means 
of exciting the nerves of the skin that counter-irritant effects are pro¬ 
duced, it is of the greatest importance that the integrity of this 
structure should be preserved, and hence, counter-irritation of any kind 
should never be carried to such an extent as to destroy the integrity 
of the cuticle. In the treatment of cases of acute poisoning by opium 
and other vegetable alkaloids, the counter-irritant effects of heat, 
moist or dry, applied to the spine, will produce more marked effects 
than can be produced in any other way, except by the use of elec¬ 
tricity. Indeed, in a case in which we were called in consultation 
w r e were able to revive the patient by the application of heat to a 
degree which was considered little less than miraculous after the 
nervous system had ceased to respond to the most powerful electric 
currents, either galvanic or faradic. 

Escliarotics. —Escharotics, commonly called caustics, include all 
drugs which destroy living tissue, either healthy or diseased. Caustic 
'potash, arsenious acid, chloride of zinc, sulphuric acid, nitric acid , 
muriatic acid, chromic acid, and bromine. 

The principal use of these powerful drugs is to destroy morbid 
growths, principally cancerous structures, and to cauterize poisoned 
wounds. They are very efficient agents for destroying the poisonous 
bite of a rabid dog. It is said that if the wounded tissue is thoroughly 
destroyed at any time before the manifestation of the symptoms of 
the disease, its course will be prevented. This is known to be the 
case if the caustic is applied to the part soon after it is bitten. 

Caustic potasli is one of the most efficient agents for this purpose, 
as it penetrates ver£ deeply. The method of applying, is to take a 
piece of adhesive plaster, cut in it an opening the size of the part to be 
cauterized, and then apply it to the skin in such a way as to leave the 
part exposed through the opening in the plaster, making the plaster to 
adhere tightly all around. Then grease the upper surface of the plaster, 
and place the caustic upon the exposed surface of the skin. When its 
action has been continued long enough, wash the part thoroughly with 
equal parts of vinegar and water. A favorite mode of applying the 


ANTHELMINTICS. 


780 


potash as a caustic is a combination with chalk, the mixture being 
known as Vienna 'paste. It is much less energetic in its action than pure 
potash. When used, it is mixed with sufficient alcohol to form a paste, 
and then applied as directed for caustic potash. Another.mode of ap¬ 
plying it, which is said to be almost painless, is to mix morphia with the 
powder, in the proportion of one part of morphia to three of the powder. 
Then make into a paste with chloroform. Spread upon a piece of lead 
plaster, and apply to the part. 

Arsenic is a very energetic caustic, and produces the most intense 
pain. Its use is somewhat hazardous on account of its actively poi¬ 
sonous properties, and hence it should never be employed except by a 
person fully acquainted with its properties, and the proper mode of 
using it. Its most useful application is in the treatment of malignant 
growths, for which it appears to be very well adapted, owing to the in¬ 
teresting fact that it affects the diseased more rapidly than the healthy 
tissues, so that the cancerous tissue may be destroyed without af¬ 
fecting the healthy parts. In use, it is usually mixed with from eight 
to ten times its bulk of starch or some other inert substance and ap¬ 
plied in the form of paste. It should never, however, be applied to 
more than a single square inch of surface at a time. This caustic has 
been largely used by quacks in the so-called cancer remedies. 

Nitric acid is a very powerful and active caustic. Its principal 
uses are in application to ulcers and small growths upon the skin, 
such as warts. It should be applied with a glass rod or a splint 
of wood. 

Chromic acid should be used in the same way, and is employed 
for the same purposes, as nitric acid. 

Bromine, one of the most severe, thorough, and rapid of all caus¬ 
tics in its action, is largely used in cases of gangrene. 

Anthelmintics. —These are medicines which destroy intestinal 
worms, or cause them to be expelled from the intestinal canal. T]ie 
most efficient anthelmintics are spigelia , or pinkroot, chenopodium, 
or wormseed, koosso, santonin, male fern, pumpkin seeds, and pome¬ 
granate rind. 

Pinkroot is the most efficient remedy for round worms, and given 
in moderate quantities produces only transient unpleasant effects on 
the patient. It does not destroy, but simply narcotizes the worm, and 
hence should be used in connection with some active cathartic. The 
cathartic usually employed for this purpose is senna, and the favorite 


790 


RATIONAL RE ME DIRS FOR DISEASE. 


method of using is to put together equal parts of fluid extract of 
spigelia and senna, of which the dose for a child two or three years of 
age is half a teaspoonful to a teaspoonful, for an adult a tablespoonful, 
repeated every four hours until it purges. 

Wormseed also is a valuable remedy for lumbrici, or round-worms. 
Used in the form of oil, it is very efficient. The dose for a child, 
three or four years of age is ten drops, which may be given on sugar, 
before each meal for two days. 

Koosso is an excellent remedy for tape-worm. For an adult thu 
dose is half an ounce of the powdered flowers taken in water. It 
should not be taken by pregnant women, as it is likely to produce- 
abortion. 

Santonin is usually employed for round-worms. It destroys 
the worms, but a cathartic is necessary in order to expel them. 

Male Fern is used chiefly for tape-worm. In administering it, the 
patient should take only milk and a little bread for one day, and the 
next morning, if an adult, should take half a drachm to a drachm of 
the extract, fasting, and repeating the dose in two or three hours. 
He should take his dinner at the usual time, and in the evening should 
take a cathartic. 

Pumpkin Seeds are also a valuable remedy in case of tape-worm. 
They are said to be even more efficacious than male fern, and are per¬ 
fectly harmless. The seeds should be beaten up with sugar or made 
into an emulsion with water, and should be taken as directed for male 
fern. 

Pomegranate Rind is also useful in destroying tape-worm. A 
pint of the decoction made from two ounces of the fresh root should .be¬ 
taken in three doses before breakfast. Other directions for the use of 
anthelmintics will be given in another connection. 

MISCELLANEOUS REMEDIES. 

Pepsin. —This is the active principle of the gastric juice. It is pre¬ 
pared from the stomachs of pigs. In South America a preparation is- 
made from the lining coat of the gizzard of the ostrich. In this country, 
gizzards of ducks, turkeys, and chickens are also used for the active prin¬ 
ciple they are supposed to contain. A preparation made from these 
sources and termed “ Ingluvine ” has been employed to some extent dur¬ 
ing the last few years. There is no doubt but that pepsin may be sep¬ 
arated from the stomachs of hogs, calves, and other animals, and that it 


V 


PEPSIN. 


791 


possesses the power to dissolve albuminous foods in connection with 
acids. The extent of its utility as an aid to digestion is, however, by 
no means well determined. The majority of physicians claim to find 
great benefit from its use, but careful examination of specimens of 
pepsin employed have shown that the large share of that which is sold 
is wholly inert. It has also been shown that the quantity employed 
is so small, in comparison with what is necessary to render any very 
great service, as to be of no real value. It is probably the case that in 
a large share of instances in which beneficial results have been sup¬ 
posed to be derived from its use, the benefit received was really the re¬ 
sult of improved hygiene. It is probable, however, that if care is 
taken to secure a good quality of pepsin, some benefit may be received 
from its temporary use in cases in which a deficient supply is pro¬ 
duced by the system. Dr. Chambers, of London, an eminent author¬ 
ity in diseases of the stomach, has called attention to the fact that no 
good can be derived from the use of pepsin for a longer period than 
two or three weeks, and that its use for a greater length of time is in¬ 
jurious. A preparation of much greater value than that which is 
offered for sale in the druir-stores can be made from the stomach of a 

O 

calf by preparing it in the following manner: Wash the stomach free 
from all extraneous matter, removing also the greater share of the mu¬ 
cous membrane. Stretch it upon a board and scrape it hard with a 
dull knife or ivory paper-holder. Carefully collect what is scraped 
off, and dry it at a temperature not exceeding 100° on a plate of glass. 
When dried, it should be thoroughly powdered, and is then ready for use. 
A proper dose would be five to ten grains. An infusion may also be 
made from the stomach of a calf by maceration in water for half an 
hour. In general, however, when pepsin is to be employed, it is best 
to obtain a reliable article directly from some good manufacturer. We 
have found that obtained from Wyeth to be better than any other we 
have tried. Pepsin is especially valuable in cases where it is found 
necessary to sustain life by nutritive rectal injections. For this purpose 
we have used it wkth most excellent results in the manner described 
under the head of “ Nutritive Enemata.” 

Dry Cupping is an excellent means of treating some affections, 
particularly lumbago. It may also be applied to the spine with ad¬ 
vantage for the relief of symptoms arising from congestion of the 
spinal cord. The application may be made by means of the regular 
apparatus, which consists of an air-pump with a properly constructed 


792 


RATIONAL REMEDIES FOR DISEASE. 


cup for application to the skin, or when such an apparatus is not at 
hand, by a much simpler method, which is always available. Take 
either an ordinary cupping-glass, a tea-cup, or a small goblet. Drop 
into the bottom of the cup a little piece of cotton saturated with al¬ 
cohol and set fire to it. When it is in full blaze, so that the air has 
been nearly expelled from the glass, invert it and press it upon the 
part to which the cup is to be applied. The flame will be at once ex¬ 
tinguished, so that no pain will be inflicted. As the air within the 
glass cools, the skin will be drawn up into it and the blood thus at¬ 
tracted to the part. Very powerful effects may be thus produced. 
Another method of expelling the air from the glass is to hold it over 
the chimney of a lamp for a few seconds and then apply very quickly 
without turning the mouth upward, so as to prevent the escape of the 
hot air. 

Charcoal.—For medical purposes only fresh charcoal and that 
made from the finest woods should be employed. The best charcoal is 
that made from boxwood such as is used in engraving, from the shells 
of cocoa-nuts, or from vegetable ivory. We have made the largest 
use of charcoal from cocoa-nut shells, and have been perfectly satisfied 
with the results obtained from it. 

The particular value of charcoal is as an absorbent. On account of 
its great porosity it is able to absorb and condense many times its own 
volume of various gases. When saturated with one gas it is still able 
to absorb another. It is this property which renders it valuable as a 
filtering medium. On account of its absorbent and oxydizing qualities 
it is useful as an antiseptic also. We have used it with marked suc¬ 
cess in cases of severe flatulency, and also in acid dyspepsia. It will 
often produce the most marked relief when taken for the purpose of 
absorbing gases, and will generally prevent acidity if taken freely 
after the meal or half an hour or an hour before the time at which this 
.symptom usually makes its appearance. 

Poultices. —These applications are useful as means of applying 
moist heat when a prolonged application is desired. The “ drawing ” ef¬ 
fects attributed to them are chiefly due to the stimulating effects of 
heat. There is little difference in the effects of the various kinds of 
poultices which are employed. When stimulating effects are wished, 
as when it is desired to “ bring a boil to a head ” quickly, or to pro¬ 
mote suppuration, the poultice should be applied hot, and renewed suf¬ 
ficiently often to keep up a degree of heat above that of the skin, at 


POULTICES. 


793 


least to 100° F. When soothing effects are desired, as when the appli¬ 
cation is made to painful wounds, bee-stings, etc., it should be only 
agreeably warm, and need be renewed only sufficiently often to prevent 
it from souring or becoming dry. The use of poultices is similar to 
that of fomentations. In the case of wounds, when the skin is broken, 
they are often preferable, being softer and so less irritating. The most 
commonly employed poultices may be made according to the following 
directions:— 

Bread aud Milk Poultice. —Place in a basin a handful of fine 
crumbs of stale bread, from which the crust has been carefully ex¬ 
cluded. Pour on boiling milk, stirring all the while, until the mixt¬ 
ure becomes of the thickness of mush. Care should be taken to make 
the mixture perfectly smooth. Spread on a cloth, making the layer a 
quarter to half an inch in thickness, and sufficiently large to extend 
well over the part to be treated. The poultice may be applied directly 
to the skin, or a thin cloth may be placed between. A neat way of 
making the application is to put the poultice in a muslin bag of 
proper shape and size, and apply with a cloth between the bag and the 
skin. Much hotter applications can be borne in this way than when 
the application is made in the usual manner. This is one of the most 
conveniently prepared poultices, and is not excelled in efficacy by any 
other. 

Bread and Water Poultice. —The most quickly prepared poultice 
is that made of bread and water. Pour boiling water upon well pre¬ 
pared bread crumbs in a basin. Let soak until well softened, make 
smooth with a spoon, and apply as directed above. A still more expe¬ 
ditious method is to take a thick, smoothly cut slice of stale white 
bread, cut away the crust, dip into hot water, remove at once, lay on a 
cloth and apply to the part to be poulticed. 

Bran Poultice.— This is useful when large poultices are required 
to be used for some time. Throw two or three handfuls of bran into 
a milk pan. Set on the stove and pour in enough hot water, while vig¬ 
orously stirring, to moisten, without making it wet. Throw quickly 
into a bag prepared for the purpose, in quantity sufficient to about 
half fill. Fasten the mouth of the bag quickly, spread the bi’an 
evenly, and apply as hot as can be borne. When the bran becomes 
sour, as it usually does in a few hours, procure a fresh supply. Renew 
the application as often as necessary. 

Indian Meal Musli Poultice. —Spread well-boiled Indian meal 
upon a cloth and apply in the usual way. 


794 


RATIONAL REMEDIES FOR DISEASE. 


Starch Poultice. —Make a moderately thick, smooth paste in the 
usual manner, and spread upon linen cloth. A very useful application 
in cases of irritable and inflamed skin eruptions confined to a circum¬ 
scribed portion of the body. 

Slippery Elm Poultice. —Pour boiling water on slippery elm flouy 
making a mixture of proper consistency for a poultice. Apply in the 
usual manner. 

Liuseed Meal Poultice. —The following is the plan recommended 
by the celebrated Dr Abernethy:— 

“ Get some linseed powder, not the common stuff full of grit and 
sand. Scald out a basin; pour in some perfectly boiling water; throw 
in the powder, stir it round with a stick till well incorporated; add 
a little more water and a little more meal; stir again, and when it is 
about two-thirds the consistence you wish it to be, beat it up with the 
blade of a knife till all the lumps are removed. If properly made, it is 
so well worked together that you might throw it up to the ceiling, and it 
would come down again without falling to pieces; it is, in fact, like a 
pancake. Then take it out, lay it on a piece of soft linen, spread it 
the fourth of an inch thick, and as wide as will cover the whole in¬ 
flamed part; put a bit of hog’s lard in the center of it, and when it 
begins to melt, draw the edge of the knife lightly over and grease the 
surface of the poultice. [Vaseline may be used instead of lard.] When 
made in this way, oh ! it is beautifully smooth ; it is delightfully soft - r 
it is warm and comfortable to the feelings of the patient.” 

Charcoal Poultice. —Sprinkle fresh, finely powdered charcoal over 
a bread and milk poultice in a thin layer and apply as usual. 

Egg and Alum Poultice.— Mix well a teaspoonful of powdered 
alum and the whites of two eggs. This is an astringent application. 

Mustard Poultice or Plaster. —Mix ground mustard with boiling 
water to the consistency of thin paste. Spread on a piece of thick 
muslin or brown paper covered with muslin. Apply for ten or fifteen 
minutes. It should be removed as soon as decided smarting is felt. 
Never leave it on until a blister is produced. The object of the appli¬ 
cation is not to produce a blister but to excite activity of the skin. 

Carrot and Turnip Poultices. —Some people prefer poultices made 
of carrots or turnips, though we can see no special advantage in their 
use. The mode of making is simply to boil the carrot or turnip, 
mash fine with a fork or rub through a colander, and apply as directed 
for other poultices. 


GARGLES. 


795 


Poultices are made from various other substances, but there is no 
evidence that they possess any real superiority over those described. 
In case the parts to which the application is made are very painful, a 
little laudanum may be sprinkled on the poultice; but usually this 
soothing application is all that is needed. 

Gargles. —In certain diseases of the throat, gargles are of much 
service, if properly applied. As ordinarily used, gargles are of little 
consequence, since they do not reach the part affected. They are, of 
course, applicable only to the upper part of the pharynx and the ton¬ 
sils. In order to bring the fluid in contact with the diseased parts it 
is necessary to allow the gargle to pass as far back into the throat as 
possible without swallowing. This requires that the head should be 
well thrown back. Young children cannot be made to gargle proper¬ 
ly, and the fluid should be applied with a swab, which may consist of 
a small piece of soft sponge attached to a stick or lead pencil, or a soft 
cloth wound around the end of a stick. The greatest care should be 
taken to fasten the sponge or cloth securely, as a safeguard against its 
slipping into the throat of the little patient. When a swab cannot be 
used without great difficulty, the bulb atomizer may be successfully 
used. 

The objects in the use of gargles are chiefly the following: 1. To 
produce an astringent effect upon the mucous membrane of the phar¬ 
ynx in cases of chronic congestion of the part, as in chronic sore 
throat and enlarged tonsils; 2. To soothe irritation arising from inflam¬ 
mation; 3. To remove morbid deposits by dissolving and washing 
them away, as in diphtheria. The following are a few useful prescrip¬ 
tions :—• 

Alum Gargle. —Dissolve in a tumblerful of water a teaspoonful 
of powdered alum. Use in chronic sore throat. Be careful to bring 
it in contact with the teeth as little as possible, and never use as a 
mouth wash, as the alum is injurious to the teeth. Rinse the mouth 
well after using. 

Lime Gargle. —Take a lump of lime the size of a large goose egg. 
Slake it with two quarts of boiling water. Let it settle, and pour oli 
the clear solution. Use as a gargle, or by means of the atomizer. Ex¬ 
cellent in diphtheria and croup for dissolving the false membrane pe¬ 
culiar to these diseases. 

Chlorate of Potash Gargle. —Put two heaping teaspoonfuls of 
powdered chlorate of potash into a four-ounce bottle, fill nearly full 


796 RATIONAL REMEDIES FOR DISEASE, 

with hot water, and shake until the powder is dissolved. Use when 
cold. 

Brandy and Water Gargle.— Take equal parts of brandy and 
water. Employ when an astringent effect is desired. This solution is 
not intended to be applied to the oesophagus or any point lower down 
than the throat, hence it should never be swallowed. 

Permanganate of Potash Gargle.— Dissolve in a pint of pure 
water half a teaspoonful of crystals of permanganate of potash or 
soda. Use of full strength or diluted with water in cases of sore 
throat in which the breath is very foul. Also useful as a mouth-wash 
for fever patients. It turns the teeth brown, but the stain can be 
readily removed by means of a cloth or brush. 

Carbolic Acid Gargle. —To a tablespoonful of glycerine, add ten 
drops of pure carbolic acid. Mix well and then add three tablespoon¬ 
fuls of water. Shake thoroughly. May be best used with a swab or 
by means of the atomizer, though it can be employed as a gargle by 
adults. 

Chlorine Solutions. —(a) One part of a freshly prepared solu¬ 
tion of chlorine gas, or chlorinated soda, in three to five parts of pure 
water, according to the strength of the solution and the sensibility of 
the affected parts. Keep tightly corked, and wrap the bottle with a 
dark cloth or paper. 

(b) In a pint bottle place a teaspoonful of chlorate of potash. Drop 
in a half-teaspoonful of muriatic acid, cork the bottle quickly, 
and shake it gently in such a way as to bring the acid well in contact 
with the crystals. A greenish-yellow gas will appear in the bottle. 
After allowing the bottle to remain closed for ten or fifteen minutes, 
remove the stopper and pour in quickly half a teacupful of water. 
Stopper the bottle again immediately and shake four or five minutes. 
Bepeat the process until the bottle is two-thirds full. Use as strong 
as patient can bear without causing irritation of the mucous mem¬ 
brane. 

(c) Dissolve in a half-pint of equal quantities of vinegar and 
water two heaping toaspoonfuls of common salt. Use very freely. 

Lotions. —Medicated lotions of various kinds are useful for a va¬ 
riety of purposes, but particularly as astringents, as soothing and 
cleansing agents, and to neutralize morbid secretions. We mention 
below a few of the most approved. It will be observed that we have 
omitted to mention arnica, one of the most popular of all washes. 


LOTIONS. 


797 


This we have purposely done, believing it to be a poisonous drug 
which should never be employed. We cannot better describe the 
dangers attendant upon its use than has been done by Dr. Farquhar- 
son in the British Medical Journal, from which we quote as follows: 

“ Of all the occasional offenders of this sort against comfort, and 
even life, is arnica, which is commonly resorted to by the ignorant 
public as a sovereign remedy for sprains. It is pretty generally rec¬ 
ognized among medical men, no doubt, that it now and then produces 
erysipelatous inflammation of the skin; but book knowledge of this 
sort makes little impression in comparison with the observation even 
of a simple case. Prof. Hebra is one of the most persistent and 
strenuous opponents of arnica, and I well remember his vigorous de¬ 
nunciation of its evil effects, from the text of a very acute inflamma¬ 
tion of both hands, for which it was responsible, and where the skin 
was covered with large blisters, and almost running into gangrene. 
A year or two ago I had the opportunity of seeing a typical case in 
the person of an old lady to whose sprained arm a non-professional 
nurse had applied a weak solution of arnica, contrary to my advice. 
A true erysipelas started from the point of application, and slowly 
spread all over the body, causing much irritation, discomfort, and de¬ 
pression, and greatly retarding her recovery from what would have 
been otherwise a comparatively trifling injury. . . My advice to 

you is to let this drug take its rightful place among those substances, 
of extinct reputation which still continue to sleep peacefully in the 
Pharmacopoeia. ” 

Alcohol Wash. —Mix alcohol and water in the proportion of one 
part of alcohol to three of water. Often of service in restraining the 
exhausting night-sweats of the advanced stage of consumption. Also 
in night-sweats from other causes. The trunk of the body should be 
bathed with the solution night and morning. Brandy or whisky may 
be used instead of alcohol. 

Vinegar Wash. —Use one part of strong cider vinegar and three 
parts of water. As vinegar evaporates more readily than pure water, 
this is an excellent cooling lotion for use in sponging fever patients. 
Vinegar and water in equal parts makes an excellent lotion for use in 
cleansing the feet, armpits, and other parts of the body in which the 
perspiration has a fetid odor. 

Wash for Fetid Feet. —Another excellent wash fur fetid feet is 
made by dissolving in half a pint of pure soft water a heaping tea¬ 
spoonful of powdered sal ammoniac. Use twice a day. 


798 


RATIONAL REMEDIES FOR DISEASE. 


Wash for Sore Mouth and Chapped Hands. —Two teaspoon¬ 
fuls of chlorate of potash dissolved in half a pint of water. Wash 
the mouth with the solution several times a day in cases of aphthae, or 
ulcerated sore mouth. For chapped hands, apply after cleansing the 
hands well with soft water. After applying, allow the hands to dry 
without wiping. Apply morning and evening. A little glycerine 
added to the solution adds to its utility. 

Borax Wash. —Three teaspoonfuls of powdered borax, a table¬ 
spoonful of glycerine, and a large tumblerful of water. An excellent 
soothing lotion for inflamed or chapped surfaces. Useful in sunburn. 

Wash for Hands. —Dissolve in a pint of soft water a tablespoon¬ 
ful of glycerine. Washing the hands with this preparation daily will 
keep the skin soft and prevent chapping. When the hands have be¬ 
come chapped, wash them with the chlorate of potash or sal ammoniac 
solution, and apply pure glycerine before drying the hands. Do not 
wipe off the glycerine. 

Face Wash. —The following is an excellent wash for sunburn: 

© 

Borax, one teaspoonful (powdered); glycerine, two teaspoonfuls; wa¬ 
ter, two teacupfuls. Daily washing of the face with this solution will 
prevent chapping, and will remove the effects of sunburn. 

To Remove Tan, Clear the Skin, etc. —Both the following lotions 
are useful for this purpose, when daily employed : 1. Lemon juice, an 
ounce; powdered borax, a teaspoonful; water, four ounces. 2. Grated 
horse-radish root, one ounce ; cold buttermilk or vinegar, three ounces; 
use after allowing to stand a few hours. Apply at night, and do not 
wash off until morning. 

Lotions for Dandruff.— Borax, half a teaspoonful; soft water, four 
tablespoonfuls; glycerine, a teaspoonful. Wash the head well with 
fine soap and water, then rub on lotion with considerable friction. 

Eye Washes. —A great amount of harm is done by the indiscrim¬ 
inate use of eye waters of various sorts. Many eyes have been de¬ 
stroyed by the application of lotions of an irritating character. No 
strong medicines of any sort should ever be applied to the eye. The 
organ sometimes requires the use of gentle astringent washes, but 
these should be used with the greatest care, and under the direction 
of a competent physician when possible. The following washes are 
very mild in character, and may be used with benefit in simple mucous 
inflammation of the eye, one of the most common affections of this 
organ: 1. Pure alum, one grain; pure soft water, two tablespoon- 


799 


LINIMENTS AND OINTMENTS. 


ful's. Put a few drops in the eye twice a day. 2. Sulphate of zinc 
or white vitriol, one grain to two tablespoonfuls of soft water. 3. 
Strong tea, clear and cold. The value of tea is due to the tannin 
which it contains. 

Liniments. —Liniments are useful in allaying pain and in stimu 
lating vital action in parts in which increased activity is desired; also 
as a means of mild counter-irritation. The advantages afforded by 
liniments are nearly all possessed by the ordinary fomentation, or the 
fomentation alternated with the cold compress. However, there are 
cases in which liniments are useful, and so we give prescriptions for a 
few:— 

Camphor Liniment.—Camphor, two tablespoonfuls; olive-oil, 
half a teacupful. Mix well before applying. 

Ammonia Liniment. —Ammonia water, two tablespoonfuls; olive- 
oil, four tablespoonfuls. Specially useful in lumbago and stiff neck. 

Lime Liniment.— Mix equal parts of lime-water and flax-seed 
oil. Olive-oil will answer equally well. An excellent application for 
use in the latter stages of eruptive diseases. It is said to prevent pit¬ 
ting in small-pox if the surface is kept smeared with it. 

Chloroform Liniment. —Mix one part of chloroform with two 
parts of olive-oil. Apply to relieve pain, as to sprained joints. 

Numerous other combinations might be given, but these will suf¬ 
fice for most purposes in which liniments are useful. In their appli¬ 
cation it should be borne in mind that a large share of the benefit de¬ 
rived from remedies of this sort must be attributed to the rubbing 
which accompanies their application. Hence they should be “well 
rubbed in,” and should generally be applied warm, especially when in¬ 
tended to relieve pain or promote absorption. 

Unguents, or Ointments. —The uses of ointments are similar to 
those of liniments. They are often of great value in allaying irritation, 
and also in applying medicaments to the skin in parasitic and other 
cutaneous diseases. We give a few prescriptions only, as others will 
be given in connection with the description of the conditions for which 
they may be usefully employed. 

Yaseline Ointment. —This consists of pure vaseline, which is a 
product obtained from petroleum. It may be used pure or slightly 
scented with rose or other agreeable perfume, or used as the basis for 
any medicated unguent, the application of which is desired. Yase- 


800 


RATIONAL REMEDIES FOR DISEASE. 


line is of about the consistency of lard. When pure, it is odorless 
and tasteless. It is practically identical with what is sold as cosmo- 
line, which is obtained from the same source, but is not so wholly free 
from odor. It may be rendered sufficiently firm for any use as an 
unguent by the addition of a very small proportion of wax or of par¬ 
affine. Used pure, vaseline is an admirable agent for inunctions. 
For this use, most prefer it without perfume. It is far superior to 
what is sold for olive-oil, which is, in fact, chiefly composed of lard 
oil or cotton-seed oil. 

Cocoamit Oil. —A year or two ago we obtained a specimen of 
refined Canton cocoanut oil, with which we experimented in giving 
inunctions. The result was so satisfactory that we have since em¬ 
ployed this fine unguent. It is much finer than vaseline, or than any 
other vegetable oil with which we are acquainted. Its faint nutty 
odor is to most persons agreeable, rather than otherwise, and its greater 
fluidity at the temperature of the body facilitates its application. It 
becomes rancid when kept in a warm place, and hence should be kept 
as cool as possible. It keeps better when covered with lime water. 

Carbolic Acid Ointment. —A mild ointment is made by adding 
to two tablespoonfuls of vaseline ten drops of pure carbolic acid. 
The acid should be very thoroughly mixed with the vaseline, other¬ 
wise it will cause painful burns. If the odor is unpleasant, it 
may be hidden by some agreeable perfume, as rose or bergamot. 
This is an excellent application for the relief of burns. It also affords 
great relief from the irritation of prurigo. May also be used with 
success in the treatment of parasitic diseases of the skin, when they 
are confined to a limited area; but it should not be applied to the 
whole body at the same time, as poisonous effects have occurred from 
its absorption when used in this way. 

Itch Ointments. —The best remedy for scabies is sulphur, and 
hence most itch-ointments contain this ingredient. Its only faults are 
its marked and unpleasant odor and its irritating properties. The 
first may in some considerable degree be obviated by such perfumes 
as bergamot and sandal-wood oil, and the second by using the finest pre¬ 
cipitated sulphur instead of ordinary powdered brimstone. The fol¬ 
lowing are some of the most reliable ointments in use:— 

No. 1. Flowers of sulphur, a tablespoonful; lard or vaseline, 
three tablespoonfuls; fifteen drops of oil of bergamot, or a sufficient 
amount of oil of sandal-wood. 


INHALATIONS. 


801 


No. 2. Add to each tablespoonfu# of the above mixture, half a 
teaspoonful of finely powdered iodide of potash. 

No. 3. Flowers of sulphur, a teaspoonful; balsam of Peru, a tea¬ 
spoonful; vaseline or lard, two tablespoonfuls. This is a milder oint¬ 
ment, and hence better adapted to children and persons with sen¬ 
sitive skins. 

No. 4. Liquid styrax, a tablespoonful; vaseline or lard, two ta¬ 
blespoonfuls; melt and strain. A very mild ointment, the smell of 
which is not at all unpleasant. 

No. 5. A favorite preparation at one of the Paris hospitals is the 
following: Carbonate of potash (saleratus), a teaspoonful; flowers of 
sulphur, two teaspoonfuls; vaseline, three tablespoonfuls. This is 
said to cure with one application after a thorough bath. 

Ointment for Sunburn. —Spermaceti and almond oil, each, two 
tablespoonfuls; honey, half a teaspoonful. Scent with attar of roses. 
Apply at night. 

Inhalations. —The treatment of diseases of the throat and lungs 
by means of the inhalation of remedies has already been referred to. 
There seems to be no reason why medicaments should not be applied 
to the mucous membrane as well as to the skin, as the two structures 
are so closely allied, and the diseases by which they are affected in 
many respects similar. It has been shown that by means of the in¬ 
halation of medicated vapors or of substances in a state of minute sub¬ 
division, such as is produced by the atomizer, remedies may be con¬ 
veyed to the remotest air-cells of the lungs. It is evident, then, that 
if there are remedies which may be usefully employed in the treat¬ 
ment of the mucous membrane of the mouth, the same remedies ought 
to be of service in the treatment of allied diseases of the lungs. Ex¬ 
perience shows this to be the case. Even the inhalation of vapor 
alone is very useful in some diseased conditions of the pulmonary mu¬ 
cous membrane. We haVe seen a dry, irritable cough relieved as if by 
magic by breathing deeply a few times in an atmosphere charged with 
watery vapor, or taking a few breaths of the atomized spray. Still 
greater relief may be secured by the combination with the watery va¬ 
por of emollient substances, or, in severe cases, anodynes. In pulmo¬ 
nary hemorrhage, the inhalation of a styptic fluid furnishes the most 
certain means of checking the loss of blood. By similar means, profuse 
secretion may be checked, and other morbid conditions corrected. 

As just intimated, inhalations are administered by two methods; 

51 


m2 


RATIONAL REMEDIES FOR DISEASE. 


viz., by the inhalation of volatile substances mingled with the vapor 
of water, and by the means of atomization of liquids. The first 
method is by far the simpler, but is of course far more limited in its 
application. An inhaler can be easily improvised by inverting a fun¬ 
nel over a vessel containing the substance to be inhaled, upon which a 
quantity of boiling water has been poured. By placing the mouth at 
the small end of the funnel the vapor may be drawn into the lungs. 
The breath should always be exhaled, or breathed out, through the 
nose. In case a funnel of proper size is not at hand, one may be con¬ 
structed of stiff paper which will answer the purpose admirably. A 
tea or coffee pot may also be used with entire success if care is taken 
not to use too much of the solution. When the inhalation is to be 




taken for a long time, as in croup and diphtheria, two inhalers may be 
used, or the inhaler may be placed over a lamp on a stand at the bed¬ 
side and the vapor conducted to the mouth by means of a large rubber 
tube. It is wise to have on hand an inhaler which has been made for 
the purpose, as much trouble will thereby be saved, and the treatment 
can be much more efficiently given. Such an apparatus, which we 
have had made and have for some time used, is represented in Figs. 273 
.and 274, which will be easily understood. 

A steam atomizer may be made to do duty m giving a fomentation 
ora local vapor bath,by removing the atomizing tube and replacing it 
by a glass tube connected with a rubber tube of proper length by 
means of which the steam can be conducted to the spot where it is 
needed, the other end of the tube being inclosed in a woolen cloth 
when a fomentation is required. By enveloping a patient in blankets, 
placing objects under the blankets so as to elevate them slightly from 
his body, and conducting the vapor from the atomizer underneath the 
blankets, a vapor bath may be administered to a patient in bed. Care 









































AGENTS EMPLOYED IN INHALATION. 


803 


must be taken to protect the patient and the bedding from the con¬ 
densed water which drips from the end of the rubber tube. The tube 
.should be of considerable size, so that the steam may not be impeded. 

The following are the most useful agents employed in inhalation:— 

Oxygen .—As elsewhere remarked, this gas has been used to a con¬ 
siderable extent in the treatment of various diseases, and with a con¬ 
siderable degree of success. It is usually inhaled from a gas-bag or 
cylinder from which the supply can be properly regulated. In case of 
emergency, however, when its use is desired and the usual means for 
its administration are not at hand, the atmosphere of a small apart¬ 
ment may be highly charged with the gas by throwing chlorate of pot¬ 
ash upon a very hot shovel or a few live coals. In first producing the 
gas a teaspoonful should be used at once, but the quantity can be re¬ 
peated at intervals of two or three minutes, so that the air may be kept 
in a condition of superoxygenation for some time. This agent lias 
proved to be very useful in asphyxia from drowning, from the inha¬ 
lation of some irrespirable gas, or the inhalation of chloroform. The 
inhalation of compressed air has to some extent the same effect as the 
inhalation of oxygen. 

Ozone. —This powerful agent is oxygen in an active state, as else¬ 
where stated. It exists normally in the atmosphere at certain 
times, but in so small quantities as to be unappreciable to the senses. 
It has been shown to be useful in the treatment of various affections, 
and especially in the class of affections for which oxygen has been suc¬ 
cessfully used. There is probably no other agent so useful in correct¬ 
ing the fetor of the breath which is usually present in advanced stages 
of consumption and in ulceration of the larynx and trachea. It can be 
produced in very small amounts, by mixing together in an earthen 
vessel, as a saucer or a deep plate, three parts of very strong sulphuric 
acid with two parts of crystals of permanganate of potash. The 
mixture should be made slowly, being stirred with a glass rod or a stick. 

Water. —As before explained, the vapor of water is the vehicle 
most commonly employed for the inhalation of vapors of volatile sub¬ 
stances used in this way. Water is necessary also in the inhalation 
of substances by means of the atomizer. In the use of both of these 
methods, not a small share of the results obtained is justly attributable 
to the effects of water, independent of the other agents employed. It 
has been shown that warm vapor is exceedingly useful in allaying irri¬ 
tability of the mucous membrane in asthma, chronic bronchitis, pharyn- 


804 


RATIONAL REMEDIES FOR DISEASE. 


geal inflammation, etc. Vapor can be produced for inhalation by the 
ordinary vaporizing apparatus, or by any of the simple plans already 
mentioned. When its continuous use is necessary, however, or it is de¬ 
sired to impregnate the whole atmosphere of a room with warm vapor, 
it can be readily done by placing upon the stove, in the apartment, a large 
wash-boiler partly filled with water and containing one or two large 
sheets; when the w r ater is boiling well, large quantities of vapor can be re¬ 
peatedly produced by raising the sheets out of the water, as is frequently 
done in washing. Vapor may also be generated with great rapidity, and 
in close proximity to the patient, by placing in a pail or tub several 
bricks, stones, or other objects, heated quite hot, and pouring upon them 
boiling water. By the use of a large number of hot bricks, vaporiza¬ 
tion can be kept up in this way for any length of time. 

Vinegar. —The inhalation of vapor from a mixture of water and 
vinegar will often be found very grateful to patients suffering with an 
irritable condition of the air-passages. It is useful in diphtheria, having 
a considerable influence in loosening the false membrane. 

Lime.—It is not, of course, possible to vaporize lime for purposes 
of inhalation, but in slaking freshly burned lime by pouring hot water 
upon it a very violent action will ensue, by means of which the vapor 
thrown off will be laden with very fine particles of lime, which may 
thus be inhaled and brought in immediate contact with the mucous 
membrane of the throat. Used in this way, lime is a most excellent 
agent for dissolving false membranes which are formed in the throat 
and larynx in diphtheria and croup. The method of using is very sim¬ 
ple. The lime may be slaked in a copper pot, and inhaled from the 
spout, or it may be placed in a sauoer, and held near the patient's 
nose, while both head and saucer are covered with a blanket. The bet¬ 
ter plan is to cover the vessel containing the lime with a funnel made of 
stiff paper, the nose of the patient being placed at the upper end of the 
funnel. A stiff paper bag answers a very good purpose. The mouth of 
the bag should be placed over the vessel containing lime, and the pa¬ 
tient’s mouth and nose placed within the opening made by cutting off 
one of the cornel's of the diagonal. Dr. Austin Flint, of New York, in 
cases of croup places the patient in a small room, taking care to secure 
good ventilation of course, and places beside the bed, as near the patient 
as possible, a large tub in which lime is kept constantly slaking. By 
this means the air of the room is continually filled with warm vapor, 
and is also charged with lime particles. Cures have been effected by 


AGENTS EMPLOYED IN INHALATION. 


805 


this means where all other remedies had proven ineffectual and the case 
was considered hopeless. Lime-water may be also used with the 
atomizer. The proper strength to employ is one part saturated lime- 
water to one or two parts of water. This remedy is especially useful in 
the treatment of diphtheria for the purpose of facilitating separation 
of the false membrane. 

Carbolic Acid. —For the inhalation of the vapor of carbolic acid, 
make a solution of the acid in equal parts of lime and water in the pro¬ 
portion of half a teaspoonful of pure carbolic acid to an ounce of glycer¬ 
ine; of this, add one teaspoonful to a half pint of boiling water. For 
use with the atomizer, a solution may be made as follows. One tea¬ 
spoonful of glycerine; two tablespoonfuls of water; three drops of pure 
carbolic acid. Shake thoroughly before using. Carbolic acid is of great 
service in the treatment of diphtheria, and is also very useful in the ad¬ 
vanced stages of consumption, when the expectoration is of an offensive 
character, and the breath strongly fetid. It is also of service in all dis¬ 
eases of the lungs in which the breath is offensive. 

Balsam of Tolu.— To a large tumblerful of boiling water, add a 
teaspoonful of balsam of Tolu. This is a very pleasant and soothing 
remedy. Use with the vapor inhaler. 

The following preparations are all to be used with the atomizer:— 

Glycerine. —Mix one part of glycerine with five to ten parts of 
water. This makes a soothing application for use in croup, ulceration of 
the larvnx, and acute inflammation of the throat. 

Glycerine and Tannin. —Mix as much tannin as can be heaped on 
a silver dime with a tablespoonful of glycerine. When it is well dis¬ 
solved, add two tablespoonfuls of water, shake well, and if there is any 
sediment in tire solution, filter before using. A good application for use 
in chronic pharyngitis, and also in the early stage of acute inflammation 
of the throat. 

Gum Arabic. —Dissolve in two tablespoonfuls of water, half a 
scruple to a scruple of gum arabic. Filter, if the solution is not per¬ 
fectly clear. 

Salt. —Common salt is of especial service in the treatment of what 
is termed dry catarrh of the throat and bronchia; it may be used in 
varying proportions according to the effect, as from a small pinch of 
salt dissolved in two tablespoonfuls of water to two-thirds of a teaspoonful 
in the same amount of water. 


806 


RATIONAL REMEDIES FOR DISEASE. 


Chlorinated* Soda. — The solution should consist of from ten 
drops to half a teaspoonful of chlorinated soda to two tablespoonfuls of 
water. It is excellent to correct fetid breath. The undiluted solution 
of chlorinated soda is of great service in disinfecting the air of sick¬ 
rooms. The atomizer should be carried into all parts of the room, so that 
the whole air may be washed with spray. 

Permanganate of Potash. —The strength of the solution should 
be from one to ten grains dissolved in two tablespoonfuls of water. 
Useful in diphtheria, sore mouth, ulcerated sore throat, and in all cases 
of fetid breath. 

Tar. —In cases of advanced consumption in which there is very of¬ 
fensive expectoration which is raised with difficulty, great relief is often 
afforded by the inhalation of the spray of tar. The solution .should be a 
teaspoonful of purified tar to an ounce of hot water. The quantity of 
fluid inhaled in spray, when used in the treatment of chronic cases, should 
be about one ounce once or twice a day. In acute cases, the application 
may be made three or four times a day. In diphtheria and croup it is 
often necessary that the inhalation should be made almost constantly 
for some hours at a time, or, if too fatiguing to the patient when applied 
continuously, it should be repeated at intervals of half an hour or so, or 
whenever there is any difficulty in respiration. When the spray or 
vapor inhaled is quite warm, the patient should not expose himself by 
inhaling cold air for half an hour or an hour after receiving treatment. 

Adhesive Plasters. —There are many cases in which adhesive plas¬ 
ters are of very great service, especially in surgery, in which they are 
most often used for holding cut or wounded parts together until they 
are knit together by the repairing efforts of nature. Plasters are also 
useful for confining a part which is the seat of disease, as in pleurisy, 
in which the extreme suffering of the patient will often be relieved by 
the application of strips of adhesive plaster to the affected side. Great 
relief is often received in lumbago and neuralgia by wearing plasters 
over the affected parts, by which means the action of the muscles is, to 
a great degree, restrained, thus preventing irritation. Isinglass plaster 
is one of the most commonly employed in surgery, though a newly in¬ 
vented rubber plaster is rapidly taking its place on account of its much 
greater strength and durability. We employ the latter almost altogether 
for surgical purposes. Plaster made from pitch is very often used for 
the relief of lumbago. Burgundy pitch is often used in the form of 
plaster as a mild counter-irritant. 


DECOCTIONS. 


807 


Decoctions. —Decoctions of various sorts are much used by the 
common people in the home treatment of diseases. They are also a 
favorite remedy with most barbarous tribes. They arc made from seeds, 
roots, barks, and in fact all the different parts of plants. Some decoc¬ 
tions, as those of juniper berries, wormwood, and cherry bark, contain 
very powerful medicinal properties, but the great majority of domestic 
remedies of this sort contain scarcely any property, except the nauseous* 
taste, in addition to those of the water of which they are largely com¬ 
posed. The success of domestic remedies is largely due to this fact, the 
patient, by the use of some simple or harmless “ tea,” being prevented 
from using remedies which might be positively harmful. Hot drinks 
flavored with peppermint, sassafras, wintergreen, or almost any one of 
a great variety of substances used for teas, are often of great service in 
encouraging activity of the skin in conditions of the system in which 
powerful elimination is required. 

Blackberry-Hoot Tea. —To three pints of water, add two heaping 
tablespoonfuls of small blackberry roots; or the bark of larger roots may 
be used. A tablespoonful of this may be used three or four times a day 
in cases of diarrhea and dysentery in which the results desired are not 
secured by other remedies, which is seldom the case. The remedy is 
harmless, and often does some good by means of its astringent effects. 

Tea of White-Oak Bark. — Take two tablespoonfuls of well 
bruised white-oak bark. Boil for half an hour in a pint of water. Then 
add enough water to make up for what has boiled away, and strain. 
This may be used in the same conditions as the decoction of blackberry 
root. 

Tooth Powders. —Every person should keep constantly on hand a- 
supply of powder for cleansing the teeth. Great care, however, should 
be taken in purchasing the powders which are sold at the drug-stores, 
as many of them contain deleterious substances. One of these is pow¬ 
dered pumice-stone, which cleanses the teeth very rapidly at the expense of 
the enamel. No powder should be used which contains any gritty sub¬ 
stance. Even powdered charcoal, which has been much employed in 
cleaning teeth, has been objected to by experienced dentists, who claim 
that the fine particles of charcoal* work down between the teeth and 
gums, and cause separation of the gums from the teeth. As good a 
powder for practical purposes as can be produced anywhere can be made 
by mixing precipitated chalk and carbonate of magnesia in thepropoi- 
tion of two tablespoonfuls of the chalk to a heaping teaspoonful of mag- 


808 


RATIONAL REMEDIES FOR DISEASE. 


nesia. Flavor with cinnamon, wintergreen, peppermint, or any other 
agreeable flavor. Pulverized chalk should not be used, as it is gritty. 
Care should also be taken to avoid purchasing the prepared chalk which 
is sold by druggists as a cosmetic. An excellent powder may also be 
made by mixing precipitate of chalk with oris root and other harmless 
substances. None, however, are especially superior to that made by the 
formula given. 

Medicated Baths. —Various substances are frequently added to 
water baths for the purpose of producing some particular effect, as to 
soothe an irritated skin, to soften thickened epidermis, to destroy para¬ 
sites, etc. The following are a few of the most useful baths of 
this sort :— 

Bran Bath. —Steep a quart of bran in two or three quarts of water 
for an hour, then simmer for half an hour. Strain, and use the water 
for a sponge bath. When the full bath is desired, a much larger quan¬ 
tity of bran may be used and the water obtained from it added to the 
bath. This application is especially useful in acute eczema and other ir¬ 
ritable conditions of the skin. 

Gelatine Bath. —If a full bath, soak a pound of gelatine in two 
quarts of water for an hour or two, or until well softened. Then heat 
until melted. It should be stirred in before it is allowed to cool. The 
indications are the same as for the bran bath. 

Alkaline Bath. —Dissolve in the water for the full bath a quarter 
of a pound of carbonate of soda or ordinary baking-powder. Saleratus 
may be used if soda is not convenient. This bath will often give great 
relief to the severe burning and itching of eczema. It is also an excel¬ 
lent means for softening epidermis when it is thickened by disease. 

Soap Bath. —Dissolve a pound or two of white soap in five or six 
quarts of hot water. This is sufficient for a full bath. For some cases, 
as the preparatory bath for the treatment of itch, ordinary soft-soap is 
better than white soap. 

Salt Bath. —Add one to five pounds of salt to the water of a full 
bath. The effect of this bath is very much the same as that of a sea 
bath. It excites the skin somewhat more than ordinary water. 

Mustard Bath. —The mustard bath is sometimes employed when it 
is necessary to excite great activity of the skin in a short time. We 
have never found occasion for using it, however, as we have been able to 
obtain the effect desired by regulating the temperature of the bath. It 


MEDICATED APPLICATIONS. 


809 


is administered by adding two or three ounces of mustard to the water 
of the bath. 

Medicated Fomentations. —When an intense effect is desired 
through the application of fomentations, the ordinary effects may be in¬ 
creased by the addition of mustard to the water in which the flannels 
are wet. Turpentine is also somewhat used, but we have never found 
reason for applying it. The usual plan is to wring out the cloths and 
sprinkle on a few drops of turpentine just before applying to the skin. 
Salt water is frequently used for fomentations with the idea of increas¬ 
ing the stimulating effect, which it may do to some degree. 

Sulpho-Yapor Bath. —This bath is administered by burning a 
small quantity of sulphur in the vapor-box while the vapor bath is be¬ 
ing administered. Care should be taken to close the box tightly and to 
protect the patient’s mouth and nostrils from the fumes of the burning 
sulphur by closing the space about his neck with a towel. The sulpho- 
vapor bath is a very efficient means for destroying parasites of the skin. 
It has been highly recommended in rheumatism, though we have never 
been able to discover any effects which were not as readily obtained 
through the vapor bath alone. 

Glycerine Bath. —Soak one-half ounce of gum tragacanth in a 
pint of water, add an ounce of glycerine, and boil. Then add four 
gallons of water of proper temperature, and the bath is ready. Very 
excellent indeed in some forms of skin disease, particularly those of 
an irritable character. 

Salt-Rubbing Bath .—This consists in rubbing the whole surface 
with common salt, the skin having first been moistened by a wet- 
hand rub, sponge bath, or other water bath. The effect is to excite 
vigorous action of the skin. This bath is indicated in all cases in 
which there is marked debility with inactivity of the skin. It is not 
probable that any special effect is produced by the slight quantity of 
salt which is absorbed. The results obtained by the bath are undoubt¬ 
edly attributable to the local effects of the salt and the rubbing upon 
the skin. 

The Hot-Air and Vapor Douche. —We have devised an appa¬ 
ratus for the application of vapor and hot air in the form of the 
douche, but have not yet had the opportunity of experimenting with 
their effects, but hope to find them applicable to a certain class of 


810 


RATIONAL REMEDIES FOR DISEASE. 


cases in which the excessive sensitiveness of the surface forbids the 
use of hot fomentations or hot bags. 

Lime-Water. —Place a piece of clean, freshly burned lime in a 
two-quart glass fruit-can. Pour in water sufficient to nearly fill the 
can. After allowing the lime to slake for an hour or two, shake the 
contents of the can thoroughly and allow to settle until clear. Keep 
the can covered. The lime-water may be turned off from the sedi¬ 
ment, or it may be drawn off by means of a syphon. Dilute with 
one to three parts of water or milk when taken internally. May be 
used alone with the atomizer in cases of diphtheria. 

To Remove Stains Produced by Nitrate of Silver and Iodine* 

—Stains produced by nitrate of silver or iodine are very persistent, and 
as they are frequently produced on the hands and clothing in their use 
in medicine and surgery, it may not be improper to mention the best, 
methods for removing them. 

1. To remove nitrate of silver stains, wash the stains in a strong 
solution of iodide of potash, or moisten with a weak alcoholic solution of 
iodine, and wash immediately with ammonia water. 

2. To remove nitrate of silver stains from linen, use a strong solu¬ 
tion of cyanide of potash to which a few drops of the tincture of iodine 
has been added just before using. It should be remembered that cyanide 
of potash is a powerful poison which produces speedy death when swal¬ 
lowed. When employed for the purpose named, it should be kept in a 
closely stoppered bottle, and labled “poison.” 

3. To remove iodine stains, wash in a strong solution of hypo-sulphite 
of soda, and rinse thoroughly with water. 


DISEASES AND THEIR TREATMENT. 


The definition of disease we have elsewhere given as being a de¬ 
rangement of the structure or functions of the body. Strictly speaking, 
any degree of derangement is a diseased condition, although such states 
are not usually called disease unless the departure from the condition of 
health is so great as to occasion considerable inconvenience in the way of 
suffering or danger to life. All modern physiologists agree in this view, 
although a large share of medical works still retain forms of expression 
which embody erroneous ideas of disease. In common parlance the term 
disease is often applied to conditions which are merely symptoms, as 
dropsy, vomiting, etc., and for the convenience of the reader we shall in 
this work consider symptoms of this sort in the usual manner; since 
they require special treatment, and are often the most prominent mani¬ 
festation of the morbid conditions by which they arc produced. 

Although there are a great number of individual diseases and mor¬ 
bid conditions, 1,147 different diseases and injuries to which the human 
body is liable being enumerated in the list prepared by the Royal Col¬ 
lege of Physicians of London, a careful study of all these different mor¬ 
bid states reveals the fact that the same principle holds good in reference 
to diseases as in reference to the various organs and numerous parts of 
the body; namely, that while there are a great variety of individual 
forms, there are in fact but a very few primary morbid conditions. The 
nature of these primary diseases or morbid conditions is by no means so 
well known as is the minute structure of the anatomical elements ol 
the body, and,yet sufficient is known to enable us to greatly simplify our 
ideas of the nature and proper treatment of disease through an under¬ 
standing of its simplest elements. In order to give the intelligent reader 
a better idea of the nature of disease in general, we will briefly consider, 
before passing to a description of individual diseases, what has been 
termed the constituent elements of disease or constituent diseases under 
the two heads, structural derangements and functional derangements. 

811 



812 


DISEASES AND THEIR TREATMENT. 


STRUCTURAL DERANGEMENTS. 

It may well be doubted whether there can be any distinct mani¬ 
festation of disease without a greater or lesser degree of derangement 
of the structure of organic parts, since function is wholly dependent 
on structure. For the sake of convenience, we may consider as struct¬ 
ural derangements such diseased conditions as involve changes in the 
tissues of the body to such an extent as to render them perceptible by 
the senses. Under this head we will first notice— 

Morbid Conditions of the Blood and Other Fluids. —Changes in 
the blood are not usually considered as organic or structural in char¬ 
acter ; but, as we have previously seen, the blood is really a fluid tis¬ 
sue, and changes in it embody more or less modification of the charac¬ 
ter of its constituent elements, as do changes in solid parts. Hence, 
it appears to us to be perfectly proper to class under this head mor¬ 
bid conditions of this sort. Diseased conditions of the blood are pro¬ 
duced in a variety of ways. Perhaps the most frequent means by 
which the blood becomes diseased is by a retention of the waste prod¬ 
ucts, or excrementitious elements, of the system, which are naturally 
eliminated as rapidly as produced. The nature of these various ele¬ 
ments we have already elsewhere explained (see pp. 300-315), and so 
need only remark that the most important are the following: Uric 
acid, or urea, a poisonous element eliminated by the kidneys; choles- 
terine, and other poisonous elements of the bile, eliminated by the 
liver; carbonic acid, eliminated by the lungs; and a variety of poison¬ 
ous elements eliminated by the skin and by the mucous membrane of 
the alimentary canal. When the function of any one of these great 
outlets of the system is suspended, the poisonous elements which it is 
designed to remove accumulate in the vital fluid, and occasion symp¬ 
toms of poisoning to a greater or lesser degree. This morbid condi¬ 
tion is present in a large share of all general diseases, and is, indeed, 
one of the most common predisposing causes of disease. The blood 
may also become diseased by the absorption of poisons from without, 
as by the reception of poisonous gases, disease germs, ajid poisonous 
substances in solution in drinking-water, or taken in conjunction 
with the food. It is also through the blood that the morbid elements 
of contagious diseases penetrate the system. 

Another mode by which the blood becomes diseased is by a change in 
the proportion of its constituent elements, by which it becomes unable 


MORBID CONDITIONS OF THE BLOOD. 


813 


to perform its functions properly. These changes may consist in an 
increase or decrease in the proportion of fibrine, of albumen, of water, 
of salts, of the white globules, or of the red corpuscles. Each of the 
changes indicated is attended by its particular class of symptoms. 
When fibrine becomes too abundant, the blood is likely to coagulate in 
the vessels, forming clots. When it is deficient, the fluidity of the 
blood becomes so great that severe hemorrhage may result from a 
very slight wound, or the blood may even ooze through the thin cov¬ 
erings in certain parts of the body, particularly the mucous membrane 
of the lungs. Deficiency of albumen renders the blood inefficient to 
support the nutritive processes of the body. When it is too abundant 
in consequence of overfeeding, the blood becomes too highly charged 
with nutritive elements, producing feverishness, and even inflamma¬ 
tion. This is known as plethora, the opposite of which is anemia. 
When the fluid portion of the blood is too abundant, as it may 
become from drinking excessive quantities of fluids, injury may be 
occasioned by the excessive fullness of the blood-vessels. In the op¬ 
posite condition the blood becomes thick, and is circulated with diffi¬ 
culty. A deficiency in the number of red corpuscles, a condition usual 
in debility and deficient nutrition, is usually accompanied with defi¬ 
cient oxygenation of the blood, a function which is chiefly performed by 
the red corpuscles. This condition is one of the characteristics of 
anemia. An excessive proportion of white blood corpuscles is also 
attended by serious interference with the vital functions. 

In consequence of these changes in the blood, morbid conditions 
are produced in all the other fluids, whether secretions or excretions. 
If the blood contains retained or absorbed poisons, every fluid secre¬ 
tion and excretion will be contaminated with the same. If it is de¬ 
ficient in nutritive elements, the various vital fluids essential to the 
maintenance of life will also be deficient in the particular elements by 
which they are characterized, which are derived from the blood. 
And not only the fluids, but also the solids of the body, must be af¬ 
fected by changes in the blood, since the solids are all produced from 
the blood. 

Diseased Conditions of the Solid Structures of the Body.— 

The diseased conditions of the solid structures of the body, which are 
readily appreciable by the senses, are of two classes: First, those which 
are due to mechanical and chemical causes; and, second, those which 
result from abnormal vital action. The latter class may not be in the 


814 


DISEASES AND THEIR TREATMENT. 


strictest sense primary diseased conditions, as little is known of th® 
morbid vital action from which they result, but they may, for the 
present, be so considered. 

Under the first head may be included all kinds of surgical ac¬ 
cidents, bruises, fractures, etc.; injuries from chemical agents, as 
burns, injuries from caustics, or from irritating and corroding gases; 
the effects of gravitation, as in congestion of the lungs resulting from 
the accumulation of blood in the lower part in certain weak states 
of the system when the patient lies continually on the back; the 
production of varicose veins in the lower extremities from long stand¬ 
ing or walking; the effects of mechanical obstruction to the circu¬ 
lation, as from wearing garters, and tight-lacing, also from the press¬ 
ure on the blood-vessels of enlarged glands and tumors of various 
sorts; the results of obstruction of the ducts of glands, as in obstruc¬ 
tion of the biliary ducts ; the results of interference with respiration, 
occasioned by mechanical obstruction of the trachea or oesophagus, or 
from pressure on the chest by tight-lacing, or malposition of the body. 

Under the second class, that is, structural derangements due to ab¬ 
normal vital action of various parts of the body, we may mention the 
following: Changes in the size of the organs, changes in their consist- 
oncy, exudations, transudations, degenerations, morbid growths. On 
account of the narrow limits of our space, we can delay but briefly on 
these various morbid changes, which of themselves furnish material 
for many large volumes. We must, however, hastily glance at a few 
of the most important. The changes in size of the organs are, of 
course, but two,—increase and diminution. Increase in size is termed 
hypertrophy. It is said to be either true or false, as the increase in size 
is due to the actual increased growth of the proper tissue of the organ, 
or to a mere expansion of volume without any actual increased growth 
of the tissue; as, for example, in hypertrophy of the heart we have 
sometimes an increase of size due to the increased growth of the 
heart’s muscle, and at other times we have an increase in the size 
which is due to simple dilatation of its cavities and thinning of its 
walls without any actual increase in substance. In the majority of 
cases it happens that both forms of hypertrophy are present at 
once. Diminution in size is known as atrophy. In true atrophy 
there is a decrease in proper tissue. This may be accompanied either 
with an increase or decrease of size, since in some cases in which loss of 
proper tissue occurs, there is at the same time a great increase of size 


DEGENERATIONS AND MORBID GROWTHS. 


815 


from the deposit of abnormal or adventitious tissue, the latter proc¬ 
ess being, in fact, in many cases the real cause of the atrophy. 

Changes in consistency consist of hardening or softening. These 
changes may take place either with or without inflammation. 

Certain fluids, when thrown out into the cavities of the body, or 
deposited in the interstitial spaces of the tissues, become solid or semi¬ 
solid. These are termed exudations, in contradistinction from fluids, 
which, thrown out or deposited in this manner, remain in a fluid state, 
and are termed transudation s. Exudation is a very common result 
of inflammation. Another solid or semi-solid deposit, which may be 
called an exudation, is tubercle, a characteristic product of consump¬ 
tion, or tuberculosis. Tubercles are said to be of two kinds,—the 
small gray tubercle, and larger yellowish masses of a cheesy consist¬ 
ency, called yellow tubercle. 

There has been much discussion among pathologists as to which 
is the true tubercle. Probably the most correct view is that the two 
are simply different stages of the same morbid product, the gray 
tubercle after a time being converted into a yellow tubercle. More 
will be said on this subject in connection with the description of con¬ 
sumption. The peculiar deposit which takes place in a scrofulous en¬ 
largement of the glands, somewhat resembling tubercle, is also an ex¬ 
udation. Transudations give rise to dropsy or chlorosis, the former 
when the fluid collects within the closed cavities, the latter when the 
escaping fluid is discharged from the body. 

Degenerations and morbid growths of various sorts are changes 
in the structure of organs resulting from mal-nutrition, which is prob¬ 
ably due to a depressed condition of the vitality of the parts in 
which these changes occur. Under the head of degenerations is in- 
eluded what is known as fatty degeneration, in which the normal tis¬ 
sue of a part is changed to fat, as in fatty*degenerations in the nerv¬ 
ous system or in the muscular tissue of the liver, kidneys, heart- 
walls, blood-vessels, and, in fact, almost all the organs of the body. 
In some cases the proper tissue is absorbed, and a chalk deposit made 
in its place. This is known as calcareous degeneration, and frequently 
succeeds fatty degeneration. A peculiar form of degeneration of the 
liver, kidneys, and spleen, has been observed, in which the normal tis¬ 
sue of these organs resembles wax. This is known as waxy or larda- 
ceous degeneration. Under the head of morbid growths are included 
various forms of cancer, fibrous tumors, and allied growths of a morbid 
character. 


DISEASES AND THEIR TREATMENT. 


816 

* 


FUNCTIONAL DERANGEMENTS. 


Functional derangements of a primary character may be enumer¬ 
ated as irritation, inflammation, congestion, depression, and fever. 

Irritation is a condition in which there is an abnormally in¬ 
creased activity in a part, due to morbid excitation caused by some 
abnormal influence, mechanical, chemical, or physical. 

Congestion is a condition of a part or organ in which the small 
blood-vessels contain an unnatural quantity of blood. There are two 
forms, active and passive. In active congestion there is abnormal ac¬ 
tivity of the circulation, which is the result of irritation or unnatural 
excitement of the vital activities of a part. In passive congestion 
there is no increase in the amount of blood circulating through the 

o o 


part. In fact, the amount of blood actually passing through its blood¬ 
vessels may be diminished. The condition is one in which from some 
obstruction to the circulation the venous blood does not pass onward 
as rapidly as it should, and hence accumulates. The accumulation 
may be the result of mechanical obstruction of the circulation or de¬ 
ficiency in the vital activity of the tissues. Passive congestion is always 
accompanied with a depressed condition of the affected part. The results 
of congestion depend on the nature of the organ affected. Whether 
active or passive, it always causes a decided disturbance of the func¬ 
tions of the part. If a secreting or excreting organ is affected, the 
natural product may be increased or diminished according to the in¬ 
tensity and character of the congestion. Congestion, both active and 
passive, is often accompanied with pain. The pain of active congestion 
is much more acute than that of passive congestion. Active conges¬ 
tion is of short duration, as if long continued it passes into inflamma¬ 
tion or passive congestion. 

Inflammation is a morbid condition, the symptoms of which are 
usually described as being heat, pain, redness, and swelling. It should 
be mentioned, however, that the symptoms given are not the 
real disease. Inflammation itself is undoubtedly only an advanced 
stage of the condition before described as irritation. When irritation 
becomes intense or is sufficiently long continued, certain changes in 
the tissues occur which are recognized as inflammation. One of the 
first and most characteristic symptoms is an increase in the number 
of white blood corpuscles in the part subject to the morbid process. 
The heat, pain, redness, and swelling are for the most part due to the 


CA USES OF DISEASE. 


817 


increased blood supply, although no doubt a portion of the increased 
amount of heat is caused by the abnormal activity of the tissues of 
the diseased part. The results of inflammation, like those of depres¬ 
sion, depend in some degree upon the part affected. As we shall men¬ 
tion in particular the inflammation of various parts of the body, we; 
need not dwell further upon the subject here. 

Depression, either local or general, is a condition in which there 
is deficient vital activity. It may be the result of a deficient supply 
of the natural agents upon which the system depends for support, as 
heat, light, electricity, food, and pure air, or it may be the result of too 
intense and prolonged activity, or the influence of some noxious agent 
upon the system, as powerful poisons. It is always present in ane¬ 
mia and all forms of debility. It is probable also that various degen¬ 
erations previously described, and probably also morbid growths, as 
well as tubercles, are due to depression, since it is observed that these 
morbid conditions almost universally occur in connection with condi¬ 
tions of general or local debility. 

Fever is a morbid process somewhat difficult to describe. It is; 
perhaps hardly primary in character, since it may include all the other 
functional derangements mentioned. Fever is always characterized 
by an elevation of temperature, a change in the frequency and force of 
the pulse, and a disturbance in greater or lesser degree of the functions 
of every organ of the body. The various minor symptoms of fever 
will be noticed elsewhere, and the peculiar characteristics of the vari¬ 
ous individual fevers will be given in connection with their descrip¬ 
tion. 

CAUSES OF DISEASE. 

In preceding portions of this work we have dwelt so fully upon 
the relations of air, water, food, heat, light, electricity, and various 
other external agents, together with the influence of habits, to the hu¬ 
man system in health and disease, that for our present purpose we 
have only to summarize the foregoing statements. The principal 
causes of disease may be classified as follows:— 

1. Abnormal conditions of the surroundings or of the relations of 
external agents to the human body. This class, of course, will include 
all errors and abnormal conditions pointed out under the head of hy¬ 
giene of food and diet, hygiene of the air, and the relations of 
heat, light, and electricity to the body. 


818 


DISEASES AND THE IB TREATMENT . 


2. Injurious habits, which may be made to include some of the 
preceding, though the term is here used with particular reference to 
the abnormal use of various organs of the body, as excessive or defi¬ 
cient exercise of the nervous system, muscles, or of other parts of the 
body, deficient mastication of food, etc. 

3. Accidents. This class may in one sense be considered as includ¬ 
ed under the first, but the term is here employed in the ordinary sense, 
it being intended to include in this class all kinds of surgical acci¬ 
dents and injuries. 

In many, cases, poisons in the blood, arising either from re¬ 
tained excretions or by absorption from without, are the source 
of disease; but cases of this sort are so manifestly a result of the op¬ 
eration of the causes mentioned in the preceding classes that they 
cannot be mentioned as a separate class. 

As samples of the foregoing, we call especial attention to the fact 
that disease may be produced by excess or deficiency of heat, cold, food, 
drink, light, or electricity, a supply of all of which, in proper quantity, 
is essential to the maintenance of health. We may also call attention to 
the fact that among the most frequent causes of serious and often fatal 
diseases, are impurities in the air, in the shape of noxious gases, dust, 
miasmatic poisons, and the germs of infectious and contagious diseases, 
and probably also certain peculiar elements, the nature of which is not 
certainly known, but which give rise to epidemics, sometimes local in 
character, but often spreading over a whole continent. The foregoing- 
are what are generally known as the exciting causes of disease. Any 
one of the causes mentioned may, under certain circumstances, be a pre¬ 
disposing cause of disease. We will now call attention to what may be 
most properly denominated— 

Predisposing Causes of Disease. —As just remarked, any one of 
the causes or the classes of causes already mentioned may produce a con¬ 
dition of the system predisposing it to disease; but the causes which 
may, under all circumstances, act as predisposing causes, and are never 
other than predisposing in character, are those which arise from temper¬ 
ament, sex, age, idiosyncrasy, hereditary tendencies, climate, occupation, 
modes of life, etc. Of the various predisposing causes mentioned, prob¬ 
ably the most powerful and inveterate in its tendency of all is heredity. 
The actual transmission of disease by heredity occurs only in very ex¬ 
ceptional instances. The majority of cases of so-called inheritance of 
disease are simply cases in which the tendency or predisposition to dis- 


SYMPTOMS AN1) DIAGNOSIS. 


81 U 


ease has been inherited, the nature of which is simply a weakness or de¬ 
ficiency of vitality on the part of some portion of the organism. 

, SYMPTOMS OF DISEASE. 

We have not space here to enter upon a lengthy consideration of the 
classes of symptoms by which disease is characterized; and it is unneces¬ 
sary to do so, as we have provided in the concluding portion of this 
work an ample and thoroughly classified index of symptoms, by refer¬ 
ence to which the identification of diseases will be greatly facilitated and 
in ordinary cases rendered easy, even for those who are wholly unversed 
in medical technicalities. It should be remarked, however, that symp¬ 
toms are the language of disease. In health, all the various vital proc¬ 
esses are performed easily and regularly, and some of the more im¬ 
portant, as the circulation of the blood, digestion, assimilation, and ex¬ 
cretion, are performed unconsciously. Whenever the performance 
of the function of an organ which does its work unperceived by the 
senses during health becomes sensible, even though scarcely perceptible, 
we have one of the first evidences of disease. In order to understand 
the significance and importance of the various symptoms of disease, it is 
necessary that we should be familiar with the functions, structure, and 
appearance of the various parts of the body during health; hence the im¬ 
portance of a knowledge of anatomy and physiology in relation to the 
study of the treatment of disease. The language of health has already 
been well considered in the sections devoted to physiology. The lan¬ 
guage of disease, or symptomology, as it relates to the various classes of 
disease and individual diseases, will be explained in connection with the 
description of various classes of morbid conditions and individual dis¬ 
eases which will follow. 


DIAGNOSIS. 

Diagnosis is simply ascertaining the nature of a morbid condition 
or disease under which a person may be suffering, by an examination of 
the symptoms present in the case. Diagnosis is by far the most difficult 
part of the practice of medicine. It is in this department chiefly that 
medicine derives great advantages from the collateral sciences, and it is 
chiefly in its relations to diagnosis that medicine may itself lay claim to 
being a science. The practice of medicine is certainly nothing more than 
an art, and a not very highly developed art at that. In difficult cases, 
the process of diagnosis requires of the medical practitioner the applica- 


820 


DISEASES AND THEIR TREATMENT. 


tion of all he has been able to learn by the most thorough and careful 
research, and, frequently, his own deepest personal insight into the nature 
and phenomena attending the manifestation of disease in its great diver¬ 
sity of forms. It will not be expected, of course, that every person can 
be made, even by the most useful helps, a skillful diagnostitian, and on 
this account, perhaps, all medical knowledge can never do away with 
the necessity for a skillful physician. In a large proportion of cases the 
most important work for the physician to do is to make a diagnosis, thus 
ascertaining what is the real condition of the patient, and, from this, 
reasoning back to a discovery of the causes of the diseased state, by the 
removal of which, a very large proportion of all cases may be brought 
to recovery, even without the application of any remedial measures 
whatever. 

PROGNOSIS. 

Prognosis is an expression of the probable way in which the disease 
will terminate in any given case. Of course, the wisest and most ex- ‘ 
perienced physicians can do nothing more than express an opinion re¬ 
specting the result of the disease, since no one can foresee what accidents 
or unfortuitous circumstances may appear to prevent the result which 
might otherwise have been favorable. It is also impossible to tell in any 
given case how long the vital forces of the patient will hold out, or 
whether the patient has sufficient vital power to bring him to a successful 
issue. It is evident, then, that any expression respecting the termination 
of the case should be made with the greatest caution. It is frequently 
possible to guess with great accuracy, and a person of experience may be 
able to form from the various symptoms present and a consideration of the 
temperament, age, sex, constitution, and the hereditary tendencies of the 
patient, and also from his present condition and his condition at the be¬ 
ginning of the disease, a very correct estimate of the probabilities in the 
case. A knowledge of certain symptoms, which observation has shown 
to be, very frequently, if not always, characteristic of cases which will 
terminate fatally, is of great service as an aid to a correct prognosis. 
The following may be mentioned as among the most unfavorable 
symptoms: Dropsy occurring in connection with some organic disease, 
as of the kidneys or heart; great emaciation coming on gradually, and 
steadily progressing in the latter stages of chronic disease; patches oc¬ 
curring on the mouth or in the fauces during the advanced stages of 
chronic disease; disposition to slide down in bed ; delirium in which, al- 


PRINCIPLES OF TREATMENT, 


821 


though at home, the patient expresses himself as desirous to go home; 
persistent drawing of the arm toward the body when an attempt is 
made to feel the pulse; difficulty in protruding the tongue, or loss of 
power to do so, together with great trembling when it is protruded; 
very great difficulty in breathing ; obstinate hiccough ; what is known 
as the “ Hippocratic countenance,” by which is meant the peculiar ap¬ 
pearance of the face observed in the last agonies of death,—pinched nos¬ 
trils, sunken eyes, hollow cheeks, and general aspect of suffering. 

GENERAL PRINCIPLES OF TREATMENT. 

A few remarks on the general principles of treatment which 
should govern all who have any responsibility to bear in the treat¬ 
ment of the sick will be in place at this point. It is necessary at the 
outset to study the case with care, inquiring respecting the history of 
the disease as well as the previous history of the patient. Examine 
carefully into his present condition, interrogating every part of the or¬ 
ganism so as to be sure of ascertaining all of the morbid conditions 
present as Tar as possible. Be careful to ascertain the cause of the 
sickness if it is possible to do so. When this is done, then institute 
measures for the relief of the patient. The following suggestions may 
be of service :— 

1. The first tiling to be accomplished is the removal of the cause of 
the sickness when it has been ascertained, if it is of such a nature 
that its removal is possible. Sometimes this is not the case, but often 
it is. For instance, if a person has become sick from breathing an 
atmosphere filled with poisonous gases, or vapors from arsenical wall¬ 
papers, common sense would dictate that he should be removed from 
the poisonous atmosphere into one which is perfectly wholesome. If 
the illness is the result of eating unwholesome food or drinking water 
contaminated with germs, these causes should be removed at once. 
Even if the difficulty exists in the patient’s mind, as is not infre¬ 
quently the case, especially in nervous diseases, something may be done 
to secure its removal by exerting upon the patient a proper mental in¬ 
fluence. The importance of attention to the cause of the disease and 
its removal is generally very much neglected, though it is evidently a 
matter of primary importance. 

2. Never apply or administer any remedy without a clear idea of 
how the patient will derive advantage from it, and without its being 
clearly required. Hap-hazard treatment always does more harm than 


822 


DISEASES AND THEIR TREATMENT. 


good. The application of a remedy when there are no distinct indica¬ 
tions for its use is likely to result in evil rather than good. When 
it is impossible to ascertain at once the real pathological condition, so 
that a systematic plan of treatment cannot be entered upon, do not 
adopt any plan of treatment, but study the case carefully, in the mean¬ 
time administering only such remedies as are indicated for the imme¬ 
diate relief of the patient or the palliation of his symptoms. 

3. A cardinal principle that should govern every physician or other 
person who engages in the treatment of the sick should be to act in 
harmony with nature; that is, to endeavor to facilitate the remedial 
processes which nature institutes and in many cases carries forward to 
a successful result. Be very careful never to hinder-the efforts of 
nature by officious interference. It is a much safer error in the treat¬ 
ment of the sick to do too little than to do too much. While adminis¬ 
tering treatment of any sort, the immediate effect as well as the re¬ 
mote influence of the .remedies employed should be very carefully 
watched and studied, not only for the purpose of securing good results 
with the case in hand, but in order to make the experience valuable 
with reference to the treatment of similar cases. In many cases, 
perhaps the majority, the thing to be accomplished by treatment is not 
to stop the morbid action which is in progress, but to modify or con¬ 
trol it. In a great majority of cases, especially in acute diseases, the 
object of the morbid action is remedial. Nature is at work, endeavor¬ 
ing to free herself from obstruction, to remove obnoxious elements 
from the system, or in some way to remove existing causes of derange¬ 
ment and to restore harmony to the vital processes ; but nature works 
blindly, she is not intelligent, and often destroys herself in the effort 
of self-preservation, by too great intensity of action. Hence, when the 
morbid action is becoming too intense, it should be checked by the em¬ 
ployment of well-known means for lessening vital action, which have 
already been described and of which cold is the most useful and an al¬ 
most indispensable agent in the treatment of nearly all acute diseases. 
When the vital action is sluggish or is of too little intensity for the 
accomplishment of the object desired, at least within a reasonable 
length of time, such remedies should be applied as will increase or 
stimulate vital activity, for which purpose heat, electricity, and water 
properly employed, are among the very best of agents. On this ac¬ 
count, the three agents mentioned are among the most indispensable 
remedies in the treatment of all chronic diseases, which are chiefly char- 


PRESERVATION OF VITAL FORCE. 


823 


acterized by insufficiency of vital effort. The effort should aiways be 
made to restore as far as possible the balance of vital activity in the 
different parts of the system, which balance is always destroyed when¬ 
ever a part or the whole of the system is in a state of disease. 

4 Since nearly all cases of disease, especially of acute disease, will re¬ 
cover if left to themselves, provided the vitality of the patient holds 
out until the remedial process is accomplished, it is in many cases of 
the very greatest importance that proper attention should be given to 
economizing and preserving the vital forces of the patient. Hence 
it is evident that depressing agents should never be employed 
wffien they are not distinctly and positively indicated. It is indeed 
fortunate for the present generation that the old-fashioned methods of 
treatment, the essentials of which w 7 ere blood-letting and violent pur¬ 
gation together with mercurial salivation and other harsh measures of 
treatment, have gone out of fashion. It has been offered as an apology 
for the decline of the popularity of the remedies mentioned, among in¬ 
telligent practitioners, that the nature of disease has changed, or the 
constitution of the people has changed. It seems to us that the latter 
suggestion is the true one, and in our opinion it is no wonder that the 
constitution of the present generation is decidedly different from that 
of the preceding, and that, as we have often heard said, “ bleeding and 
purging are not well borne by people nowadays.” The only wonder 
to us is that the people of the present generation have any constitu¬ 
tion at all, wdth the exception of an individual now and then who is 
so happy as to be the descendant of some person who fortunately 
escaped the old-fashioned “ mercurial course ” of the last genera¬ 
tion. The old idea that disease is a condition of excessive vitality 
was exploded long ago, and we are now waiting for the explo¬ 
sion of the modern fallacy, that all diseases, or a great share of them, 
are conditions of deficient vitality requiring stimulation carried to 
as great an extreme as was depletion in the old plan of treatment. 
The folly of the excessive-stimulant plan is still more clearly seen 
when it appears, as it does whenever careful and candid investigation 
is made, that the remedies employed as stimulants invariably oper¬ 
ate in a manner directly opposite to the way in which they are in¬ 
tended to act. It has been most thoroughly demonstrated that alco¬ 
hol, the most largely employed of the so-called stimulants, is a power¬ 
ful depressant instead of a stimulant, that it destroys instead of creat¬ 
ing force, and that it obstructs rather than re-inforces vitality. The 


824 


DISEASES AND THEIR TREATMENT. 


proper plan to pursue in choosing remedies is to select those which 
will accomplish the desired result with the least expense of vitality to 
the patient, as by this means he will he given the best possible chance 
for recovery; and in case there is any doubt whether the application of 
a certain remedy will do more harm than good, that is, whether it will 
hinder more than it will help the remedial process, or weaken the pa¬ 
tient by lessening his vitality more than it will aid him by checking 
the morbid process,—we say, whenever there is any doubt as to which 
of these two ways will be that in which a remedy will operate, the 
remedy should by all means be omitted, as it will be far safer to trust 
the patient in the hands of nature than to incur the risk of employing 
a doubtful remedy. 

5. In the treatment of disease, four classes of cases, considered with 
reference to the results of treatment, come under consideration: (1) 
Those in which by proper treatment a complete and perfect cure can 
be effected; (2) Those in which the disease pi'ocess can be checked, the 
patient made very comfortable, and his life thus greatly prolonged; 
(3) Those in which nothing can be done except to delay the progress 
of the disease and lessen the patient’s suffering; (4) Those which are 
not only absolutely incurable, but the progress of which can in no 
way be affected by treatment and all that can be done is simply 
to palliate the patient's sufferings and smooth his pathway to the 
grave. Whenever a case is taken in hand for treatment it should be 
carefully considered with reference to which of the results described 
may be expected; and although the case may be evidently hopeless it 
should not be abandoned, but all should be done which can be done to 
meet the indications in the case, if not for cure, for the palliation of 
the disease. This plan has the advantage also that in not a few in¬ 
stances in which it has been pursued the unfavorable opinion which 
has been entertained has by the result been shown to be erroneous, 
since the patient has, in spite of all discouraging predictions, ulti¬ 
mately recovered. We have in practice met several cases of this sort, 
and have in consequence made it a rule of practice never to abandon 
a case so long as there is the faintest ray of hope of effecting a cure, 
and even when the last hope seems to be destroyed still to continue 
our efforts for the relief of the patient even though nothing more 
than mere palliation may be expected ; and even in cases of this sort 
we have in some instances been most happily disappointed in seeing 
patients recover, notwithstanding the apparently hopeless character 
of their disease. 


IRRITATION. 


825 


GENERAL DISEASES. 


Under this head we shall include chiefly those diseases which af¬ 
fect the whole system and which require in consequence general or 
systemic treatment. For convenience, and as we shall find no better 
opportunity for so doing, we will first give the proper methods of 
treatment of what have been already described as primary forms of 
disease. 

IRRITATION. 

This condition has already been described as being one in which 
there is an excitement or increased intensity of vital action. 

Causes. —The causes of irritation, in the sense in which we are here 
considering it, are chiefly an increased intensity of the so-called vital 
stimuli, or those agents upon which the maintenance of life and health 
depends, as an excess of food, light, electricity, or mental influence. By 
any of these agents the vital action of the whole or a part of the or¬ 
ganism may be increased to an abnormal extent. Where the excite¬ 
ment is not sufficiently intense to occasion disturbances of other parts 
of the organism it is called irritation. 

Treatment. —The proper treatment of this condition involves 
chiefly the removal of the exciting cause. The departure from a normal 
condition is so slight that where the cause is removed, the vital forces 
quickly acquire equilibrium, and harmony is readily established. If the 
irritation arises from an excess of food, it is best not only to refrain 
from taking food in excessive quantities but to practice abstinence, or to 
take food in less than the quantity required in health for a short time 
The same principle applies with reference to other causes of irritation 
and abnormal excitement. If the patient has been subject to excessive 
heat, make cooling applications. If irritation of the eyes has been pro¬ 
duced by exposure to intense light, remove the light altogether or to a 
great extent for a short time. So, also, if the cause is too great mental 
activity from exciting influences, the latter should not only be removed 
but the patient should be given as nearly as possible absolute mental 
rest till an equilibrium has been established. In all forms of irrita¬ 
tion sleep is a sovereign remedy, as the vital action is always lower 



S26 


DISEASES AND THEIR TREATMENT . 


i luring this condition. Soothing applications, such as a tepid bath, a 
vapor bath of moderate temperature, gentle rubbing or massage, and 
in many cases the application of a mild current of electricity, are of 
the greatest service in the removal of irritation, whether of a general 
or local character. 

CONGESTION. 

This has also been described as a condition in which a part of 
the body contains too much blood. This morbid condition must evi¬ 
dently be of a local character, since the whole body could not be 
congested. Too much blood in one part necessarily implies too little 
in another part, unless, indeed, the patient be suffering from the con¬ 
dition known as plethora, in which the whole quantity of blood is 
abnormally increased and the usual symptoms of local congestion are 
extended to the whole system. The results of congestion and its 
accompanying symptoms vary greatly, according as it is active or 
passive in character. 

Symptoms of Congestion. —Active congestion is characterized by 
an increased amount of arterial blood in an organ, the result of which 
may be temporary swelling or enlargement and pain, together with 
an increase of temperature and even redness in color. These symptoms 
are also all present in inflammation. That condition, as we shall show 
presently, is accompanied with other characteristic symptoms not 
found in simple congestion. 

In passive congestion there may be swelling of the part, from the 
turgescence of blood or from the infusion of serum into the tissues, as 
in dropsy. If there is a change in color, the part will be dark and 
purplish, instead of bright red as in active congestion and inflam¬ 
mation ; there may also be pain in passive congestion. If pain is 
present, it will be of a dull, heavy, continuous character, instead of 
acute, sharp, and lancinating, as is usually the case in active conges¬ 
tion. The causes of both active and passive congestion having already 
been given elsewhere, we do not need to delay on the subject here. 

Treatment. —In the treatment of congestion it is of primary im¬ 
portance that its character should be recognized, as the modes of treat¬ 
ment to be employed in the two forms of congestion are essentially 
different. In active congestion there is excessive activity of the cir¬ 
culation, and consequently, in many cases, of all the tissues of the or¬ 
gan or part affected. A most important indication of treatment. 


TREATMENT OF CONGESTION, 


827 


then, is to lessen the activity of the blood-vessels, as well as of the 
other tissues in the congested part. There is no better agent for ac¬ 
complishing this than cold properly applied. The degree of the inten¬ 
sity of the application will depend upon the violence of the action 
and the location of the disease. Cold applications may consist of sim¬ 
ply tepid bathing or sponging, or the application of cool compresses, 
the cold pack, cold foot-bath, cold spray or douche, or the application of 
ice, according to the part affected or the effect desired. Special modes 
of application in the congestion of different cases will be pointed out 
in connection with*the description of local diseases, Another excel¬ 
lent means of counteracting the effects of active congestion is deriva¬ 
tive treatment; that is, artificially producing temporary congestion in 
other parts of the body, thus drawing the blood away from the affected 
part. This may be most easily done by means of hot applications in 
the form of fomentations or local hot baths. Dry heat may also be 
employed. In some cases, great benefit may also be obtained from the 
temporary ligation of certain parts, as of the limbs, by which a large 
amount of blood may be temporarily removed from the circulation. 
When possible also, the congested part should be placed in such a po¬ 
sition that gravitation will aid in relieving it of its surplus blood, as, 
for example, in congestion of the brain the head should be raised above 
the level of the other portions of the body.. The same may be said of 
local congestions elsewhere. This remark applies to both active ami 
passive congestion. 

In the treatment of passive congestion, the application of cold is less 
frequently indicated than in active congestion. In these cases, hot appli¬ 
cations are generally much more successful, although we have usually ob¬ 
tained the best results in the use of alternate hot and cold applications. 
Cold applications produce at first a strong contraction of the blood¬ 
vessels and thus an increased activity; but if long continued, the vi¬ 
tality of the part is lowered, and hence the original difficulty will be 
increased. So also in the use of hot applications; the effect at first is 
astringent in character, like that of cold. It should be remarked, how¬ 
ever, that applications for this purpose must be hot; that is, of a tem¬ 
perature above that of the body. Applications of a temperature from 
106°“ to 110° F. are best. In extreme cases, a still higher temper¬ 
ature should bo used. If too long continued, hot applications result in 
rather increasing than relieving the local difficulty. By alternating the 
two, however, it is possible to continue and intensify the good effects of 


828 


DISEASES AND THEIR TREATMENT. 


each remedy for some time. As a general rule in the treatment of conges¬ 
tion, hot and cold applications should be made at intervals of from two 
to six hours, and between the applications the part should be covered 
with a tepid compress, changed sufficiently often to prevent its becoming 
warm. Chronic and passive congestion of internal organs, when acessi- 
ble, as in chronic congestion of the mucous membrane of the pharynx, 
may be benefited by the use of astringents ; but by far the most po¬ 
tent remedy is the application of hot water or steam, as hot as can be 
borne without pain,—a temperature of 103° to 115°. When the con¬ 
gested parts are * not accessible, as in the case of the liver, spleen, and 
kidneys, the hot and cold douche applied over the affected part supplies 
the best known means of relieving the difficulty. Another point of 
great importance in the treatment of passive congestion, which indeed 
should be attended to at the outset of treatment, is ascertaining the cause 
of the disease. If, as is often the case, the congestion is produced by 
mechanical obstruction of any sort, as by restriction of the clothing, by 
pressure, or by any other means of a like character, it should be 
promptly removed. Passive congestion may often be greatly relieved 
by rubbing. Care should be taken to rub the parts in such a direction 
as to press the blood forward in the veins, thus aiding the venous circu¬ 
lation, which is chiefly at fault in passive congestion. In cases in which 
the difficulty is continued until transfusion of the serum into the tissues 
has occurred, causing puffiness or swelling of the parts, great advantage 
may often be derived from the use of properly adjusted bandages. The 
bandage should be applied smoothly and with even pressure over all parts 
of the organ, in such a manner as not to interrupt the circulation. The 
rubber bandage is preferable to all others for this purpose. 

DEPRESSION. 

As elsewhere stated, depression Is a condition in which there 
is a deficiency of vital action. It may be either general or local in 
character. Its symptoms may be either an increase or decrease of irri¬ 
tability. Increase of irritability in consequence of depression, although 
a seeming anomaly, is a well-established fact, having been determined 
by numerous observations, not only upon men but also upon animals, in 
which it is frequently found that just before dissolution, when the de¬ 
pression has reached the highest degree compatible with life, irritability 
is sometimes enormously increased. The irritability of depression is, 


TREATMENT FOR DEPRESSION. 


820 


however, peculiar, being in a marked degree deficient in strength and 
vigor, usually lasting but for a very brief period, and being followed by 
a great increase in depression. Depression is one of the most prominent 
symptoms in all diseases of debility, in cases of convalescence from acute 
diseases or serious surgical injuries, and a great variety of local and 
general conditions. 

The causes of depression, as elsewhere shown, are anything whatever 
which exhausts the vital forces faster than they are replenished by nu¬ 
trition. The treatment of depression is exactly what would be indicated 
by the common sense of the most inexperienced person; that is, simply to 
economize the vital forces by lessening the expenditure of force so far as 
possible and increasing the supply through improved and augmented nu¬ 
trition. The treatment of depression implies the application of all hygi¬ 
enic means, obedience to all hygienic rules, and placing the system so far 
as possible in harmony with all the laws of nature. When this is done, 
unless the cause is one which cannot be removed, the patient will shortly 
recover. The length of time required will, of course, depend upon the 
natural activity of his system, upon the degree of reserve force which 
he possesses, and upon the thoroughness with which he complies with 
the conditions necessary for recovery. 

The popular treatment for depression is the use of tonics and stim¬ 
ulants. The theory of the application is that they impart strength to 
the enervated system. That this is not the case, however, is well known 
to every scientific physician. Indeed, not a few of the most eminent 
physicians declare wfith emphasis that stimulants are not strengthen¬ 
ing, that stimulation means simply excitement, which, as we have al¬ 
ready seen, in depression is always followed by an increase of depression, 
and that stimulants decrease rather than augment vital force. We also 
have good authority for the statement that tonics and stimulants are pre¬ 
cisely alike in their action, differing only in degree. On account of then* 
mildly stimulating effects, the depression following the use of tonics is 
not so noticeable as in the employment of stimulants proper. We cannot 
but regard the use of tonics and stimulants in chronic debility of any 
sort as erroneous in principle and deceptive in practice. They produce 
a feeling of strength which is not accompanied with an actual increase 
in vigor. 

This is well shown in the experiments of Dr. Smith upon tea and 
coffee, two of the mildest of all agents of this class. He found that after 
taking a cup of strong tea, although previously depressed from prolonged 


830 


DISEASES AND THEIR TREATMENT. 


exercise, he felt an increased disposition to active exercise and found him¬ 
self able to take muscular exercise with much greater ease than under 
ordinary circumstances. Thus far the effects of the stimulant and tonic 
seemed to be satisfactory, but unfortunately for the theory which main¬ 
tains the utility of these agents he found upon awakening the next morn¬ 
ing after the experiment, even though he had been recuperated by the in¬ 
fluence of sleep, that he felt very much more fatigued and exhausted than 
after exercise without the use of tonics or stimulants. This experiment 
conclusively shows that the supposed strength imparted by tonic or stimu¬ 
lant is not real force or vigor, but simply apparent. By the use of tonics 
and stimulants the system is goaded into an expenditure of the force and 
vigor which it already possesses, but no additional strength is imparted. 

This view of the action of tonics and stimulants is based upon sci¬ 
entific evidence so conclusive that there can be no doubt of its correct¬ 
ness. We do not say, however, as the reader has doubtless observed, 
that tonics and stimulants should never be employed in conditions of 
depression. What we insist upon is that they should never be em¬ 
ployed with the idea that they impart strength, since this is a thor¬ 
oughly exposed fallacy. They should be employed only when it is 
desired to accomplish what they are only capable of accomplishing; 
namely, to bring into action or develop forces which the system al¬ 
ready possesses in a latent form. There are, no doubt, many cases in 
which this is in the highest degree desirable. 

O O 

These cases are those in which there has been a sudden depression 

of vital action from any cause whatever. In these cases the sudden 

«/ 

lowering of vital activity may be so great as to occasion death by the 
cessation of some of the important functions of the body before the 
system has had time to recover itself, although there may be sufficient 
vital force to bring about recovery if it were only developed at the 
right moment. 

In cases of this sort the most powerful stimulants and tonics may 
be employed, as in the depression attendant upon asphyxia from any 
cause, syncope, or fainting, from loss of blood, great prostration as the 
result of poisoning, sudden collapse occurring in the course of some in¬ 
tensely acute disease, etc. In these cases life may be saved by the ju¬ 
dicious employment of stimulants; yet even in such cases great care 
should be used that the stimulant is not employed so freely nor for so 
great length of time as to exhaust the vital forces beyond the extent 
to which they are recuperated, as when this is done much more harm 


INFLAMMA TION. 


831 

than good results from their use. Hence, the utility of stimulants is 
of a very limited character, and they should be employed only when 
good can be accomplished by their transient effects. Ordinarily, stim¬ 
ulants and tonics should be most sedulously avoided in the continuous 
treatment of depression. They are only for cases of emergency, and 
.should never be employed day after day, week after week, or con¬ 
tinued for months, as is often the case. 

We firmly believe with many noted physicians that notwithstand¬ 
ing the good results which may be obtained by the proper use of 
stimulants, they may be dispensed with altogether, if proper substi¬ 
tutes are employed, without any detriment to the patient’s chances 
for recovery. Electricity as a stimulant is vastly superior to alcohol 
or any other stimulant or tonic furnished by the materia medica. 
This potent agent so closely resembles the nerve force itself that it 
seems to be almost equivalent to a substitute in cases of extreme de¬ 
pression. As an excitant of vital action it is vastly superior to alcohol, 
and when properly used no unpleasant effects whatever follow its em¬ 
ployment. It is indicated in all cases of debility or depression in 
which its use is not interdicted by some personal idiosyncrasy antag¬ 
onistic to its influence.. Sunlight employed in the form of the sun¬ 
bath is another natural tonic, the application of which may be indef¬ 
initely repeated without fear of causing subsequent increase of the dis- < 
■eased condition for which it is employed. 

In all cases characterized by debility, avoid the use of all depress¬ 
ing agents. The patient should be relieved of care, and should be 
surrounded with cheerful conditions. The food should be abundant 
and wholesome, but simple in character and easy of digestion. As a 
general rule in chronic depression, the severe practices of the old- 
fashioned water-cure treatment should be most carefully avoided. 
Water may be employed judiciously with great advantage as a means 
of increasing nutrition. Massage may be carefully employed for the 
same purpose to very great advantage. More specific directions for 
treatment will be given in the consideration of various diseases char¬ 
acterized by depression and debility. 

INFLAMMATION. 

Inflammation, like congestion, is characterized by the four spe¬ 
cial symptoms, heat, pain, redness, and swelling. In inflammation, 
however, these symptoms are all much more intense than in conges- 


832 


DISEASES AND THEIR TREATMENT. 


tion. In this respect, inflammation may he considered as an advanced 
stage of irritation. It includes in its different stages all the pri¬ 
mary morbid actions previously mentioned; namely, irritation, both 
active and passive congestion, and depression. On account of its re¬ 
semblance to congestion it is sometimes not easy to distinguish be¬ 
tween the two diseases, especially at the beginning of the morbid con¬ 
dition or process. Indeed, at the beginning there is no distinction, 
for the inflammatory process is induced by irritation and congestion. 
The real distinction between inflammation and congestion is not easily 
perceptible in the early stages, at least before any special results have 
been produced. Microscopical researches have shown, however, that 
there is a difference even at this early period which consists in the 
great increase of white blood corpuscles. This may be very easily ob¬ 
served in the delicate web of a frog’s foot placed beneath the micro¬ 
scope. Upon placing the point of a needle or other mechanical or 
chemical irritant upon the membrane, all of the phenomena of irrita¬ 
tion, congestion, and inflammation may be observed occurring in their 
proper order, the beginning of inflammation proper being indicated by 
the accumulation of white blood corpuscles in and about the gradu¬ 
ally dilated blood-vessels of the affected part. There is every reason 
for believing that this is exactly what occurs in larger animals and 
human beings. If inflammation is arrested in its first stages, the ef¬ 
fects are only those described. If continuous, however, the morbid 
action may give rise to the exudation of matters which afterward 
harden and cause induration of the parts, or the intensely local action 
may become so great as to occasion death of some of the tissues, in r 
volving coagulation of the blood and obstruction of the circulation. 

This is what occurs in a boil. When death of the tissues has taken 
place, the dead parts are treated like foreign substances in order to 
prevent contamination of the system by absorption of the dead and 
disorganizing matter. The dead part is separated from the living by 
a wall of defense which is thrown up about it and by a layer of cor¬ 
puscles exactly resembling white corpuscles of the blood, but in this 
case termed pus corpuscles. It is these corpuscles which form the 
greater part of the whitish or yellowish discharge from abscesses or 
suppurating wounds. As thus seen, it is wholly devoid of offensive 
odor, and is termed healthy pus; but when by the breaking down of 
dead tissues the pus becomes filled with products of decay, and is watery 
in character, it is termed unhealthy, or ichorous pus, and often has a very 


INFLAMMA TION. 


833 


offensive odor. Pus is formed partly from the blood, by the removal 
of its white corpuscles, and partly from the tissues themselves, which 
undergo destruction about the dead part for the purpose of loosening 
it and thus removing it from the body. If a part which has thus died 
has been loosened and removed, an examination of the surface beneath 
will show that underneath the purulent matter is a layer of small red 
prominences termed granulations, which indicate that new tissue is 
forming. By degrees the cavity left, if not too large, will be filled up 
with newly made tissue, which is, however, of a somewhat different 
character from that which was removed. It sometimes happens that 
in consequence of a still greater intensity of inflammatory action the 
tissue of the diseased part dies very suddenly, from the stagnation 
and coagulation of the blood in its blood-vessels. This is termed gan¬ 
grene, the consideration of which must be left for the section devoted 
to surgery, to which province it particularly belongs. 

Inflammation is generally described as being acute, sub-acute, or 
chronic, the distinctions between which are the same as those which gov¬ 
ern the classification of other diseases. The symptoms above described 
are those of acute inflammation. In sub-acute inflammation the same 
symtoms will be noted, though their intensity will be less, and they suc¬ 
ceed each other at longer intervals. In both acute and sub-acute inflam¬ 
mation the whole system participates in the disturbance. The greater 
the extent and the higher the degree of the intensity of the inflamma¬ 
tory process, the greater will be the general disturbance. The temper¬ 
ature of the body as well as that of the diseased part will be found 
almost invariably to be above normal. When a large and important 
organ, as a lung, the liver, or the stomach, is affected, the temperature 
of the whole body may rise to a very high point, while a very slight 
inflammation accompanying the efforts of the system to expel a sliver 
from the skin may not at all affect the general temperature. It is 
the great elevation of temperature which in the majority of inflam¬ 
mations is the thing to be most dreaded and which is the chief cause 
of a fatal result in a lar^e share of the cases in which death occurs from 

o 

inflammatory affections. 

In what is termed chronic inflammation, the intensity of the vital 
action is much less than in acute inflammatory affections.. Indeed, 
although the results of so-called chronic inflammation are in some re- 
spects similar to those of acute inflammatory action, it appears to us 
that there are good reasons for believing that there is really no such 

53 


834 


DISEASES AND THEIR TREATMENT, 


thing as chronic inflammation, but that the condition generally denoted 
by this term is really only chronic congestion, either active or pas¬ 
sive. We are sure that this is true of a large share of the cases 
usually included under the head of chronic inflammation, whether it 
be applicable to all or not, and we have never yet found difficulty in 
explaining the phenomena of what is generally termed chronic inflam¬ 
mation in accordance with the views expressed. When a part is af¬ 
fected by acute inflammation, if recovery does not take place it finally 
continues in a state of active or passive congestion, most frequently 
the latter, which is the condition generally known as sub-acute or 
chronic inflammation. Inflammations have been classified according 
to the variety of tissue affected by them, but as this classification is 
of no practical importance, we need not present it here. The especial 
■characteristics of local inflammations will be given in connection with 
their description elsewhere. 

Causes. —Inflammation may be induced by mechanical or chem¬ 
ical irritants, by poisons generated in the system or received into it 
from without, through morbid nervous influences, and perhaps by 
other means. Its general character is the same, however, whatever 
may be its cause. 

Treatment. —The treatment of inflammation is essentially the 
same as that for active congestion, which has already been quite fully 
described. In inflammation, however, as the intensity of the morbid 
action is much greater than in simple congestion, the activity of the 
remedies employed should be proportionally increased. In the first 
stages of inflammation, cold and other agents for reducing heat and 
vital action should be energetically employed. The morbid tendency 
may be combated not only by the local application of cold, but by 
derivative treatment as directed in congestion, and also, from reflex 
influence, by applications to remote parts; as, for example, inflam¬ 
mation of the brain may be treated by the application of cold, even 
ice, to the head, and of heat to an appropriate extent. By these means 
the head will be cooled by the direct abstraction of heat, and also 
through the contraction of its blood-vessels, in consequence of the 
stimulation of the nerve centers which control the circulation of the 
brain. The same means may be employed in the treatment of inflam¬ 
mation of the lungs, liver, kidneys, spleen, and other internal organs. 
When inflammation has continued until it becomes evident that sup¬ 
puration must take place, it is often necessary to moderate the cold 


IXFLAMMA TIOX. 


835 


applications, and in many instances it is best to employ hot applications, 
and thus facilitate the suppurative process so as to hasten the ter¬ 
mination of the disease. Care should be taken in the treatment of 
the inflamed parts to avoid using cold in such a manner as to produce 
gangrene. The color of the affected part should be frequently ob¬ 
served. So long as it remains of a dull red color and is hot to the 
touch, cold may be safely employed. Bright scarlet redness without 
great heat should, however, be regarded as a contra-indication for the 
employment of cold, as it is a primary symptom of the death of the 
tissue, or gangrene, and when present, hot applications should be 
promptly made. Blueness of an inflamed part is also an indication 
for the application of heat. 

In severe inflammatory attacks it should be recollected that the 
whole system requires attention as well as the local seat of the dis¬ 
ease. The temperature of the patient should be kept as nearly as 
possible at the normal standard by means of sponge baths, packs, 
compresses about the trunk, ice to the spine, cold baths, and the other 
remedies elsewhere described as useful for this purpose. The diet of 
the patient should be unstimulating, and at the outset of the disease 
restricted in amount. In the beginning of the inflammatory affection 
the person may, without detriment, fast for twenty-four hours, and 
should for a day or two take only a very little and very light food. 
The importance of this observation is well shown by the fact that 
Nature usually indicates her inability to dispose of food under these 
circumstances by taking away the appetite. More specific direc¬ 
tions for the treatment of inflammatory affections of special organs 
are given in connection with the treatment of local diseases. 


83G 


DISEASES AND THE IB TREATMENT. 


GENERAL DISEASES OF NUTRITION. 


Under the head of general diseases proper, we will first call atten¬ 
tion to those which are dependent upon general disturbances of nutri¬ 
tion, and which, although in some instances involving numerous local 
derangements, are not known to he dependent upon any specific local 
disease or morbid condition. First among diseases of this class, as the 
most frequent of all, we will call attention to— 


This is a disease which is characterized by deficiency in the red 
blood corpuscles and in the nutritive elements of the blood. There 
are two varieties, acute and chronic. 

ACUTE ANAEMIA. 

SYMPTOMS.—Great pallor; hollow cheeks; sunken eyes; pinched nose; coldness; 
dry or clammy skin; frequently a weak pulse, which is easily excited by slight exercise; 
fainting, or tendency to faint on slight exertion; great weakness; swelling of the feet. 

Cause. —The most frequent and almost the only cause of acute anae¬ 
mia is excessive hemorrhage. The occasion may be a wound of any 
sort, surgical operations, blood-letting, bursting an air-vessel, nose¬ 
bleed, hemorrhage from the lungs or from an ulcer in the stomach, as 
in bloody vomiting. Acute anaemia is distinguished from chronic by 
its sudden appearance. It may be produced in an hour by sudden 
hemorrhage or may be two or three days in coming on in consequence of 
repeated small hemorrhages. The pallor by which it is characterized 
is peculiar, and gives to the patient a strange appearance, as it often 
occurs in persons who are quite plump. 

The skin of a light-complexioned person acquires a dead, almost 
ashen appearance. In dark-complexioned people and the dark-skinned 
races, the color of the skin is darkened rather than lightened by anae¬ 
mia. The thermometer indicates a considerable fall of temperature, 
not only externally but internally. Upon placing a stethoscope, or in¬ 
strument for examining the chest, over the jugular vein, a peculiar 
sound will be heard, known as the venous hum, or ‘ bruit de diablel 
due to the thinness of the blood. Some of the symptoms noticed, as 



CHRONIC ANAEMIA. 


837 


unnatural pallor immediately resulting from loss of blood, may con¬ 
tinue for a long time, and even for months and years. 

Treatment. —Rest, good food, transfusion of blood or milk. 

The first thing essential in the treatment of acute anaemia resulting 
from severe hemorrhage is rest. The patient should be placed at once 
in a horizontal position and kept so for some time, if there is the least 
tendency to syncope, or fainting, whenever he attempts to sit up or 
walk. After a large hemorrhage, absolute rest should be required of 
the patient, even if he does not experience premonitory symptoms of 
fainting when in an erect position. It is very important that this 
point should be recollected, as in many cases patients have died from 
sudden paralysis of the heart in consequence of standing upon their 
feet or walking after a severe hemorrhage. Sometimes the patient 
must be confined in bed not only for a few days but for several weeks. 
On account of there having been so great loss of blood, every means 
should of course be taken to increase the patient’s nutrition. He 
should be given an abundance of wholesome food prepared in a man¬ 
ner easy of assimilation. Tonic treatment, particularly the use of 
electricity and massage, is of very great value. In severe cases of 
hemorrhage, in which the patient’s life has been seriously threatened, 
and in other cases in which the urgency of the case is not so great, 
blood has been injected into the veins of the patient by the process 
known as transfusion. Both human blood and the blood of animals 
have been employed for this purpose. 

Although the process of transfusion is attended with considerable 
danger, there is no doubt that many lives have been saved by it. 
When the blood of the lower animals is used, a peculiar and even dan¬ 
gerous disturbance of the system follows; and in case the amount of 
blood injected is quite large, inflammation of the kidneys occurs. 
These results are said not to occur when human blood is employed and 
injected in a proper manner. Very recently the injection of warm, fresh 
cow’s milk has been employed by Dr. Thomas of New York and others, 
and, as it is claimed, with the most favorable results. This process can 
of course be used only by expert surgeons. 

CHRONIC ANAEMIA. 

SYMPTOMS.—Dry, thin, wrinkled skin; emaciation; shortness of breath ; nervous¬ 
ness; baldness; dropsy; fatty degeneration of the heart, liver, kidneys and other parts; 
in women, amenorrhoea and ieucorrhoea in many cases. 


838 


DISEASES AND THEIR TREATMENT. 


The symptoms of chronic anaemia are, with slight exceptions, in¬ 
cluded in those of acute anaemia, the chief difference being that in¬ 
stead of being produced so suddenly as in the acute form they occupy 
a long time in appearing. 

Causes. —Under the leading causes should be noticed first, predis¬ 
position. Some persons inherit a tendency to hemorrhage, having what 
is termed hemorrhagic diathesis. Such persons are commonly known 
as “ bleeders.” "Women are much more liable to chronic anaemia than 
men, principally owing to the fact that they have about one-tenth less 
blood in proportion to the weight of the body, and partly because they 
are more exposed to the causes which occasion the disease in the chronic 
form. Another cause of anaemia is deficient nutrition, or the use of 
too small a quantity of food. As the blood is made of what we eat, it 
is evident that if too small a quantity of nutritive material is introduced 
into the blood its elements will be deficient. Deficiency of light and of 
pure air may also be justly mentioned as common causes of anaemia. 
This is very clearly shown by the great frequency of the disease among 
milliners, factory operatives, and others who are much excluded from 
the sunshine and obliged to breathe impure air. Excessive or deficient 
physical exercise is another frequent cause of anaemia. A person who 
takes too much exercise may use up the elements of the blood more 
rapidly than they can be produced from the food which he is able to 
digest. On the other hand, deficient exercise occasions deficient nutri¬ 
tion by causing loss of appetite, impaired digestion, etc. Exposure to 
excessive heat or to a low temperature are both causes of anaemia. 
Prolonged nursing in women, sexual excesses in either sex, serious 
hemorrhage, external or internal, and numerous forms of disease, par¬ 
ticularly spermatorrhoea, leucorrhoea, animal parasites, dyspepsia, and 
fever, are frequent causes of anaemia. Parasites are a common cause 
of the disease in this country, and very frequently in Egypt, where 
a peculiar animal parasite infests the small intestines of individ¬ 
uals, and thrives by sucking the blood of the patient. Chronic dys¬ 
pepsia is one of the most frequent of all causes of anaemia. A per¬ 
son cannot be a dyspeptic for any length of time without becoming to 
a greater or less degree anaemic. A severe fever will produce anaemia 
almost as rapidly as a hemorrhage, by interfering with the nutritive 
processes as well as by destruction of the nutritive elements of the body 
through rise of temperature. Chronic anaemia is a very common af- 


CHRONIC ANAEMIA. 


830 

fection, especially among women and children. It should not be looked 
upon as a diseased condition which is attended by no danger, as it is a 
powerful predisposing cause of other and more fatal diseases, besides 
being itself capable of producing death if sufficiently long continued. 

Treatment. —It is evident that the first step in the treatment of 
this disease should be to remove the cause. If the cause is dyspepsia, 
this must receive attention; if intestinal parasites, they must be dis¬ 
lodged ; if prolonged nursing, nursing must be interdicted; if too lit¬ 
tle food, a larger quantity of nourishing, wholesome food must be em¬ 
ployed. The mistake must not be made, however, that by good food 
is meant what is usually termed rich food or a stimulating diet. 
Neither should a large quantity of animal food be taken, especially 
when the digestive organs are impaired, a fact which is seldom ob¬ 
served. In some cases also, particularly those in which there is a de¬ 
gree of fever, rest is an essential for recovery. The patient should be 
put to bed and required to remain there until he has gotten into a 
condition in which it is safe for him to exercise. At first, ex¬ 
ercise should be exceedingly moderate, being gradually increased. 
Tonic remedies should be employed. Electricity and massage 
are among the most useful of all agents. Inunction is another 
very useful remedy. Sun-baths as a tonic in the treatment of 
anmmia cannot be extolled too highly. If the patient is able to do so, 
a large amount of exercise in the open air should be taken daily, when 
the weather does not prevent. We have frequently attained good re¬ 
sults in the employment of Trommer’s extract of malt in many 
cases of chronic anaemia. It is a most admirable substitute for cod- 
liver oil, as has been shown by experiment on a large scale in Ger¬ 
man hospitals. Dropsy, when present in such a degree as to render- 
special treatment for it necessary, may be best remedied by the use of 
such diaphoretics as the Turkish or vapor bath. Care must be used* 
however, in the administration of the bath that the patient be not 
weakened thereby, and consequently it should not be applied until a 
considerable degree of strength has been secured. 

The popular remedy for ansemia in all its forms is iron, which is 
administered in a. great variety of forms. I he theory upon which this 
practice is based is that the blood corpuscles are deficient on account 
of the deficient supply of iron, or at any rate that their increase may 
be augmented by a supply of iron to the system. That this is an ei- 
ror, however, will be readily seen when attention is given to the fact 


DISEASES AND THEIR TREATMENT. 


S40 

that the food contains a much larger amount of iron than is really 
needed by the system, as also by the fact to which we have called 
•attention in considering the use of iron in medicine, that it is exceed¬ 
ingly doubtful whether the system can assimilate iron or any other 
mineral in an inorganic state. It is certain that the partially organized 
dorm in which inorganic substances are received as food is much 
more favorable to their absorption and assimilation than the inorganic 
•state in which they are employed in medicine. 

Another fact should be taken into consideration, namely, that when 
iron is administered as a medicine, an examination of the discharges 
from the body shows that if any proportion of that taken into the 
stomach is absorbed, the proportion is exceedingly small, nearly the 
whole being expelled with the bowel discharges, as elsewhere remarked. 
It is very probable indeed that the favorable results apparently obtained 
from the use of iron are really the effects of the other remedies em¬ 
ployed or of the improved hygienic conditions of the patient. We are 
certain at least of having cured or helped to recover some cases of 
anaemia without having found it necessary to resort to the use of iron, 
and never have seen any benefit whatever from its use in the few cases 
in which we have employed it experimentally. 

Although this doctrine may be considered by many very heretical, 
we are glad to know that we are not alone in the profession in our 
skepticism as to the value of iron as a therapeutic agent, as we have 
shown in the previous part of this work. 

An exceedingly fatal, but fortunately rare, form of this disease, 
known as progressive anaemia, has been observed during the last few 
y'ears. It is particularly apt to occur during pregnancy, and especially 
in women who have borne several children in rapid succession. In 
.genuine cases of this disease it is stated by the few physicians who 
have observed them that no remedies thus far employed have been of 
any value. The patients steadily decline from the first in spite of all 
that can be done for their relief, the fatal termination beino; reached in 
from six or eight weeks to some months. 


chlorosis. 

SYMPTOMS.—Pale or yellowish countenance; dark circles about the eyes; palpita¬ 
tion of the heart; lassitude; variable and perverted appetite; depression of the 
mind; usually suppressed or scanty menstruation. 

% 

Chlorosis is a disease closely allied to anrnmia. It in fact presents 


CHLOROSIS. 


841 


many of the symptoms of the latter disease, though there are several 
points of difference, one of the most marked of which is that there is 
little or no emaciation in chlorosis and may often be an increase of flesh, 
while in amemia the opposite is almost invariably the case. Chlorosis 
generally occurs in young girls just entering womanhood, though it may 
occur in women at any period of life, and there have been a few instances 
of its occurrence in men. It usually occurs just after the beginning of 
menstruation. One of the first symptoms noticed is lassitude on slight 
exercise. Increasing loss of color is next observed, the cheeks becoming 
blanched, and, in brunettes and persons with dark complexions, acquiring 
a yellowish tinge which has a greenish appearance in contrast with the 
dark rings that encircle the eyes. In addition to the symptoms enumer¬ 
ated above, the patient suffers with antemia, or the symptoms of amemia, 
such as great shortness of breath upon taking even slight exercise. In 
many cases, hacking cough, nervous disorders, derangement of the diges¬ 
tion, obstinate constipation of the bowels. Sometimes slight dropsical ap¬ 
pearance and swelling of the ankles occur, although this last symptom 
is not so serious as is generally supposed, the appearance of oedema being 
deceptive. One of the most unaccountable peculiarities of the disease is 
the great perversion of the appetite, the patient frequently eating slate 
and lead pencils, chalk, clay, even cotton, wool, and other indigestible 
substances, when not observed. It is generally supposed that suppres¬ 
sion of menstruation, or amenorrhoea, is a constant symptom in chlorosis. 
This is not the case, as many cases have been observed in which this 
function was performed as regularly and even more profusely than in 
health. 

Causes. —Among the causes of chlorosis the first that should be men¬ 
tioned are unhygienic habits of life, particularly sedentary habits, and 
the unwholesome mental condition produced by the reading of novels 
and other sentimental literature. The practice of secret vice very often 
entails upon its victims this serious disease. Many cases of chlorosis are 
due to the artificial modes of life imposed upon young girls by the habits 
of modern society. This accounts for the very great increase in the fre¬ 
quency of the disease which has been noticed within the last forty or 
fifty years. There can be no doubt that the neglect of physical culture 
among girls is a most potent cause of this malady. An unwholesome 
diet, particularly the use of pastry, highly seasoned food, condiments, 
fats, and sugar in the shape of preserves, candies, and sweetmeats, has 
much to do in producing this disease. Lastly may be mentioned a hered- 


842 


DISEASES AND THEIB TREATMENT. 


itary disposition and congenital defects. An eminent German observer 
has shown that in many of the worst cases of this disease the large arte¬ 
ries of the body are exceedingly small, to which defect he thinks the dis¬ 
ease is in many cases due. The popular supposition that it is caused by 
suppression of the menses is not supported by facts. In this, as in most 
other diseases in which the symptom referred to is observed, the sup¬ 
pression of the menstrual function is an effect of the disease rather than 
the opposite. It is necessary to keep this point in mind, as it has an im¬ 
portant bearing on the treatment. Another popular theory respecting the 
origin of the disease, namely, that it originates in the emotions, being 
particularly induced by disappointment in love, is not without founda¬ 
tion, although cases in which it originates in this way are by no means 
the most common. 

Treatment. —The first measures to be adopted are those which will 
secure, as far as possible, the removal of the causes of the affection. The 
diet should be properly regulated, the patient being required to take such 
food as will encourage elimination from the system of the products of 
excretion, which are diminished in this affection in a marked degree, the 
urine being pale and containing less than the usual portion of urea. 
Fruits, and such grains as oatmeal and whole-wheat meal, are among the 
most excellent articles of food for persons suffering with chlorosis. Sugar 
and fats should be avoided. Exercise should be taken in the open air, and 
the patient should be exposed to the sunshine as much as possible and 
surrounded with cheerful conditions. No special treatment should be 
employed for the purpose of bringing on menstruation until the patient’s 
condition has been improved otherwise. Indeed, it is seldom necessary 
to give this symptom especial attention, as the function will be speedily 
restored when the cause of its suppression has been removed together with 
the other morbid conditions from which the patient has suffered. As is 
the case with anremia, the favorite remedy in the popular treatment of 
chlorosis is iron, and there is little doubt that the administration of 
large doses of this drug will often cause the disappearance of some of 
the most prominent symptoms of the disease; but those who have had 
the most experience in the treatment of this affection admit that iron has 
no curative effect upon the real morbid condition present in this disease, 
and that all it can do is simply to palliate or temporarily remove the 
symptoms of the disease; for when its use is discontinued the great 
majority of cases will speedily relapse. It should be further stated with 
reference to the use of iron, that it very frequently greatly impairs the 


PLETHORA . 


843 


digestion, and consequently stands directly in the way of the effectual 
and permanent cure of the disease. Notwithstanding the general reli¬ 
ance placed upon this drug, it is undoubtedly accountable for a very 
large proportion of the failures in the treatment of this affection. We 
are thoroughly convinced by experience in the treatment of cases of this 
sort that they can be much more successfully treated by other means. 
We have never yet failed to cure cases which have come under our care 
by careful regulation of the hygiene of the patient, and the use of elec¬ 
tricity, massage, and other remedies calculated to improve the character 
of the nutritive processes of the patient. No harsh or reducing remedies 
should be employed; but it is of very great advantage to encourage elim¬ 
ination to a sufficient extent. For this purpose the proper employment 
of water in connection with electricity is of very great service. The 
wet-hand rub with salt water every day, or three or four times a week, 
together with sitz baths three or four times a week, and, when possible, 
the application of electricit}^ two or three times a week in such a manner 
as to secure a tonic effect, are useful for this purpose. 

PLETHORA. 

SYMPTOMS.—Excessive redness of the face and Ups; increased heat of the body ; 
unnaturally strong and full pulse ; unnatural mental and physical activity. 

This condition is exactly the opposite of amemia. It is characterized 
by an excessive activity of the blood and an increased number of the 
blood corpuscles. The blood is also highly charged with the waste prod¬ 
ucts or excrementitious elements of the body. In consequence of this, 
the disease is exhausting in character, producing continual mental activ¬ 
ity or restlessness. It also, on account of this increased activity which 
often amounts to irritability, produces inflammatory diseases and fevers, 
while the excessive fullness of the blood and consequent increase of press¬ 
ure within the vessels occasions a tendency to apoplexy in consequence 
of hemorrhages of the brain, and also hemorrhages in other parts of 
the body. 

Causes. —The causes of plethora are too much food, especially highly 
seasoned and stimulating articles; the excessive use of fats, sugar, and 
other clogging substances; too slight exercise; the result of which is that 
while new material is brought in, the old material is not removed as it 
should be, and consequently many vital organs become sluggish in ac¬ 
tion and the vital fluid becomes irritating in character. 


844 


DISEASES AND THEIR TREATMENT. 


Treatment. —The treatment of plethora is, in most respects, as 
nearly as possible opposite to that recommended in anaemia. The patient 
should be instructed to restrict his diet and to abstain wholly from the 
use of flesh, condiments, fat, and all stimulating foods. Sugar 
should be used very seldom. The diet should consist chiefly of fruits and 
grains, and food should be taken twice a day, never between meals. The 
patient should take a large amount of exercise daily, and be in the open 
air as much as possible. A course of energetic eliminative treatment is 
necessary to arouse to activity the sluggish organs, and by this means 
to purify the blood and thus improve it in both quality and quantity. 
There is no necessity for blood-letting, the practice so much in use for 
the relief of plethora a quarter of a century ago. At that time it was 
so commonly resorted to for this purpose that ordinary barbers practiced 
it, and many people considered it almost as essential to be bled as to be 
shaved or have their hair cut. All the benefits that could possibly be 
derived from bleeding may be obtained from the use of Turkish, Russian, 
vapor, and hot-air baths, and from the use of packs, rubbing wet-sheets, 
electro-thermal, and other forms of bath. Medical treatment is scarcely 
called for in the treatment of this affection, since recovery sneedily takes 
place when the causes are removed. 

OBESITY, OK CORPULENCE. 

SYMPTOMS.— Excessive fatness; excessive sebaceous and perspiratory secretion; 
shortness of breath, and often palpitation of the heart upon making slight exertion. 

The characteristics of this disease are so well known that it is unnec¬ 
essary to go into an elaborate description of the condition of the system 
in corpulency. The disease may occur at any time of life, but is by far 
the most frequent in early infancy and after forty years of age. Women 
are more frequently affected than men, the disease usually making its 
appearance in them at, or near, the change of life. In such extraordinary 
cases of obesity as that of Mr. Bright, of England, who attained the 
enormous weight of 609 lbs., or those in which the weight of the body 
is increased from two to four times that in health, there is, of course, no 
difficulty in discovering the disease; but in many cases it is by no means 
easy in a given case to decide whether the condition is one of obesity 
or of slightly increased fatness, which is usually termed “ good condition.” 
Indeed, it is probable that the condition of moderate rotundity which is 
consistent with the enjoyment of the highest health passes by such slow 
degrees into a condition of disease from superabundance of food that there 


OBESITY, OR CORPULENCE. 


845 


is no distinct dividing line. For practical purposes, however, it must be 
said that a person is in a morbid or diseased condition on account of the 
increase of fat whenever the accumulation becomes so great as to per¬ 
ceptibly interfere with any of the vital functions. In addition to the 
symptoms already mentioned, various local symptoms are often observed, 
as varicose veins in the lower limbs, unnatural redness of the face, and 
especially of the nose, clumsiness of gait, and a sediment in the urine. 
In consequence of the body being covered with a thick layer of fat, there 
is a marked tendency to the accumulation of heat, which is conducted 
away from the body very slowly, so that the person is made to suffer 
greatly with heat, especially in the summer season and upon making 
violent exertion. To guard against inj ury from this source, nature sets 
up a profuse perspiration whenever the system is exposed to an unnat¬ 
ural degree of heat from either internal or external causes, by which the 
patient is often very greatly weakened. 

Singular as it may appear, the condition previously described as 
plethora is by no means constant in obesity. In many cases the condi¬ 
tion of the blood is that of anaemia, there being a marked deficiency in 
the proportion of red blood corpuscles. Indeed, there must be a decided 
tendency to anaemia manifested, sooner or later, in nearly all cases of 
obesity. This is an important point to be borne in mind, as it has a 
practical bearing on methods of treatment. The excessive accumulation 
of fat is not, as may be supposed, confined to the outside of the body. 
Post-mortem examinations of corpulent persons have shown that nearly 
every organ and structure of the body, internal as well as external, 
suffers from the excessive deposit of fat. The liver is usually more or 
less enlarged, sometimes greatly so, and is infiltrated with fat. The 
kidneys are not only imbedded in a mass of fatty tissue, but their sub¬ 
stance is also filled with it. The heart is generally loaded down with 
fatty accumulations, and the walls of the arteries are more or less weak¬ 
ened by the exchange of their normal tissues for fat. The muscles, also, 
are invaded by the fatty deposits in a very marked degree. In fact, very 
few, even of the most delicate organs of the body, escape the general 
morbid tendency. These changes in internal organs are what are known 
and have been previously described as fatty degeneration, and the con¬ 
sequences of these morbid processes entail upon the sufferer from obesity 
the most serious effects of this disease. The deficiency in the number of 
red blood corpuscles gives rise to an unpleasant, and often serious 
dyspnoea, or difficult breathing, which is occasioned by any unusual ex- 


846 


DISEASES AND THEIR TREATMENT. 


ercise. The change in the structure of the heart is the cause of frequent, 
and sometimes serious palpitation. In severe cases the heart’s action be¬ 
comes extremely weak and irregular. One point which may be worthy 
of particular mention is that obesity not only entails upon persons sub¬ 
ject to it certain inconveniences which arise directly from this morbid 
condition, but renders them in a very unusual degree liable to suffer from 
various other diseases, among which may be mentioned as those to which 
corpulent people are particularly liable, apoplexy, rheumatism, gout, 
diabetes, severe colds, fevers, and inflammatory affections of all sorts. 

The tendency to apoplexy as being characteristic of this disease is 
readily accounted for by the changes in the blood-vessels, by which their 
walls are weakened and thus rendered much more liable to rupture from 
any degree of pressure induced by exercise, emotion, excitement, or any 
other cause. The frequency of rheumatism and gout in fleshy persons 
is undoubtedly occasioned by the retention of the waste products, or ex- 
crementitious principles, in the system, which results from the torpid, in¬ 
active state of the liver, kidneys, and other excretive organs. It is this 
gross condition of the system also which predisposes an obese person 
to febrile and inflammatory affections; and we should not omit to re¬ 
mark that when the last-mentioned diseases occur in very corpulent 
people they almost invariably manifest an unusual degree of severity and 
fatality. On account of the grossness of the blood and the lowered vital¬ 
ity of the tissues in consequence of their impaired condition, certain skin 
diseases, particularly eczema, are very common accompaniments of 
obesity. This is particularly true of young children, in whom excessive 
fatness is the most common cause of the often very troublesome affection 
known as intertrigo, or chafing. 

When left to itself the disease finally terminates in death, which may 
be either the direct result of the enormous accumulation of fat through 

o 

interference with the operation of the vital organs, or, as is much more 
frequently the case, death may result from apoplexy, syncope, or from 
any acute or chronic disease with which the patient may become affected, 
either independently or as a direct result of his obesity. 

The only diseases at all likely to be confounded with obesity are gen¬ 
eral dropsy and emphysema. The first condition may be readily dis¬ 
tinguished by means of the phenomena of bloating (see “ Dropsy ”); the 
second morbid condition, which is a peculiar affection in which the tissues 
become distended with ah', may be readily distinguished by the resonance 
produced by tapping or percussing the affected part. 


OBESITY, OR CORPULENCE. 


847 


Causes. —Many persons inherit a predisposition to obesity. This is 
often seen in families in which parents exhibit a decided tendency to ex¬ 
cessive corpulency. In some instances, all of the members of a family 
may be affected by it. It is also noticed that when the disease is mani¬ 
fested in parents at a particular age it is very likely to occur in chil¬ 
dren at or about the same period of life. As before mentioned, the 
disease seems to depend somewhat upon age, being much more frequent 
in early childhood, after forty years of age, and in females after change 
of life. The greater liability of females to this affection is noticed in 
infants as w T ell as in adults. Those individual peculiarities which make 
up what is termed temperament also appear to have much to do with 
the causation of this disease, it being well known that phlegmatic or 
lymphatic people are much more liable to it than are those of an active, 
nervous temperament. The immediate or exciting causes of obesity are 
excesses in diet, deficient exercise, and morbid conditions of the system 
due to other diseases. Gluttony and laziness have long been recognized 
as the two great causes of obesity, so that it has become customary to 
regard an excessively fat man as one who has been given to the gratifi¬ 
cation of appetite and is of an indolent disposition. This does not, how¬ 
ever, apply to 'women in that degree in which it is applicable to men, 
since, as before remarked, they are at a certain period of life liable to 
this disease independent of hereditary predisposition or of habits especially 
calculated to provoke its manifestation. There are, of course, exceptions 
also among men, and yet the general rule holds true in £0 large a pro¬ 
portion of cases, that, as before remarked, a fat man is generally con¬ 
sidered as one who is, or has been, an excessive eater, and has been given 
to habits of ease and luxury. As has been previously mentioned, obesity 
is an accompaniment, or possibly the result, of the morbid conditions 
present in several diseases named, but most frequently in chlorosis. 
Certain diseases of the lungs and heart also, in consequence of diminish¬ 
ing the elimination of the waste products of the system, produce a 
marked tendency to the accumulation of fat. The same may also be 
said with reference to what is known as Addison’s, or the Bronze disease. 
With reference to the influence of diet in the production of this disease, 
it should be further explained that obesity is produced, not alone by the 
excessive use of fat, but by an excess of certain other kinds of food, par¬ 
ticularly those of a fatty or carbonaceous character, as the development 
of fat is particularly favored by food of this class. 

It is w r ell known that animal fats wdien taken into the system are 


848 


DISEASES AND THEIR TREATMENT. 


deposited with little change, and hence greatly favor the production of 
adipose tissue. It has not been thoroughly proven that starch, sugar, 
or gluten is converted into fat in the system ; but there can be no 
doubt that these substances supply the place of the material which other¬ 
wise would be consumed, but, in consequence of the substitution, may be 
converted into fat, so that they become indirectly, if not directly, the 
cause of excessive fatness when taken in large proportions. The obesity 
of children is not infrequently due to artificial feeding, the food given 
being of such a character as to produce fat in disproportion to the 
amount of muscular tissue formed. 

Treatment. —In calling attention to the treatment of this disease 
we wish especially to impress upon the reader the fact that obesity is by 
no means so harmless and insignificant a disease as is generally supposed. 
This might well be inferred from the marked and grave character of the 
many effects occasioned by excessive fatness, to which we have already 
called attention. Hence it cannot be too much insisted upon that de¬ 
cided measures should be promptly adopted, not only for the cure of this 
malady whenever it is found to exist, but also for its prevention when¬ 
ever there is known to be a hereditary tendency to it, or conditions which 
will be likely to induce it. Obesity is by no means so easy to cure as 
might be supposed. When once thoroughly established upon the system, 
and especially when of a hereditary character, it is found exceedingly diffi¬ 
cult to cure, patients not infrequently relapsing after an apparent cure 
has been effected, and in many cases receiving little benefit by any mode 
of treatment which they can be induced to undergo. One of the great 
obstacles in the way of the efficient treatment and radical cure of the dis¬ 
ease, is the reluctance manifested by many of those affected by it to com¬ 
ply with and assist in carrying out the measures of treatment essential to 
secure recovery. This is especially the case when the disease has been 
brought on by excessive indulgence in eating and indolence. The force 
of long-continued habit is so strong that in many cases the patient affirms 
that he would prefer to suffer the inconveniences of the disease and incur 
the risk of ultimate suffering and premature death which it involves, 
rather than forego the gustatory enjoyments to which he has long- 
been accustomed. The strong aversion to physical exercise is another 
impediment in the treatment of this disease, the cure of which in many 
cases depends in great measure upon the cultivation of habits of regular, 
systematic, and even severe, physical exercise. The measures of treat¬ 
ment to be adopted for the cure of the disease, and also for its preven- 


OBESITY, OR CORPULENCE. 


849 

tion in cases where there is a marked tendency to it from any cause, are 
such as will secure the following conditions:— 

First, the diminution of the supply of food, especially fattening food, 
or that which has a tendency to induce obesity. 

Second, an increased consumption of muscular tissue, thus creating a 
demand for food for the legitimate purpose of replenishing waste. 

Third, the increased formation of red blood corpuscles, which are de¬ 
ficient in the many common forms of obesity. 

Fourth, an increased supply of oxygen to the system, by means of 
which the surplus material which would otherwise be deposited as fat 
will be consumed and so removed from the body. 

If such measures of treatment can be adopted as will secure the per¬ 
fect realization of the four indications mentioned, cases of obesity in 
which recovery cannot be secured will be very rare indeed. The only 
difficulty is in securing the necessary conditions. The first of these may 
be secured in the manner already suggested; namely, by diminishing the 
amount of food taken by the patient, especially of those substances 
which have a tendency to produce fat. The mistake should not be made, 
however, of supposing that obesity is to be cured by starvation. The prob¬ 
lem to be solved in the dietetic management of the disease is to diminish 
the amount of surplus and useless material in the form of fat without 
at the same time lessening the patient’s strength and undermining his 
constitution. 

The starvation cure, while it will undoubtedly rapidly diminish the- 
weight, at the same time reduces the patient’s strength and induces a 
condition of anaemia, or poverty of the blood, which is very likely to 
result in a relapse into a condititon far worse than the first, since 
obesity occasioned or accompanied by anaemia is far more obstinate to 
cure than any other form. Consequently, those measures of treatment 
which greatly weaken the patient are much more likely to do harm 
than good, so that the remedy will prove far worse than the disease. 
The patient’s diet should be reduced to a rpinimum in quantity, but it 
should be so carefully adjusted that sufficient nourishment shall be 
given him to maintain his strength. In extreme cases of obesity 
the restricted diet may be employed for a very short period; cer¬ 
tainly not sufficiently long to in any very great degree weaken the 
strength of the patient. The regulation of the quality of the diet is 
of fully equal importance with the restriction with reference to 
quantity. 


54 


850 


DISEASES AND THEIR TREATMENT. 


The following articles of food, on account of their tendency to in¬ 
crease fat, should be entirely forbidden: Butter, cream, fats of every 
description, rich sauces, pork, goose, duck, most kinds of game, salads, 
pastry, ices, raisins, dates, figs, all kinds of sweet and preserved fruits, 
nuts of every description, and, in fact, nearly all kinds of starchy, 
fatty, and saccharine articles of food. 

The following articles may be eaten occasionally, but should be 
taken very sparingly indeed : New or unskimmed milk, eggs, potatoes, 
carrots, parsnips, and most other vegetables, rice, buckwheat, mutton, 
and beefsteak. 

The articles in the following list, and those of a similar character, 
should form, almost exclusively, the diet of a person suffering with 
obesity: All kinds of green vegetables, such as asparagus, cabbage, 
green peas, beans, and spinage; and acid fruits, such as lemons, sour 
oranges, sour apples, and currants. Of the grains, cracked wheat, 
graham flour, rye, and oatmeal in moderate quantities, may be eaten. 
Meat should be used in moderation, the best varieties being venison, 
chicken, trout, and lean beef wholly free from fat. All the articles of 
food mentioned should be cooked entirely without the use of either 
fat or sugar. Very moderate quantities of salt should be employed. 
Tea, coffee, chocolate, and cocoa should be entirely interdicted, as also 
should all kinds of alcoholic drinks, and stimulants and narcotics of all 
kinds. The idea that animal food is the diet par excellence, and that 
articles of food of this class may be taken in almost unstinted quan¬ 
tities without harm, is a very mistaken one. This statement is based 
upon the following facts :—• 

First, food of an exclusively albuminous character is capable of 
forming fat and thus contributing to the production of obesity. This 
is true, however, only when it is taken in excessive quantities, as has 
been shown by numerous experiments upon animals 

Second, the use of large quantities of animal food favors the in¬ 
creased production of urea and the retention in the blood of the ex- 
crementitious principles, which, as previously remarked, are among the 
most potent causes of the many grave effects which result from obesity, 
particularly the great liability to inflammatory affections, fevers, rheu¬ 
matism, and gout. In not a few cases in which an exclusive animal 
diet has been adopted in this disease, the patient has found himself in 
a much worse condition from the injurious effects of his clogging and 
stimulating diet than that occasioned by the original disease. This 


OBESITY, OR CORPULENCE. 


851 


we regard as a very important point to be kept in mind in the treat¬ 
ment of obesity, on account of the wide-spread and popular character 
of the error and the serious evils resulting from it. 

While the amount of solid food should be reduced to the minimum 
quantity, as before remarked, the fluid portion of the diet, at least if 
pure water be the only drink, may be increased to any extent required 
by the desires of the patient. It is even advisable to urge upon the 
patient the importance of drinking daily considerable quantities of 
pure water, preferably cold water, as warm drinks are not to be rec¬ 
ommended in this disease on account of their tendency to increase the 
activity of the skin, which is already abnormally active. From six to 
ten, or even more, glasses of water may be taken each day with ben- 
fit, unless there is a marked disturbance of digestion of a character to 
contra-indicate the taking of so large a quantity of fluid. The object 
of this measure is to increase tissue change by increasing the fluidity 
of the blood. The efficiency of water-drinking as an agency for 
this purpose has been fully dwelt upon elsewhere. 

The patient should be encouraged to take exercise to the full ex¬ 
tent of his ability. It would, of course, be useless to recommend to 
persons advanced in years and excessively corpulent to engage in any 
very active or violent physical exertion. Such a recommendation 
might, in extreme cases, even prove fatal by occasioning excessive 
action of the heart or congestion of the brain, the results of which 
might be sudden paralysis of the heart on account of its weakened 
condition, or apoplexy through rupture of a blood-vessel in the brain. 
There are very few curable patients, however, even those who are the 
most remarkable specimens of obesity, who are unable to walk, at least 
for a short distance, and these should be urged to take as much exer¬ 
cise of this sort each day as they can endure, not of course attempting 
too long walks at first, nor continuing the exercise sufficiently long to 
produce very great exhaustion, but repeating it at sufficiently short in¬ 
tervals to secure the largest possible amount of exercise each day. 
For younger persons, those who suffer in a less marked degree, swim¬ 
ming, rowing, and the practice of gymnastics, may be recommended 
as a particularly efficient mode of exercise, as it brings into action the 
muscles of the upper as well as of the lower extremities and also those 
of the trunk. Only the lighter kinds of exercise should be taken, 
especially at first, but this should be done regularly and systemat¬ 
ically, if possible under the eye of a tutor, at least at first, so as to 
secure thorough and methodical exercise of the whole muscular system. 


852 


DISEASES AND THEIR TREATMENT. 


Hippocrates recommended vigorous exercise as a sovereign remedy 
fox' excessive fatness. He also made what seems to us a very sensible 
suggestion, namely, that obese persons should accustom themselves to 
light, thin clothing in winter as well as in summer and the practice of 
exposing the uncovered body for a considerable length of time every 
day to the free action of cool air. By the adoption and faithful appli¬ 
cation of the hygienic measures already suggested, the great majority 
of fat people may reduce themselves to reasonable proportions. Not 
infrequently, however, a considerable length of time may be required, 
but the patient should persevere, feeling sure that the course- which he 
is pursuing is the wisest one which can be adopted, and will, in all 
probability, secure for him the best results which can be obtained. If 
the dietary suggested becomes so unpalatable that the appetite is im¬ 
paired and the digestion is in danger of suffering, a slight modification 
may be made for three or four days or a week to give the patient a 
little opportunity to recover his appetite and enable him to enter upon 
his regimen again with renewed vigor. It is better to adopt a rigid 
dietary and then interrupt it at intervals of three or four weeks in the 
manner suggested, than to endeavor to follow continuously a more 
liberal regimen. 

All cases of excessive corpulency, and especially severe cases, may 
be greatly benefited, and the chances for recovery greatly increased, by 
other measures of treatment in addition to those already mentioned. 
The most useful of these are frequent cold bathing and the employ¬ 
ment in plethoric cases of powerful eliminative measures. A cold 
sponge or shower bath may be taken daily with benefit. It should be 
of short duration and taken in a warm room, and great care should be 
exercised to secure thorough reaction. In addition to this treatment, 
one to three vapor or hot-air baths and wet-sheet packs may be taken 
each week with benefit. When there is great inactivity of the liver and 
kidneys, daily fomentations over these organs and the wearing of the 
abdominal bandage will be found of very great advantage. The ex¬ 
cessive tendency to sweat which is present in this disease, although a 
remedial process, sometimes requires checking on account of its weak¬ 
ening tendencies. For this purpose cold shower and sponge baths are 
indicated. Another excellent measure of treatment is daily sponging 
of the body with an astringent wash composed of one part vinegar to 
three parts of a decoction of sage, oak-bark, or some other mild astrin¬ 
gent. The increased secretion of fat will also be checked by this 


I 


OBESITY, OR CORPULENCE. 853 

method of treatment. Much may be contributed to the patient’s com¬ 
fort by bathing the parts most affected with equal parts of alcohol 
and water, by which the excess of sebaceous matter will be removed. 

We are aware that we have devoted more space to this affection than 
the general opinion of its importance would justify; but this we have 
done on account of the fact that it is generally neglected by medical 
writers, and, as before remarked, is quite too commonly regarded as of 
too trivial moment to require serious attention except on account of 
its inconveniences. We cannot properly conclude this subject, how¬ 
ever, without calling attention to two notorious evils. We refer to the 
tobacco cure of obesity and the numerous quack nostrums advertised 
and sold under the taking title of “Anti-Fat” remedies. With refer¬ 
ence to the tobacco cure of corpulency, much might be properly said, 
but as we can say nothing better on the subject, we are glad to be able 
to quote the following excellent remarks by the eminent Prof. Immer- 
mann, of Bale, which are worthy of special attention, coming as they 
do from a gentleman whose nationality is certainly not remarkable 
for antipathy to the weed: “ While English and American physi¬ 

cians have celebrated tobacco-chewing as a very efficacious prophylac¬ 
tic against corpulence, and prescribed it, we can by no means coincide 
in such a recommendation in any case, since this nauseous habit can 
scarcely in our opinion act in a limiting manner upon the deposition of 
fat, otherwise than by undermining the appetite, and by setting up a 
chronic dyspepsia, provoking a certain degree of marasmus. The 
same holds good, and perhaps in a still higher degree, of other customs 
and vices, such as the habitual use of the preparations of coca and 
hashish, and of opium-smoking , and above all, of that senseless and 
injurious misuse of morphia in subcutaneous injection, which latter 
fashionable vice is, as we know, at the present day so much in vogue 
that in some places, and especially in medical circles it is looked on as 
quite the mode to be a slave to it.” 

The remarks of Prof. Immermann respecting the manner in which 
the excessive use of tobacco antagonizes obesity, apply with particu¬ 
lar force to the numerous anti-fat nostrums advertised so extensively 
in the newspapers. We have known several instances in which these 
remedies have been employed by corpulent people, and in some cases 
with the most disastrous results. They are highly poisonous com¬ 
pounds, which destroy the digestion ; and though these means will in 
some cases reduce fat, it is at the fearful expense of ruining the con- 


854 


DISEASES AND THEIR TREATMENT. 


stitution. Equally to be condemned as of essentially the same nature, 
is the practice once common among young ladies, and we fear not yet 
entirely out of vogue, of eating pickles and drinking vinegar for the 
purpose of exchanging a healthy plumpness for a slender form. Much 
more might he said, and perhaps with profit, hut the limitations of our 
space forbid us to dwell upon this subject longer. 

SCROFULA, OB KING’S EVIL. 

SYMPTOMS.—Skin eruptions, particularly about the head and face; enlarged lym¬ 
phatics, especially those of the neck; nasal catarrh; thickened upper Up ; discharges 
from the ears; enlarged tonsils; inflammation of the eyelids; capricious appetite; dis¬ 
ease of the joints and bones. 

Scrofula is a disease common to all countries, and in some one of 
its many forms of manifestation it is probably more common than any 
other constitutional disorder. According to careful estimates, twenty- 
four per cent of the inhabitants of England are affected by this dis¬ 
ease. The name scrofula is supposed to have been derived from the 
fact that the hog, sus scrofa , frequently presents enlarged lymphatic 
glands similar to those observed in this affection, or perhaps from 
the fancied facial resemblance to the hog produced by the thickened 
glands and upper lip and enlarged neck which are exhibited in many 
cases of this disease. The first symptoms of the disease most fre¬ 
quently appear between the ages of five and seven years, though they 
may appear at any period of life from early infancy to old age. Not 
infrequently the disease appears in early childhood and disappears at 
puberty, though in many cases the period of puberty is marked by a 
decided increase in the activity of the disease, or the appearance of tu¬ 
berculosis or consumption as a complication, or, perhaps, as another de¬ 
velopment of the constitutional affection. Until recent times, scrofula 
has been regarded as a blood disease, but modern researches have 
shown it to be a depraved condition of the nutritive processes, the exact 
character of which remains to be demonstrated. That it is closely al¬ 
lied to consumption and some other constitutional affections, is, how¬ 
ever, clearly proven. Eruptions on the skin, especially about the face 
and head, are among the earliest symptoms of the disease. Severe 
nasal catarrh, accompanied with a profuse and thick discharge of an irri¬ 
tating character, is also one of the earlier symptoms in many cases. 
In consequence of the irritating effects of the catarrhal discharge, the 
nostrils and upper lip become much thickened and enlarged. Next 
appear enlarged lymphatic glands and enlargement of the throat, com- 


SCROFULA, OR KING'S EVIL. 


855 ' 


ing on rapidly or by almost imperceptible degrees, most frequently in¬ 
volving the glands of the neck, sometimes those of other parts of the 
body. Discharge from the external ear, sore eyes, enlarged tonsils, 
and other morbid conditions mentioned under the head of symptoms, 
are all noticed in marked cases of the disease, so that it is by no means 
difficult to distinguish. 

The term scrofula has, however, been much abused, not only by un¬ 
professional people, but also by physicians, being charged with nearly all 
the ills to which human flesh is heir. It is the fashion with many per¬ 
sons, and not a few physicians, to attribute almost every obscure affec¬ 
tion, especially those of children, to this disease. This fashion has, per¬ 
haps, arisen from the fact that, in different cases of this disease, disturb¬ 
ances are produced in nearly every organ and function of the body. In 
surgery especially, it has been the custom to attribute nearly all diseases 
of the joints and bones which occur in childhood to scrofulous infection, 
but we believe it has been clearly shown by Dr. Sayre and other eminent 
observers, that in a large share of the so-called scrofulous diseases of 
the joints and bones, some mechanical injury has been the real starting- 
point of the disease. No doubt in many of these cases the injury might 
not have resulted in serious disease had it not been for the constitutional 
tendency to scrofula; and yet if the injury had not occurred, very likely 
the disease would not have been manifested in the particular manner ob¬ 
served, if, indeed, it had not remained dormant altogether. When the 
disease has been well marked in infancy, and does not disappear at 
puberty, it is very likely to continue, progressively increasing and gradu¬ 
ally undermining the constitution. The majority of scrofulous persons 
finally die of consumption. As has been before remarked, there has 
been traced a distinct connection between these two diseases, although 
it should not be supposed that a scrofulous person must necessarily die 
of pulmonary disease. 

Respecting the real nature of the disease, it should be said that the 
results of the most thorough researches upon the subject seem to show 
that it consists rather in a peculiar susceptibility of the system to the 
morbid influence of disease-producing agents from without. This ab¬ 
normal vulnerability, as the morbid condition may be called, is especially 
manifested in the lymphatic glands, the affection of which, so character¬ 
istic of this disease, is supposed to arise from their absorption of irritating 
matters from the exterior of the body, as the reception of germs or the 
absorption of morbid matter from a diseased skin. 


DISEASES AND THEIR TREATMENT. 


856 

Causes. —Among the causes of scrofula should be placed first, heredi¬ 
tary predisposition; not that the disease itself may be inherited, as is 
generally supposed, but, as is the case with nearly all hereditary affections, 
there is a transmission from parent to child of a susceptibility to mor¬ 
bid influences by which this disease is characterized. It is probable that 
in a large share of the cases of scrofula, the disease is simply the re¬ 
sult of development, through favoring circumstances, of tendencies in¬ 
herited from consumptive or scrofulous parents. We believe, however, 
that the influence of a bad hygienic condition has been clearly shown to 
be so active an agent in producing this disease, and in developing an in¬ 
herited tendency to it, that we may be justified in charging bad hy¬ 
giene with by far the greatest number of cases of scrofulous disease. 
Among the most important errors in diet are those appearing in early 
infancy. Of this sort should be mentioned the feeding of children upon 
food not suited to their condition, such as vegetables and farinaceous 
articles, and particularly the evil custom in some countries, especially 
Sweden and Germany, of allowing young children to imitate the exam¬ 
ple of their parents in drinking coffee and beer. It has also been shown 
by evidence which is entirely worthy of credence, that scrofula, as well 
as consumption, is very often produced in human beings, especially 
children, through the medium of milk. A child may imbibe a scrofulous 
taint through being nursed by a scrofulous or consumptive mother or 
wet-nurse. The testimony is equally clear that this disease is not infre¬ 
quently produced by milk from scrofulous or consumptive cows. That 
scrofula is by no means an uncommon disease in cows, has been clearly 
shown by the demonstration that the affection known as 'pearl disease 
among cows and other live stock, is identical with scrofula and other 
tuberculous affections. Some idea of the prevalence of this disease 
among cows may be gained from the statement of an eminent physician 
who asserts that at least fifty per cent of the live stock of Hanover, 
Germany, is affected with pearl disease, or scrofula. 

The production of scrofula has also been attributed to the use of 
potatoes, starchy vegetables, and other farinaceous articles of food. 
This error has prevailed so extensively in some countries that it 
bas become the fashion for mothers to prohibit the use of vegetables, 
2'>articularly potatoes, to their children; and as a German medical 
writer has said, “Many a poor child has been sent hungry to bed 
while its anxious mother passed a sleepless night in consequence of 
the discovery that it had eaten a potato.” Scientific investigation has 


SCROFULA, OR KING'S EVIL. 


857 


shown, however, that in this case, as well as with many popular notions 
of the same sort, there is no real foundation either in theory or in re¬ 
liable experience. We believe, however, it can be clearly shown that 
the large use of animal food, especially the use, as food, of animals in 
which scrofulous disease has been developed by confinement in stalls 
or close pens for the purpose of fattening, is one of the most serious 
dietetic causes of scrofula. Experiments have shown that the flesh, 
as well as the milk, of tuberculous or consumptive animals, will give 
rise to scrofula or consumption when eaten, even if cooked with a 
moderate heat. This being the case, how can we resist the conclusion 
that the use, as food, of the flesh of animals which have been fattened 
under conditions the best calculated to produce scrofulous disease, and 
the carcasses of which, in a large number of cases, show the actual 
anatomical changes resulting from scrofula, and especially the use of 
the flesh of the hog, which is known to be almost universally affected 
more or less intensely with scrofulous infection, must be among the 
most active and wide-spread causes of this almost universal malady ? 
We are firmly convinced, not only by theoretical reasoning, but from 
practical observations, that of all dietetic errors, the use of swine’s 
flesh is the most active cause of scrofulous disease. 

We should not omit to mention, however, that eating between 
meals, the use of pastry, candy, sweetmeats, and tidbits of all sorts, is 
also a prolific cause, not only in producing scrofula, but in developing 
scrofulous tendencies which might otherwise remain latent. Bad air, 
arising from overcrowding, deficient ventilation of living-rooms, sleep¬ 
ing apartments, and school-houses, must also be mentioned as a pro¬ 
lific cause of scrofula. If, as has been frequently shown by careful 
investigations of the subject, scrofula is, in some degree at least, an 
infectious disease, being communicable by means of diseased particles 
thrown off from the lungs by respiration, it will readily be seen that 
the crowding together of large numbers of children, quite a large per¬ 
centage of whom must in all cases be suffering more or less with 
scrofulous affections, must be in the highest degree dangerous. 

Uncleanliness of the skin, through want of frequent bathing, must 
also be a very common cause of this affection, or at least of the de¬ 
velopment of pre-existing scrofulous tendencies on account of increas¬ 
ing the liability to diseases of the skin. Certain diseases, as measles, 
scarlatina, diphtheria, typhoid fever, small-pox, and other affections of 
a grave character, frequently occasion the development of this disease. 


858 


DISEASES AND THEIR TREATMENT. 


It has also been shown that vaccination is not infrequently the means 
of inducing, or at least developing, scrofulous affections. There is 
good reason for believing that vaccine virus may be the means of com¬ 
municating the scrofulous taint to the person vaccinated when it has 
been obtained from either a child or a calf suffering from scrofulous 
disease. 

It has been generally supposed that persons of a sanguine temper¬ 
ament, or those having light complexions, blue eyes, and light hair, are 
particularly liable to scrofula, and even that the peculiarities of the 
temperament mentioned are indications of a scrofulous tendency. It 
has been shown, however, by Phillips, from a careful collection of sta¬ 
tistics, that this popular theory of disease is erroneous, and that per¬ 
sons of the very opposite temperament and characteristics from those 
named, are equally liable to the disease. Thus it will be seen that it 
is almost impossible to predict the occurrence of scrofula, before it has 
made its appearance, by any personal peculiarity. Indeed, the only 
basis upon which the probable occurrence of scrofula can be pre¬ 
dicted is that of known hereditary predisposition. It is contended, 
however, by those who have had the most experience in the treatment 
of this affection, that there is a distinct “ scrofulous habit,” of which 
there are said to be two varieties. The first, or irritable form, accord¬ 
ing to Dr. Birch-Hirschfeld, the eminent author of an able article on 
scrofula in Ziemssen’s Encyclopedia of Medicine, is characterized by a 
delicate frame of body, deficient muscular development, thin skin in¬ 
clined to bluish tint, with transparent veins especially in the temporal 
region and on the eyelid, soft hair, mostly of a light color, blue, lus¬ 
trous eyes with a dilated pupil, irritable temper, “and sexual and in¬ 
tellectual precocity.” The same author describes the second, or torpid 
form of scrofula as characterized by a burly frame of body, bloated 
appearance, richly developed adipose tissue, and muscles incapable of 
great exertion. The head is large, the physiognomy becomes heavy 
and unpleasant by the thickness of the upper lip, the broad jaws, and 
short, thick neck. The psychological character is distinguished by a 
sluggish, phlegmatic disposition and deficient development. Between 
these two typical classes there lie, of course, all the intermediate forms 
of disease. 

Treatment. —As remarked with reference to diseases of nutrition, 
the adoption of measures for the prevention of this disease or the develop¬ 
ment of the hereditary predisposition to it, is of the first importance. 


SCROFULA, OR KING’S EVIL. 


859 * 


The most effective measures of prevention would be some means of pre¬ 
venting the marriage of persons of scrofulous tendencies. The inter¬ 
marriage of families with a well-marked scrofulous tendency, should be 
regarded as a culpable transgression of one of the plainest laws of nat¬ 
ure. The children of such parents cannot escape a constitutional ten¬ 
dency which will surely result in an untold amount of suffering, and 
premature death. As this cannot be done, however, even when especial 
attention is called to the matter in cases in which the injunction is in the 
highest degree applicable, the best that can be done in most cases is to 
adopt such measures as will prevent the development of the inherited 
tendencies or the new production of scrofulous disease. The most ef¬ 
ficient of these measures will of course be a careful avoidance of all excit¬ 
ing causes of scrofula, to which attention has already been called. 

Where there is the slightest ground for suspicion of the inherited 
scrofulous constitution, preventive measures should begin with the very 
earliest period of infant life. The greatest pains should be taken to se¬ 
cure for the child proper food. The natural food of infants is milk, and 
this should be given until the period arrives when the development of 
the teeth indicates the propriety of adding other food to the diet. If 
the mother is consumptive, or has at any period in her life manifested a 
scrofulous tendency, or if she is for any reason unable to supply her 
child with its natural food, a wet-nurse should be employed. Great 
care should be taken to secure for a nurse a healthy person whose fam¬ 
ily history is wholly free from scrofulous or consumptive habits. If 
such a nurse cannot be obtained, as is many times the case, cow’s milk 
is the next best substitute; but care should be taken to secure milk 
from cows in a healthy condition. No milk should be given to the 
child until a careful investigation has first been made of the character 
of the cow from which it is obtained, the condition under which it is 
kept, the character of the food, etc. Candy, and things of a like char¬ 
acter, with which the friends of the little ones often supply them to their 
hurt, should be wholly interdicted. Excessive feeding should also be 
avoided, as scrofulous children often have a voracious appetite, and it is 
of the greatest importance that the digestive organs should be preserved 
in a healthy condition. Children should be very early accustomed to an 
abundance of fresh, pure air. Even when a very few weeks old, they 
should be taken out of doors and exposed to the fresh air and sunshine, 
in a moderate way of course, at first, and should sleep in rooms which 
are thoroughly ventilated, and not too warm, never being exposed for 
any length of time to a temperature above 70 °. 


860 


DISEASES AND THEIR TREATMENT. 


The eminent German author whose name has already been men¬ 
tioned in connection with this subject, recommends very highly the 
employment of cold sponging, which he insists should be begun very 
early and practiced daily. We suggest, however, that it is unnecessary 
to submit infants to so disagreeable a process as that of daily sponging 
with cold water, as all of the beneficial effects can be obtained by 
water which is only a few degrees less than the normal temperature. 
In general, it will not be necessary to employ water of a lower tem¬ 
perature than 80 ° or 90 °, and it is best to begin with lukewarm water, 
making it gradually cooler from day to day. By this process the skin 
will be fortified against the invasion of the irritating elements which 
are supposed, as we have intimated, to produce scrofula and to develop 
any latent scrofulous tendencies. As soon as the child is of sufficient 
age, moderate exercise in the open air should be secured. It should be 
dressed in such a manner as to secure thorough protection of the en¬ 
tire body, so as to maintain the equilibrium of the circulation, and then 
be allowed to play in the open air as much as possible—several hours a 
day at least. Too warm clothing, and especially too warm covering 
at night, should be avoided, as by this means the system is rendered 
susceptible to climatic and atmospheric changes which have a marked 
influence in exciting scrofulous affections. The measures of preven¬ 
tion sug*gested should also be employed in all cases in which the 
symptoms of the disease are already present, as they are equally effi¬ 
cient when applied as curative measures as when applied for prevention. 

In the medicinal treatment of scrofula, nearly every remedy in the 
materia medica has at one time or another been recommended and 
highly extolled as a specific. Each remedy, however, has in its turn 
fallen into disrepute and been replaced by others of a different nature, 
and, indeed, of an entirely opposite character. Even remedies which 
appeal to the imagination alone have been used, and with marked 
success. One of the most popular remedies of this sort was the touch 
of the king's hand, which was supposed to expel the disease and from 
which this malady acquired the name “ king’s evil.” Quacks have 
fattened on the sale of anti-scrofulous and blood-purifying mixtures 
wdiich had no effect upon the user except to render the blood still 
more impure and render the constitution less able to institute a suc¬ 
cessful remedial precess. 

In modern times the remedy which has been most lauded for the 
cure of scrofula is cod-liver oil. This remedy is the oil obtained from 


SCROFULA , OR KING'S EVIL. 


8G1 


the livers of codfish. The only way in which it differs from other fish 
or animal oils is the admixture with it, as an impurity, of considerable 
quantities of bile expressed from the liver. This remedy was first em¬ 
ployed in Holland and in Northern Germany for rheumatism more 
than half a century ago. By accident it was first introduced as a do¬ 
mestic remedy for scrofula, and has by degrees attained to the emi¬ 
nence of being considered as the most potent of all drug remedies for 
this disease. That it is by no means a specific, however, is readily ad¬ 
mitted by all who have had a large experience in its use and have 
studied its effects intelligently. Prof. Niemeyer well remarks that in 
many cases of scrofula, cod-liver oil “ is absolutely pernicious.” Iodine 
in some one of its numerous combinations is still employed by the 
great majority of physicians in all cases of scrofula, but it has long- 
been abandoned by the most advanced and scientific members of the 
profession as a remedy of no practical value in the treatment of this 
disease. Even those who recommend cod-liver oil do not pretend to 
employ it as a curative agent, but simply as a means of counteracting 
the tendency to emaciation and deficient nutrition by which one class 
of cases is characterized. One of the most enthusiastic advocates of its 
use asserts that “ no remedy has ever been so much abused as this one.” 

In the rational treatment of this affection it is of primary impor¬ 
tance that the principle should ever be kept in mind that the patient 
is to be treated, and not the disease from which he is suffering. If a 
cure is effected it must be through the wonder-working operations of 
nature, and not through the agency of any drug or other remedy ad¬ 
ministered to the patient. Hence it will of course be utterly useless 
to attempt to apply any routine method of treatment to all cases of 
tins disease. Indeed, it is essential to success that the most careful 
discrimination should be made in the treatment of different cases. It 
will be far better to do nothing more than to surround the patient with 
the most favorable hygienic conditions than to apply active measures 
of treatment not suited to his case. As a general principle of treat¬ 
ment, however, it may be said that the two varieties of scrofulous 
habit denominated as irritable and torpid, require the application of 
nearly opposite remedies in order to obtain good results. 

In the first, or irritable class of cases, in which the patient is usu¬ 
ally thin, inclined to be anaemic, and evidently suffering from deficient 
nutrition through imperfect assimilation of food and excessive waste, 
such measures should be adopted as will improve the energy and char- 


8G2 


DISEASES AND THEIR TREATMENT. 


acter of the nutritive processes. Care should be taken to supply the 
patient with an abundance of the most wholesome, simple, and easily 
digestible food, although equal care should be taken to avoid excessive 
feeding. All reducing measures should be avoided. Daily sun-baths, 
frequent inunctions with vegetable oil, tepid sponge baths daily or 
every other day, and, if possible, the tonic application of electricity, 
are especially indicated. If there is a feverish condition of the system, 
meat should be wholly avoided and the dietary of the patient should 
consist principally of fruits and farinaceous articles. Milk obtained 
from cows known to be healthy may be freely employed. The diet 
should in all cases be unstimulating and free from condiments and 
other irritating substances. Tea and coffee should be wholly abstained 
from. Acorn coffee may be used to advantage as a harmless substi¬ 
tute for these beverages, and one with which experience has seemed to 
connect some degree of remedial virtue. 

For the opposite class of cases, those in which there is evident tor¬ 
pidity of the system, inactivity of the excretory functions, and retained 
excretions, the same measures of treatment should be employed, but in 
addition more or less active eliminative treatment should be used, ac¬ 
cording to the requirements of the case. The German authorities rec¬ 
ommend the wet-sheet pack and frequent cold bathing, the use of 
which is especially advocated by Schroth. We recommend caution, 
however, in the use of this active measure of treatment. We much 
prefer to employ such mild measures as the vapor or hot-air bath, ad¬ 
ministered at as low a temperature as will produce sweating, the warm 
full bath, and the electric bath. The pack may be employed occasion¬ 
ally, however, with benefit, but should never be administered cold, as it 
is usually employed in Germany. With reference to the use of water 
in these cases, the eminent Dr. Niemeyer remarks as follows: “In re¬ 
cent times the cold-water cure has earned for itself the most favorable 
reputation as a remedy for scrofula, and, indeed, a series of cases is on 
record in which complete and perfect cures have been obtained by this 
means after all other modes of treatment had been applied in vain. 
We are certainly justified in asserting that cod-liver oil treatment can¬ 
not be substituted for the water-cure.” 

A few remarks should be made in this connection respecting the 
treatment of local affections incident to this disease. Scrofulous skin 
eruptions seldom require in addition to the measures of treatment 
mentioned the application of other remedial measures than those neces- 


i 


HEMORRHAGIC DIATHESIS. 


863 


sary for cleanliness, and the application of simple vaseline ointment or 
carbolated vaseline. For scrofulous catarrh of the nose, the nasal 
douche is to he recommended as a means of applying mildly astringent 
washes such as are recommended for milder forms of catarrh. 

For scrofulous sore eyes, the continuous employment of tepid applica¬ 
tions two or three times a day will usually secure recovery after a time. 
For chronic discharges from the ears, a carbolic acid lotion composed of 
one part carbolic acid to three of glycerine or alcohol, and fifty of water, 
should be employed two or three times a day in the form of a douche, 
the mode of application of which is elsewhere described. A solution of 
permanganate of potash, consisting of a tablespoonful of the crystals dis¬ 
solved in a quart of warm water, is a most successful remedy in some 
cases. With reference to the treatment of enlarged glands, Dr. Birch- 
Hirschfeld remarks as follows: “The application of the cold douche to 
scrofulous humors of the glands has in our experience several times pro¬ 
duced a favorable result. Obstinate tumors of this kind, which have re¬ 
sisted all kinds of salves and plasters, disappear sometimes under the con¬ 
tinued application of cold water.” Much more certain results can be 
obtained by the application of the alternate hot and cold douche, as by 
this means we are able to intensify the effect of both agents, which, 
when employed separately, are very efficient in causing the disappear¬ 
ance of abnormal growths. 

The bronchitis of scrofula, to which the person suffering from the 
irritable variety is chiefly subject, should receive the most prompt at¬ 
tention as soon as its presence is discovered, as by this means it is possi¬ 
ble to prevent the fatal consumption to which sufferers from this form 
of scrofula are especially liable. The same importance is attached to the 
prompt and persistent treatment of derangements of digestion, which 
have a decided tendency to the production of mesenteric consumption. 

We have dwelt thus at length upon this subject on account of its 
great importance as well as the great prevalence of erroneous views 
concerning it. Much more remains to be said concerning the numerous 
local affections which are connected with this disease; but this part of 
the subject can very well be left for consideration in the sections devoted 
to the several local diseases. 

IIEUIORRIIAOIC DIATHESIS, OR IIzEMOPIIIEIA. 

SYMPTOM.—Persistent bleeding occasioned by a slight cut, puncture, or laceration 
of the skin. 

This is a peculiar affection, the exact nature of which is not known. 


864 


DISEASES AND THEIR TREATMENT. 


Jt is, however, known to be of an hereditary character, whole families 
frequently being affected by it, and the condition often being trans¬ 
mitted through several generations. A person who is affected by this 
constitutional tendency to hemorrhage, in common parlance termed a 
“bleeder,” is liable to death occasioned by even the slightest injury. 
The extraction of a tooth or a small cut may give rise to such persistent 
and irrepressible bleeding that the patient’s life may be draineci away in 
the course of a few days. Most patients suffering with this affection die 
young, very few surviving childhood. If, however, the patient lives to 
old age, as is sometimes the case, the tendency to hemorrhage diminishes, 
and may often disappear altogether. 

Treatment. —There is no known remedy by which the constitu¬ 
tional tendency may be removed. Consequently, preventive measures- 
are b} r far the most important. These consist almost exclusively in 
protecting the individual afflicted by this disease from the occurrence of 
accidents of a character calculated to excite hemorrhage. Such persons- 
should not be allowed to use tea or coffee or other hot drinks, on account of 
their relaxing effects. The most effective remedies for hemorrhage when 
it occurs are prolonged and steady pressure, and cauterization with a 
heated iron. All other means should be tried, however, in conjunction 
with this. 

SCURVY. 

SYMPTOMS.—Great debility; lassitude; mental depression; sunken eyes; pain irr 
the limbs and joints; pallor; livid lips; sore mouth ; bleeding gums ; blood spots in the 
skin; nosebleed; hemorrhage from the lungs and bowels; shortness of breath; scurvy 
condition of the skin. 

This long list of symptoms by no means includes all of the morbid 
conditions observable in this disease. As they are the leading symp¬ 
toms, however, we need not increase the length of the enumeration. 
The disease is usually of a chronic character, the condition of the patient 
becoming successively worse so long as the disease continues, finally re¬ 
sulting in the inflammation of the internal organs, particularly the per¬ 
icardium and pleura. Dropsy of the chest is also frequently produced. 
The patient finally dies from exhaustion and general dropsy, inflamma¬ 
tion of some one of the internal organs, or hemorrhage from the bowels. 

Causes. —Scurvy is usually attributed to the restriction for a long 
time to salt meat and bread without fresh vegetables. So many cases have 
been observed which have been produced from other causes, that salt is 


TRUE DIABETES. 


865 


no longer considered as the only agent in causing the disease. It has 
been known to break out with very great virulence hi consequence of 
exposure to cold, especially to cold and wet, and also from prolonged ex¬ 
posure to heat. It has also been known to occur in consequence of 
great exhaustion, prolonged melancholy, and similar causes. In north¬ 
ern countries, particularly Russia, a form of disease known as land 
scurvy is common among people who live in cold, damp cellars, and are 
destitute of the comforts of life. An eminent English physician has 
lately called attention to the fact that scurvy is not infrequently pro¬ 
duced in women of the lower classes in some parts of England in conse¬ 
quence of the use of tea. It thus appears that this disease may be 
produced by the gross neglect of almost any principle of the laws of 
hygiene. 

Treatment. —About all that is required to be done in the treatment 
of this disease is to adopt such measures as are useful in its prevention, 
that is, to place the patient under good hygienic conditions. Sailors and 
others who have been long confined to the use of salt meat, and deprived 
of vegetables, should have an abundant supply of fresh vegetables, par¬ 
ticularly cabbage, potatoes, and articles of this class. Fresh fruits are 
equally valuable. Lemons, oranges, and other sour fruits, are also of 
special service. Those in whom the disease is due to the use of tea and 
other stimulants should of course abandon the use of the harmful agents 
at once, and adopt a rational dietary. It is a remarkable fact that im¬ 
mediately upon the removal of the causes of scurvy, the person suffering 
from this formidable disease begins to show evidences of improvement, 
and in course of time is almost certain to recover, although suffering 
from the disease in its most severe form. 

DIABETES MELLITUS, OK TRIE DIABETES. 

SYMPTOMS,—Excessive quantity of urine containing sugar; emaciation; great thirst ; 
dryness of the skin ; voracious appetite. 

The characteristic feature of this disease is the discharge of enormous 
quantities of pale urine containing sugar. As much as five or ten quarts 
of pale, sweetish urine is sometimes discharged in a single day. The 
presence of sugar in the urine may be demonstrated by the taste, or by 
means of chemical tests. The latter means is of course the most reliable. 
The test is so simple that almost any one can apply it. Place in a small 
test-tube or vial two or three teaspoonfuls of the urine to be tested, and 

55 


•866 


DISEASES AND THEIR TREATMENT. 


add about an equal quantity of a strong solution of caustic potash. Now 
.add a strong solution of sulphate of copper drop by drop until the blue 
-coagulum or precipitate which is formed is no longer dissolved. Then 
heat to the boiling point. If sugar is present the blue color will be 
changed to yellow or orange. 

All the symptoms mentioned follow each other as the disease ad¬ 
vances. The patient finally dies from exhaustion, or from inflammation 
•of the bones or of some internal organ, which is very apt to occur. In 
many cases the patient dies of consumption or inflammation of the lungs. 
The disease usually lasts from one to three years, though under favora¬ 
ble circumstances it may continue for a much longer time. This disease 
has generally been considered under the head of diseases of the kidneys, 
but as it is now well known that the sugar found in the urine is not 
produced by the kidneys, and that whatever is the seat of the disease, 
the kidneys are not directly involved, it is evidently excluded from dis¬ 
eases of the urinary organs. 

Causes. —Little is known concerning the real cause of diabetes, and 
still less satisfactory is the knowledge which we possess respecting the 
real seat of this disease, notwithstanding the numerous experiments 
upon animals and almost numberless observations of human beings 
which have been made with direct reference to the pathology of the 
disease. It has been quite well established, however, that the most 
frequent causes of this malady are exposure to cold and wet, physical 
violence, concussions of the whole body, injuries to the brain and nerv¬ 
ous system, mental exhaustion, gluttony, and especially the use of 
large quantities of sugar. It is probable that dietetic errors are the 
principal cause of this disease. It has been claimed that diabetes is 
the result of the use of an exclusively vegetable diet. That this is 
not the case, however, is clearly shown by the fact that the disease is 
no more frequent among the majority of nations which subsist almost 
wholly upon vegetable food than among those that employ diet of the 
opposite character. A strong argument against this theory is also 
found in the fact that, in the numerous dietetic experiments which 
have been made upon animals and human beings in which they have 
been required to subsist for long periods of time upon a purely vege¬ 
table diet, this disease has never been produced. On the other hand, 
the eminent Dr. Berrenger-Ferroud has given an account of the occur¬ 
rence of diabetes in an ape, in which he claimed that the only cause of 
the disease was the attempt to accustom the animal to the addition of 


TREATMENT FOR 1)1ARETES. 


867 


a proportion of animal food to his natural diet of fruits and grains 
Numerous experiments, however, have shown that when large quanti 
ties of sugar are taken into the system, sugar may be found in the 
urine after a few hours. There is some evidence also to believe that 
a predisposition to the disease is hereditary. It has been most fre¬ 
quently observed in females. 

Treatment. —All physicians of experience are agreed that in the 
treatment of this disease by far the most important measure is the 
regulation of the diet. Sugar, starch, and all foods containing them, 
should be, as far as possible, excluded from the dietary. This requires 
that the patient should abstain from the use of sugar in any form, 
from bread, potatoes, peas, beans, rice, oat-meal, corn-meal, and other 
grains, chestnuts, and all other farinaceous articles of food. Sweet 
fruits also must be avoided with equal care. The diet should consist 
chiefly of meat of different kinds, including fowl. Greens, green 
beans, lettuce, yellow beets, asparagus, cucumbers, and radishes may 
also be eaten. Most acid fruits may be taken in moderate quantities, 
such as lemons, oranges, strawberries, peaches, and currants. In many 
cases skim-milk, sour milk, or buttermilk may be taken without in¬ 
creasing the proportion of sugar, and hence without injury. Several 
eminent physicians claim to have cured a number of cases of this dis¬ 
ease by means of an exclusive milk diet, the patient being confined 
to this one article of food for several weeks. The milk should be 
carefully skimmed. The quantity required per day is from two to 
three quarts. By the employment of a diet free from sugar or starch, 
sugar may in many cases be made to disappear from the urine. When 
this is the case it may be looked upon as a very favorable indication, 
and often so long as the patient continues to abstain from those kinds 
of food which occasion the production of sugar the disease will be held 
in check. 

In many cases, however, the disease does not yield to a restriction 
of the diet. For this class of cases nothing can be done except to con¬ 
fine the patient to a flesh diet. This can be done but for a short time, 
however, on account of the great repugnance to meat which will be 
developed and the derangement of digestion which will result from so 
large a quantity of animal food. On this account, cases of this sort 
seldom derive much benefit from treatment. The patient suffers most 
from being deprived of bread, and this article of food should not be 
wholly interdicted. The patient should not, however, be allowed to 


868 


DISEASES AND THEIR TREATMENT. 


eat fine-flour bread, as this combines a very large portion of starch 
with little nutritive value. The bread eaten should consist of as large 
a proportion as possible of the nitrogenous elements with the smallest 
possible amount of starch. There are various formulas for making 
what is termed diabetic bread. That which is most effective in re¬ 
straining the production of sugar is made of bran which has been 
washed several times, and after being dried is made into a sort of 
bread with butter and eggs. This, however, is very difficult of diges¬ 
tion, and often contains so little nutritive value that the patient will 
derive very little benefit from its use. Much better bread is that rec¬ 
ommended by the eminent Dr. Pavy of England, which is made from 
almonds. The directions for making this bread will be found under 
the head “ Diabetic Bread ” in the section on “ Medical Dietetics.” Ice¬ 
land moss may also be advantageously used for bread, being made into 
cakes with milk and eggs. Its use does not increase the production 
of sugar. The best of all breads for patients suffering with diabetes 
is made from gluten flour, which can generally be obtained of drug¬ 
gists. 

It is a good plan in the dietetic treatment of diabetic patients to 
follow the method suggested with reference to the dietetic treatment of 
obesity; namely, to employ a strict diet for several days or two or three 
weeks, and then allow the patient to take a little more liberal diet for a 
few days, so that the appetite may not be so greatly impaired as to cause 
much decrease of the patient’s strength. A diabetic patient should not 
be deprived of fluids, but should be cautioned to control the desire for 
drink within as reasonable limits as possible, and especially to take small 
quantities of fluid at a time. The intolerable thirst will often be re¬ 
moved by holding bits of ice in the mouth. The great discharge of fluid 
from the body is not the result of excessive drinking, but is the cause of 
the great thirst, which is simply an expression on the part of the system 
of the lack of water in the blood. Consequently the intolerable thirst 
by which this disease is characterized is as much a real demand for fluid 
as is the thirst experienced in health. 

In addition to the dietetic measures recommended, the most that can 
be done in many cases is to employ all suitable measures for securing 
and maintaining a general healthy condition. This should be done with 
the full understanding, however, that in quite a large proportion of cases 
of persons suffering from this disease the most that can be done is to mit¬ 
igate the symptoms and prolong the patient’s life, as a radical and per- 


TREATMENT FOR DIABETES. 


869 


manent cure rarely occurs. The plan of treatment which we have 
adopted in the management of cases of this class has been substantially 
the following, with such modifications as are indicated by peculiarities 
of temperament, general condition, etc.:— 

A short warm bath should be taken two or three times a week, with 
inunctions of olive-oil or cocoa-nut oil every other day. Sun-baths 
should be taken daily when possible. The use of faradic electricity as a 
tonic, and the application of galvanism to the spine, is attended with 
much benefit. The patient should also be required to take a large amount 
of exercise in the open air, horseback riding, walking, etc, in addition to 
the daily practice of calisthenics. The results obtained by this mode of 
treatment have been very encouraging, and in some cases very remark¬ 
able. Persons in whom several years ago the disease was well marked are 
still alive and enjoying comfortable health, though they still find it nec¬ 
essary to observe great care in diet in order to prevent a recurrence of 
the disease. In some cases, special benefit has seemed to be derived from 
a strong current of galvanism applied to the base of the brain and the 
sympathetic nerve, when no apparent effect could be obtained in any 
other way. Although numerous drugs have been at times highly rec¬ 
ommended for the relief of this disease, it is generally considered that 
few, if any, have any effect upon it except by impairing the patient’s 
nutrition, and thus producing a diminution of sugar by depressing his 
vitality. It need not be said that the injury done by remedies of this 
class must be much greater than any possible good which can result 
from their use. Morphia exercises more influence over the production 
of sugar than any other known drug, but at the same time interferes 
with the nutrition of the patient, so that its employment cannot be con¬ 
sidered in any way as a curative measure. The want of success in the 
treatment of this disease may be in part attributed to the lack of knowl¬ 
edge respecting its real nature, which still continues, notwithstanding the 
numerous investigations of the subject. It is to be hoped that when the 
causes and character of the disease are better known, more successful 
remedial measures may be discovered. 

In conclusion, we would call attention to the fact that a sudden and 
very great decrease in the amount of urine should be regarded as of un¬ 
favorable import when it cannot be fairly attributed to treatment. This 
fact is well illustrated by the following case, observed while this work 
was in press: We were suddenly called by telegram to see a patient 
in consultation at a distance who had suffered for several years from 


-S70 


DISEASES AND THEIR TREATMENT. 


diabetes, passing about two gallons of urine daily. We found the patient 
in a state of unconsciousness, the pupils widely dilated, pulse barely per¬ 
ceptible, in which condition she had been for about thirty hours. Upon 
inquiring into the history of the case we found that three or four days, 
previously she had had a severe ague chill, since which time she had been 
rapidly failing until she had reached the condition in which we found her. 
Upon making inquiry of her medical attendant concerning the condition 
of her bladder and the amount of secretion, we found that within the last 
thirty-six hours not more than thirty ounces had been formed, which was 
less than one-tenth of the usual quantity. The other nine-tenths, of 
course, which remained in her system, had so poisoned the nerve centers 
as to bring the patient into the comatose condition in which we found 
her. The patient, finding the quantity of urine about that usual in health,, 
had not compared it with the amount she had been habitually secreting 
up to the time of her sickness, and hence had failed to discover *tlie real 
cause of the sudden change in symptoms. In a case of this kind the 
treatment suggested should be applied promptly and thoroughly, namely, 
alternate hot and cold applications to the small of the back over the kid¬ 
neys, and packing the patient with hot bottles, bricks, etc., to induce 
profuse perspiration. The patient should also be given hot teas, or warm 
drinks of other kinds in abundance, so as to encourage the sweating 
process. By this means the poison may be eliminated from the blood, 
and life maintained until the kidneys become able to resume their 
functions. 

DIABETES OSirSDIS. 

\ 

SYMPTOM.—Gradually increased quantity of pale urine, free from sugar. 

Almost the sole symptom of this disease is that mentioned. The 
urine differs from that of diabetes mellitus in being entirely free from 
sugar. The amount of urine produced by patients suffering from this- 
disease is almost incredible. The usual quantity is from three to ten 
quarts, and cases are recorded in which so large* an amount as between 
ten and eleven gallons has been produced in twenty-four hours. This 
disease is generally regarded as one of the mildest from which a person 
may suffer. It gives rise to no marked disturbances of the system, and 
has, in some instances, been tolerated without seeming injury to the 
system for fifty years. 

Causes. —In addition to the hereditary predisposition to the disease 
the most frequently observed causes are injuries to the spine, chronic dis- 


TREATMENT OF DIABETES INSIPIDIS. 


871 


eases of the brain and spinal cord, violent emotions or excessive physical 
exertion, the use of alcohol, and the drinking of large quantities of cold 
liquids. The prominent symptom of the disease is now generally be¬ 
lieved to be due to derangement of some part of the nervous system, 
probably of certain nerve-centers located in the base of the brain. 

Treatment. —M. Bauchardot of Paris, an eminent French physician, 
states that hygienic treatment is essential to success in the management 
of cases of this disease. All the habits of the patient should be regulated 
strictly in accordance with the laws of hygiene. Exercise should be 
taken regularly and to as great an extent as admissible from the strength 
of the patient. Warm clothing should be worn and great care should 
be taken to prevent chilliness. The diet should be simple and whole¬ 
some. Stimulating condiments of all sorts should be carefully avoided. 
Fruits and grains constitute the best diet for patients suffering with this 
disease. Nearly all fruits, grains, and vegetables may be eaten with¬ 
out injury with the exception of tomatoes, which should be avoided. 
The use of asparagus and beans should also be interdicted when pain in 
the region of the kidneys or a deposit in the urine is observed after 
eating them. Tea, coffee, chocolate, alcoholic beverages, and all other 
stimulating drinks, must be wholly discarded. Fluids should be taken 
in as limited quantities as possible to avoid too great suffering on the 
part of the patient. Iced-water, ices, and all cold drinks, should be dis¬ 
carded. It is better to take fluids warm in this disease, as by this means 
the action of the skin will be encouraged and that of the kidneys lessened. 
Hot lemonade taken with very little sugar is an excellent means of al¬ 
laying the very severe thirst present in this disease. Such remedial 
measures should be employed as will induce energetic action of the skin. 
For this purpose a sponge bath followed by vigorous rubbing, or the 
rubbing wet-sheet, should be taken daily. In severe cases, a pack, the 
Turkish, hot-air, or vapor bath should be taken once or twice a week, 
and may be employed even oftener than this if the patient is under care¬ 
ful medical supervision and is wholly devoted to treatment. Dr. Gurltz, 
an eminent German physician, highly recommends the use of galvanism 
applied to the spine and especially to the region of the kidneys. Sun- 
baths, friction of the surface of the skin with the dry hand, a woolen 
cloth, or soft flesh-brush, and all other means for increasing the activity 
of the skin and thus lessening the work imposed upon the kidneys, should 
be employed. 


872 


DISEASES AND THEIR TREATMENT. 


DISEASES OF THE DIGESTIVE ORGANS. 


We will next notice diseases which affect the digestive organs, and 
which may be regarded as the most frequent of all diseases to which the 
body is subject. Under this head will be noticed diseases of the mouth, 
pharynx, gullet, oesophagus, stomach, and intestines. 

DISEASES OF THE MOUTH, 

CATARRH OF THE MOIITII. 

SYMPTOMS .—ACUTE : Burning; tenderness ; mucous membrane dark red, dry, or 
covered with copious secretion; swelling of membrane of cheeks and tongue; coated 
tongue; perverted taste; elongated palate. 

CHRONIC: Membrane swollen, showing small nodules; thick yellow mucus on 
gums and teeth; velvety coat on tongue; foul and slimy taste in mouth. 

This is a disease, which, although of very frequent occurrence, has 
been only recently recognized as of a catarrhal character. Catarrh of the 
mouth is very similar to the same disease elsewhere, and the mouth is 
even more liable to the disease than other parts. It is often associated 
with catarrh in other organs, as pharyngeal and nasal catarrh, and ca¬ 
tarrh of the stomach. It is also a very common accompaniment of va¬ 
rious fevers. It is not dangerous to life, though in small children it 
may give rise to convulsions which may prove fatal when arising from 
this as well as when produced by other causes of reflex irritation. It 
should not be supposed that all persons having a coated tongue and a 
bad taste in the mouth have oral catarrh. Either fevers or deranged di¬ 
gestion produces these symptoms. There must be also increased secretion 
of turbid or yellowish mucus, tenderness and swelling of the membrane, 
giving to the tongue a flabby appearance in consequence of which con¬ 
dition the impressions of the teeth will be seen in the edges. The differ¬ 
ence between chronic oral catarrh and a similar condition produced by 
dyspepsia is that in oral catarrh proper the digestion is not at all dis¬ 
turbed. The two diseases may exist together, however. The elonga¬ 
tion of the uvula gives rise to constant hawking, coughing, and spit¬ 
ting, by tickling the root of the tongue. 

Causes. —The chief causes of catarrh of the mouth are cutting the 
teeth, gum-boils, rough or ulcerated teeth, wounds of the mouth or 



APHTHAE. 


873 


gums, very hot, cold, or irritating foods or drinks, smoking and chew¬ 
ing tobacco, mercurial poisoning, catarrh of some other organ, as gas¬ 
tric catarrh, typhoid and typhus fever, and scarlatina. Sitting up late 
at night and mental excitement are also given as causes by eminent 
German observers. 

Treatment. —Remove causes of irritation. In cases caused by dif¬ 
ficult teething, more harm than good is done by lancing. Use soothing 
lotions when there is much irritation, as slippery-elm and flaxseed tea, 
and rinse the mouth often with cool water. Avoid all hot drinks. The 
disease will usually speedily disappear when the cause is removed. 
"When obstinate in the chronic form, rinse the mouth morning and 
night with solution of carbonate of soda, a dram to the pint of soft 
water, or simple cool water. Cleanse the teeth and mouth thoroughly 
after each meal and before going to bed. If there is foul breath, use 
a weak solution of chlorinated soda as a gargle morning and night. 
For clamminess, chew a little piece of rhubarb just before retiring. It 
should be chewed some time, as its effects are wholly local. 

APHTHA. 

SYMPTOMS.—Catarrh of the mouth ; small white spots with red border on mucous 
membrane; great increase of saliva ; fetid breath . 

This affection is often called ulcerated sore mouth and thrush, but 
differs from both. When it occurs in a severe form, as it often does in 
young children, it is usually preceded by a slight fever and restlessness 
for several days, loss of appetite, and symptoms of catarrh of the 
mouth. When the other symptoms mentioned appear, there is consid¬ 
erable pain, and the patient, if an infant, finds difficulty in nursing in 
consequence. 

Causes. —The disease is most frequent in infants, the chief causes 
being cutting of teeth and disturbances of digestion. Aphthae also oc¬ 
curs in measles and canker sore mouth. Adults often suffer with the 
disease in a mild form in consequence of disturbances of digestion. 

Treatment. —The mouth should be washed three or four times a 
day with a saturated solution of chlorate of potash. In addition to re¬ 
moval of the exciting causes, this is the only remedy required in most 
cases. If not successful, touch the white spots with strong solution of 
nitrate of silver by means of a camel’s-hair brush. 


874 


DISEASES AND THEIR TREATMENT. 


CASCRUM ORIS, DirnTRERITIC IWIAMMATION OF 
THE MOUTH, 015 CATKER OF THE MOUTH. 

SYMPTOMS.—Gums red, swollen, bleed easily; whitish spots on mucous membrane , 
which cannot be wiped off, appearing first on gums ; unhealthy ulcers; teeth loosened; 
lymphatic glands swollen and painful; lips and cheeks swollen; copious saliva, often 
bloody; pain in drinking or swallowing; foul breath; slight fever. 

The above symptoms are usually accompanied with those of ca¬ 
tarrh of the mouth and aphthm. The unhealthy ulcers referred to are 
produced by the sloughing away of the discolored membrane. Not¬ 
withstanding the serious character of the disease, recovery usually oc¬ 
curs, even though the disease may continue for weeks or even months. 

Causes. —The most common cause of the disease in infants, in 
whom it most frequently occurs, is unhygienic conditions, bad food, 
bad air, etc. In them it is often accompanied by serious disturbance 
of digestion, which may justly be regarded in the light of a cause of 
the disease. It is common in foundling-hospitals. The most common 
cause in adults is the use of mercury, which produces the most painful 
and obstinate form of the disease; 

Treatment. —Give first attention to the causes of the malady. 
Secure good hygiene, and regulate the diet so as to improve the diges¬ 
tion. Use ohlorate of potash lotion three or four times a day, and 
rinse the mouth with cold water very frequently. Under this treat¬ 
ment the ulcers will soon begin to heal, and in a few days the patient 
will be greatly improved. It is important that infants suffering with 
this disease should be taken much into the fresh air and exposed to the 
sunlight daily. An inunction daily or every other day will greatly 
facilitate the cure when the patient is weakly. 

ULCERS OF THE MOUTH. 

In addition to the severe forms of aphthae and ulceration previ¬ 
ously described, small ulcers frequently appear on the tongue and mu¬ 
cous membrane of the cheeks. The point of the tongue is a favorite 
seat for small, painful vesicles which burst and become small ulcers. 
Follicular ulcers often occur on the mucous membrane of the lips, being 
occasioned by the stopping up of the ducts of glands situated in this 
region. The most frequent cause is disturbance of digestion or irrita¬ 
tion of rough teeth. 

Treatment. —Apply chlorate of potash lotion, and wash the mouth 
with cool water several times a day, refraining from all hot foods and 


THRUSH, OR MUGUET . 


875 


drinks. If necessary, touch the ulcers with nitrate of silver solution, 
ten grains to the ounce of water. 

THRUSH, OR MUGUET. 

SYMPTOMS—Whitish points or a frosty coating ; cheesy matter on tongue, roof of 
mouth and inside of lips ; pain on swallowing; burning pain; disturbance of digestion, 
often diarrhoea. 

This disease occurs in infants but a few days or weeks old, in very 
aged persons, and in persons much exhausted by disease, as just before 
death in consumption and fevers. In infants the local disease is usu¬ 
ally accompanied by acidity of the stomach, which is probably both a 
cause and an effect of the local disease. 

Causes. —The immediate cause of this disease is a vegetable para¬ 
sitic growth known as the thrush fungus, the production of which is 
encouraged by lack of proper cleanliness of the mouth. If the mouth 
of infants is kept thoroughly clean, the disease will never occur. The 
mouth should always be washed out with a clean wet cloth immedi¬ 
ately after feeding; as the remains of food left in the mouth 
form the best possible soil for the production of the disease. The 
practice of giving children sugar-teats, or little hags filled with a mixt¬ 
ure of bread, milk, and sugar, is a most pernicious one. A more po¬ 
tent means of producing the disease under consideration could not be 
invented. An acid state of the stomach and a feeble condition of the 
system favor the production of the disease, probably on account of the 
greater liability to the accumulation of foul products in the mouth in 
these conditions. As the disease is probably contagious, care should be 
taken to isolate patients suffering from it. 

Treatment. —Thorough cleansing of the mouth is of first impor¬ 
tance. Fungi do not thrive except in the presence of filth. Wash 
the mouth thoroughly, before and after feeding, first with cool water, 
then with a cool solution of borax or sulphite of soda in the propor¬ 
tion of a dram to the ounce of water. Sugar, honey, and similar prep¬ 
arations should not be employed, as they encourage rather than cure 
the disease. After feeding and washing as directed, it is well to apply 
a mixture of powdered borax and glycerine in the proportion of a tea¬ 
spoonful of the powdered borax to two tablespoonfuls of glycerine. 
Attention should of course be paid to the stomach and bowels, reme¬ 
dies being applied in accordance with directions given elsewhere for 
derangements of these organs. 


876 


DISEASES AND THE III TREATMENT. 


OFLA5IMATIOX OF THE TONGUE; GEOSSITIS. 

SYMPTOMS.—Tongue greatly swollen, often to double its usual size, upper surface 
white or brownish, smooth or cracked, covered with tough mucus, under surface red, ulcers 
on sides of tongue; severe pain which is increased by motion, making speaking, chew¬ 
ing, and swallowing difficult or impossible ; drooling of saliva ; glands of neck enlarged; 
in severe cases obstruction to circulation in head, and interference with respiration; high 
fever and full pulse. 

This is a very rare disease, seldom occurring except as the result 
of direct injury to the tongue, as from a burn, a caustic application, or 
the sting or bite of an insect. With the application of proper reme¬ 
dies recovery usually takes place, though in severe cases death may 
occur from suffocation. 

Treatment. —Apply general treatment to subdue the fever, and 
frequent sitz baths for derivative effect. Apply ice locally, allowing 
the patient to hold pieces of ice in his mouth. Keep the tongue 
moistened with soothing lotions> as slippery-elm and flaxseed tea. If 
ulcers form, use chlorate of potash lotion. 

In chronic inflammation of the jtongue when deep cracks or fissures 
are formed, the use of lotions of chlorate of potash and carbolic acid, 
and the application of a strong solution of nitrate of silver, ten or fif¬ 
teen grains to two tablespoonfuls of water, constitute the best remedies. 

GANGRENOUS SOKE MOUTH, OK NOHA. 

This is, fortunately, a very rare disease, as it is almost always fatal. 
It chiefly occurs in children whose constitutions are enfeebled by bad or 
insufficient food, bad air, filth, or other unhygienic conditions, and, ac¬ 
cording to Niemeyer, is often caused by the use of mercury. The disease 
is characterized by a low form of inflammation, giving rise to extensive 
sloughing, or gangrene, which begins on the inside of the cheek, extends 
to the gums, the lips, and the tongue; exposes the bones of the jaw, 
causing the teeth to drop out and the separation of portions of bone. 
Finally the disease may extend to the face, the whole cheek and even 
the nose becoming black and sloughy. When recovery takes place it is 
very slow, the lost parts being built up by granulation. The only rem¬ 
edies which do any good are those which, like the actual cautery, destroy 
the diseased tissues and thus excite a healthy action. 


SALIVATION. 


877 


SALIVATION. 

SYMPTOMS.—Abnormal production of saliva; indigestion; emaciation. 

This morbid condition is rather a symptom of disease than itself a 
disease. The amount of saliva daily produced in health is ten to twelve 
ounces. When the amount becomes so great as to be troublesome, escap¬ 
ing from the mouth, or requiring a person to spit or swallow to get rid 
of it, it may be said to be abnormal. Sometimes two to five quarts are 
produced in cases of disease. 

Causes.—The causes of salivation are numerous. Anything which 
causes irritation of the mouth or mucous membrane of the stomach will 
produce it. It frequently occurs in fevers, and is produced by the cutting 
of the milk teeth, by decayed teeth, and especially by certain drugs, 
among which are all the preparations of gold, iodine, copper, lead, and 
particularly mercury, together with jalap, digitalis, and balsam of 
copaiba. Certain vegetable foods also, particularly tomatoes, sometimes 
occasion a slight irritation of the mucous membrane of the mouth which 
produces a profuse flow of saliva, and which has by some been errone¬ 
ously taken as an evidence that tomatoes contain calomel, and hence 
should not be eaten as food. The worst form of salivation is that pro¬ 
duced by the use of mercury. In some persons a very small quantity 
of this metallic poison will produce salivation; in others, a larger quan¬ 
tity is required. Mercury is always found in the saliva in cases of mer¬ 
curial salivation, and its presence may be detected a long time after the 
drug has been administered. We have met persons who asserted that 
they had had recurrences of mercurial salivation at intervals for years 
after having had a “mercurial course.” The eminent Dr. Wright, who 
devoted much time to the study of this subject, found that saliva con¬ 
taining mercury is inert, being so poisoned by the drug that its power 
to change starch into sugar is lost. This corresponds with the effect of 
mercury upon the bile, to which we have elsewhere called attention, 
and accounts for the indigestion and emaciation of patients salivated 
by mercury. 

Treatment.—So far as mercurial salivation is concerned, the proper 
remedy is prevention by non-use of the drug. We believe that there 
is no disease or morbid condition which cannot be treated better with¬ 
out than with it. Dr. Vogel well demands that its use as a laxative 
“should be entirely done away with.” As elsewhere shown, it is 


878 


DISEASES AND THEIR TREATMENT. 


worthless as a cholagogue, even if its operation as such would be 
in any way desirable. We have also shown that it is useless, or 
worse than useless, in syphilis. What is it good for ? and if it were 
useful for any purpose, should not the fact that it may do so much 
mischief, even when least suspected, and that when once introduced into 
the system it may remain and continue its destroying work for years,— 
should not these facts lead the wise and intelligent physician, anxious 
to do his patient the greatest good and the least harm, to abandon its 
use altogether ? So it seems to us. 

In other forms of salivation, the cause should be removed as the 
first measure of treatment; and when this is done, little else remains to 
be done; recovery will soon take place. Good results may sometimes 
be obtained by the use of astringent gargles, as sage tea, decoction of 
white-oak bark, carbolic acid, or common salt. The electro-thermal 
and electro-vapor baths should be employed in cases of mercurial sal¬ 
ivation, and much benefit will be derived from their use, as they are 
the best known means of eliminating the poison from the system. 
The diet should, of course, be simple and unstimulating, and every 
means possiole should be adopted for building up the patient’s health. 

PniRlUGITIS-CIERGYMAN S SOKE THROAT. 

SYMPTOMS. —ACUTE: “Cold in the throat;” “sore throatmucous membrane 
dry, red, and swollen, or covered with a tenacious secretion ; pain in swallowing; nasal 
tone of voice; tickling in the throat, exciting cough; coated tongue ; foul breath; sali¬ 
vation. 

CHRONIC:— Slight pain in swallowing; granular appearance of the throat; elonga¬ 
tion of the palate; tough, tenacious mucus, occasioning hawking and spitting; “hack¬ 
ing” or “hemming ” cough; husky voice; expectoration of small, cheesy or calcareous 
masses; slight hemorrhages from the throat in the morning. 

Acute and chronic catarrh of the pharynx are among the most com¬ 
mon of all forms of catarrhal disease. In some localities, one form or 
another of this disease seems to be almost universal. The causes are 
not always easy to determine, but the most common origin of the af¬ 
fection is a cold. Sometimes the disease assumes the form of an ep¬ 
idemic, the people of a whole neighborhood or a much larger section of 
country being almost universally affected at some time with the symp¬ 
toms characteristic of acute catarrh of the pharynx. This is especiallv 
true of the form of the disease known as follicular pharyngitis, in 
which the throat presents a granular appearance. There are good rea¬ 
sons for believing that in these cases the disease may be allied to, if 


CLERGYMAN'S SORE THROAT. 


879 


not identical with, the affection known as diphtheria. We have ob¬ 
served cases in which the most severe form of diphtheria was evidently 
communicated by a person suffering with what was apparently simple 
follicular pharyngitis. It is doubtless possible to discriminate between 
the simple and the contagious form of the disease, but the examina¬ 
tion of patients is not generally made with sufficient care to make the 
points of difference clear. The disease, in both its acute and chronic 
form, has some tendency to extend into the larynx and thence into the 
bronchial tubes, inducing acute or chronic bronchitis, although this 
tendency is not so strong as is generally supposed. 

The chronic form of the disease is most commonly the result of re¬ 
peated attacks of acute pharyngeal catarrh, though it not infrequently 
arises insidiously, giving no history of acute symptoms. The persons 
most subject to the habit are those addicted to the use of liquor, to¬ 
bacco-users, persons of sedentary or dissipated habits, those exposed to 
an atmosphere charged with dust or irritating gases. A humid atmos¬ 
phere and changeable climate favor the production of this disease. 
Males are more frequently affected than females. It is found in its 
worst form in persons of vicious habits. What is known as clergy¬ 
man’s sore throat is a form of this disease, and it is undoubtedly the 
result of the sedentary habits of this class of persons. Diseases of the 
stomach and liver are frequently causes of pharyngeal catarrh. Bad 
dietetic habits are an important factor in the production of this dis¬ 
ease. The use of mustard, pepper, vinegar, pepper-sauce, ginger, and 
various other condiments, and the excessive use of salt, sugar, fats, and 
animal food, must be set down among the principal predisposing causes 
of this form of the disease. In this way the terms “ stomach cough ” 
and “ liver cough ” have arisen, the stomach being really the remote 
cause of the cough, the direct source of which is the irritation in the 
throat. The most annoying symptom of chronic pharyngitis is the 
hacking or “ hemming ” cough, which is sometimes very harassing. The 
couoffi arises in some cases from the irritation from the tenacious 

o 

mucus of the soft palate, and in others from the elongation of the pal¬ 
ate. When the palate becomes so long that the end rests on the back 
part of the tongue, it is very likely to cause a most annoying cough, 
and efforts at expectoration. 

Chronic pharyngitis is often found connected with partial or com¬ 
plete deafness accompanied with the usual symptoms of chronic catarrh 
of the ear which has been induced by an extension of the disease from 


880 


DISEASES AND THEIR TREATMENT. 


the throat through the Eustachian tubes to the middle ear. This is, in¬ 
deed, the most common origin of deafness, and the connection between 
these two conditions has given rise to the term “ ear cough.” Another 
common accompaniment of chronic pharyngeal catarrh is enlargement 
of the tonsils. This affection will be described under the head of 
“ Tonsillitis.” The small, cheesy particles frequently expectorated in 
this disease are masses of hardened secretion coming from the enlarged 
follicles of the throat, which may be easily seen as whitish bodies,, 
varying in size from that of a millet seed to the size of a pea, imbedded 
in the tonsils. They gradually ulcerate out, and are discharged. The 
fetid odor is due to the decomposition which has taken place. Occa¬ 
sionally calcareous decomposition takes place, when the fetid masses, 
are found to be hardened in character, and chalky. These particles, 
are usually mistaken for tubercles, being supposed to come from the 
lungs, and are taken as a sure sign of tuberculous disease, or consump¬ 
tion. We have often found it very difficult to convince patients to 
the contrary. Every one should be convinced of the truth by the fact- 
that tubercles are microscopic in size instead of being as large as these 
particles are found to be. 

Treatment.— The acute form of the disease usually disappears in a 
very short time, seldom lasting but a few days, and generally disap¬ 
pearing almost wholly within two or three weeks. This fact leads, 
most people to pay very little attention to the difficulty, which is 
thought to be only a “ cold ” that will speedily cure itself. We wish,, 
however, to direct particular attention to the fact that this popular 
notion is a very mischievous error, since it is not infrequently the occa¬ 
sion of encouraging neglect, and results in the production of chronic 
and sometimes incurable disease. A cold is by no means so transient 
in its effects as is generally.supposed. While an attack of acute ca¬ 
tarrh of the pharynx frequently disappears in a short time, the effects, 
produced by it remain more or less permanent, the patient being much 
more liable to suffer in the same way again than if he had not con¬ 
tracted the disease. As before remarked, it is by repeated attacks of 
acute catarrh that the foundation is laid for obstinate chronic phar¬ 
yngitis. Hence the importance of giving prompt attention to the- 
treatment of even the simplest form of cold in the throat. Of the 
large number of remedies proposed for the treatment of this disease, 
regular, irregular, and domestic, none give so prompt and complete re¬ 
lief as hot fomentations applied to the throat externally, and internal 


CLERGYMAN'S SORE THROAT. 


881 


applications of warmth and moisture by means of steam inhalations. 
An inhaler can be improvised by connecting a rubber tube with the 
spout of a tea-kettle or coffee-pot, or the simple form of inhaler shown 
on page 802 may be used. The inhaler referred to is so convenient and 
effective in use, and so inexpensive that it ought to be found in every 
family, ready for use when required. When there is much dryness and 
irritation in the throat the use of soothing gargles, as slippery-elm wa¬ 
ter, linseed tea, or thin mucilage water, will be found useful. Chlorate 
of potash gargle is also serviceable. When there is slight fever, as is 
generally the case, the patient may take a wet-sheet pack or a Russian, 
Turkish, or vapor bath, whichever is most accessible. The throat 
should be kept warm and moist, and the skin active. Care, should be 
taken to avoid exposure to drafts and cold air, by which means the per¬ 
spiration may be suddenly checked. By the judicious use of these sim¬ 
ple measures, nearly every case can be cured in a few days, and un¬ 
pleasant after-effects avoided. 

The treatment of chronic catarrh of the pharynx is a much more 
serious matter. There are few affections which are more obstinate 
and unyielding to treatment than this. The avoidance of all causes 
of the disease is of the greatest importance. The patient should adopt 
a plain, simple dietary, avoiding condiments, the use of fats, sugar, 
pastry, and all stimulating and clogging foods. If the patient has 
been addicted to the use of alcoholic liquors or tobacco in any form, 
these habits must be at once abandoned. Every possible measure 
should be taken to build up the general health by frequent bathing, 
keeping the skin in active condition, as well as by out-of-door exercise 
and careful regulation of all the habits. In addition to careful atten¬ 
tion to the general health, local cold applications to the throat are of 
the first importance. Gargles, lozenges, and various other remedies,, 
immense quantities of which have been used for this affection, are 
really of little consequence, as they do not reach the real seat of the 
disease. 

Local remedies, to be of any value, must either be applied directly" 
to the throat with a swab or brush or inhaled in the form of vapor or 
atomized spray. In the treatment of several hundred cases of chronic 
pharyngitis in which we have experimented in the use of a large 
number of remedies, we have found nothing of so much real value as 
the inhalation of hot spray by means of the steam inhaler already 
mentioned. The various other remedies may be employed in connec- 

56 


'882 


DISEASES AND THEIR TREATMENT. 


tion with the warm vapor, but these are of trivial importance when 
compared with the vapor itself. After using nearly all the various 
substances which can be thus employed, we have become thoroughly 
convinced that steam alone is, for the majority of cases, as useful 
as any medicated vapor. It is important that inhalation should be 
taken as hot as it can be borne, and the inhaling tube should be intro¬ 
duced into the mouth sufficiently far to bring the hot steam in con¬ 
tact with the affected membrane. The effect is similar to that of the 
hot douche. Additional benefit may be derived in some cases by the 
use of gum benzoin, a fragment of which, the size of a filbert, may 
be dropped into the inner cup of the inhaler when its use is desired. 
Hot solutions of chlorate of potash, tannin, and various other sub¬ 
stances used with the atomizer, will also be found useful in the treat¬ 
ment of this disease. For local applications with the swab or brush, 
nothing is better than a saturated solution of chlorate of potash. "We 
have sometimes used with benefit a mixture of tannin and glycerine, 
four parts of the former to one of the latter. We have also found 
useful a mixture consisting of twenty grains of hydrate of chloral and 
ten drops of tincture of iodine with an ounce of glycerine. Apply 
daily to the pharynx with a camel’s-hair brush. 

In addition to the measures of treatment mentioned, much benefit 
may be derived from the use of the hot-water gargle if pains is taken 
to allow the water to pass down deeply into the throat by throwing 
the head well back. The water should be as hot as it can be well 
borne. The effect of this is similar to that of the hot spray. The 
gargle should be used four or five times a day for four or five minutes 
at a time. The relief it will sometimes give is surprising. 

The cold wet compress worn about the throat at night, followed by 
brisk rubbing with cold water in the morning, is another useful meas¬ 
ure. This has a double effect, first, to allay local congestion; sec¬ 
ond, to harden the throat so as to diminish the liability to colds. The 
practice of wearing thick furs and woolen comforters about the neck 
is unnecessary, except in the coldest weather, and when habitual, is 
one of the most frequent causes of taking cold, as the throat is made 
unnaturally susceptible to change of temperature, and its resistance 
to cold is destroyed. 

In conclusion, we would impress upon the reader the importance of 
persevering in the treatment of this affection. Notwithstanding its 
obstinate character, patient continuance in the use of proper measures 


QUINSY AND ITS TREATMENT. 


883 


will, with rare exceptions, effect a cure; and as the disease is so fre¬ 
quently the occasion of obstinate, if not incurable, deafness, it is really 
of a very serious character even if the local symptoms are not so very 
annoying. 

QUINSY—TONSILLITIS. 

SYMPTOMS. — Chilliness; marked fever ; redness and swelling of the tonsils and 
soft palate; pain and some difficulty in swallowing; entrance of liquids into the nasal 
cavity on attempting to swallow ; pain behind the angle of the lower jaw and in front of 
the ear in advanced stage of suppuration. 

Tonsillitis, or inflammation of the tonsils, is usually accompanied 
with acute inflammation of the pharynx or soft palate, and hence 
is accompanied with nearly all the symptoms mentioned as char¬ 
acteristic of the latter affection. On account of the more ex¬ 
tensive swelling of the tonsils, there is much greater pain than 
accompanies pharyngeal catarrh, and the ear is much more liable 
to be affected by the extension of the disease through the Eu¬ 
stachian tubes. There is usually headache and a very full pulse. 
The chilliness and febrile action frequently precedes the swelling of 
the tonsils several hours or even a day. The tongue is heavily coated, 
the patient has very little appetite, and if disposed to eat would be 
nearly unable on account of the pain in swallowing. Unless speedily 
arrested in its early stages, the disease goes on to suppuration, and, if 
the discharge is not hastened by lancing, usually breaks and discharges 
in the mouth while the patient is asleep or during a fit of coughing. 
The pus of the discharge is usually swallowed when the discharge oc¬ 
curs during sleep, and the patient awakes from his troubled sleep very 
greatly relieved. The causes of the disease are the same as those 
which provoke acute pharyngitis. 

Treatment. —The treatment is practically the same as that de¬ 
scribed for acute catarrh of the pharynx, but should be much more en¬ 
ergetic. During the first stage of the disease, benefit may be derived 
from holding pieces of ice in the throat and packing the throat with 
pounded ice wrapped in a towel. At intervals of from two to three 
hours, alternate hot and cold applications should be made to the throat. 
The burning and dryness characteristic of the first stage of the disease 
may be relieved by mucilaginous gargles and drinks. Packs, tepid spong¬ 
ing. and the use of large compresses about the trunk, are measures which 
may be advantageously employed to subdue general fever. If suppura- 


884 


DISEASES AND THEIR TREATMENT. 


tion threatens in spite of efforts to abort it, it should be encouraged by 
the use of inhalations of steam and hot fomentations applied to the throat 
instead of the ice-pack. When the case is taken in time, the measures 
described will be found the most universally successful in aborting the 
disease When suppuration has evidently taken place, and the swelling 
in the throat has become soft, showing the presence of matter, much 
time may be saved by lancing the tonsil to evacuate the pus. In most 
cases, rapid recovery will take place, the tonsil returning to its natural 
size. Now and then a tonsil remains permanently enlarged. One at¬ 
tack of this disease predisposes to another, so that persons sometimes be¬ 
come so susceptible as to suffer an attack of tonsillitis from the slightest 
exposure. 

ENLARGED TO^SII.S. 

SYMPTOMS.—Sensation of a lump in the throat upon one or both sides ; difficulty in 
swallowing in extreme cases; voice changed, patient often being unable to pronounce cer¬ 
tain words; great susceptibility to "cold in the throat; ” constant irritation in throat; 
in many cases, impairment of hearing. 

As just remarked, this disease is frequently the result of acute in¬ 
flammation of the tonsils. The enlargement is sometimes confined to 
one side, but frequently both tonsils are affected. In some cases the en¬ 
largement is so great that the passage through the throat is almost en¬ 
tirely obstructed. We have frequently had cases in which the two tonsils 
came in contact, so great was the enlargement. Sometimes enlarge¬ 
ment is produced gradually. This is especially the case in scrofulous 
children. The results of enlarged tonsils are more serious than are gen¬ 
erally supposed. They not only occasion permanent injury to the voice, 
giving it a nasal character on account of the partial paralysis of the soft 
palate, preventing complete closure of the passage to the nasal cavity, 
bur not infrequently occasion serious injury to the middle ear from in¬ 
flammation of the Eustachian tubes. 

Treatment. —In cases of marked enlargement, the treatment de¬ 
scribed for chronic pharyngitis may be given with success. Where the 
enlargement is very great, there is no remedy but removal. The opera¬ 
tion is a trivial one, and should be resorted to promptly when its neces¬ 
sity becomes apparent. 


DISEASES OF THE (ESOPHAGUS. 


885 


DISEASES OF THE (ESOPHAGUS 

Inflammation and Ulceration of the (Esophagus.— The oesoph¬ 
agus is subject to all the forms of inflammation which affect the 
mouth and larynx, though less liable to be thus affected. Inflam¬ 
mation of the oesophagus is most often excited by swallowing hot 
food and caustic or irritating substances, or by injury from a fish-bone 
or some angular body accidentally swallowed. Ulcers of the oesophagus 
may be produced by injuries from foreign bodies introduced by accident, 
or by the injudicious use of the stomach-tube. When inflammation or 
ulceration of the oesophagus exists in the lower part of this organ, it 
may be overlooked, as the sensibility of this part is not very great. 
Pain is usually felt between the shoulders. 

The treatment of inflammation of the oesophagus is as nearly as pos¬ 
sible the same as that suggested for inflammation of the mouth, the 
application of cold and the swallowing of small bits of ice being the 
most effective of such measures. Little can be done for ulceration of 
the oesophagus except to improve the patient’s general health in every 
way possible, and cause him to abstain from the use of other than bland 
and unirritating articles of food. 

Stricture of the (Esophagus may result from inflammation, or 
from the contraction of its walls after the healing of an ulcer. It may 
also be produced by aneurism, or by an abscess forming at one side. It 
usually develops gradually, the patient finding difficulty in swallowing 
steadily increasing until, at last, he cannot even swallow liquids. The 
obstacle always seems to the patient to be just beneath the upper part 
of the sternum, although its real position may be opposite the lower end or 
some intermediate part. When the obstruction becomes complete, sev¬ 
eral mouthfuls will often be retained, but only to be thrown up again. 
In most cases the patient gradually starves to death. The rational 
treatment is mechanical dilatation by probes, first smaller, and then 
larger, as the dilation increases. Some cases will not yield, and in 
these the result is, of course, starvation. It seems to us, however, that 
even complete closure of the oesophagus need not be the cause of death, 
at least not for a long time, since it is now so well known that the 
patient can be nourished not only for weeks but for months, and per¬ 
haps years, by the use of nutritive enemata, or injections into the 
bowels of properly prepared food. 


886 


DISEASES AND THEIR TREATMENT. 


Dilatation of tlie (Esophagus is an opposite, though very rare 
affection, which is also the cause of death in some instances. The dilata¬ 
tion may he complete through the whole length, cases having been ob¬ 
served in which it had increased to the size of a man’s arm; or it may 
be confined to a small portion. Sometimes it exists in the form of a 
large sac connected with the oesophagus by a small opening through 
which the food passes, being retained in the sac instead of passing down 
to the stomach. In cases of the latter sort the food is retained in the 
cavities described until it undergoes decomposition, when it is expelled 
during attempts at swallowing. The treatment of this disease is very 
unsatisfactory, no remedy being in any great degree successful. In bad 
cases the only way of supporting the life of the patient is by passing 
food into the stomach by a tube, or by rectal alimentation. 

Morbid Growths occasionally occur, giving rise to both stricture 
and dilatation. These are sometimes of a fibrous character, but not infre¬ 
quently cancerous. Cancer of the oesophagus occurs most frequently in 
elderly persons who have been addicted to the use of alcoholic liquors. 
It is, of course, a fatal disease. The treatment can only be palliative, 
and the patient must be nourished by means of nutritive enemata. 
Sometimes, in cancer of the oesophagus as well as ulceration, a perfora¬ 
tion occurs, which is not infrequently accompanied by instant death. 

Nervous Diseases of the (Esophagus are perhaps the most com¬ 
mon affections to which this organ is subject. The affection most fre¬ 
quently met with is that known as globus hystericus, so-called on account 
of the peculiar sensation, which is that of a ball rising into the throat, 
sometimes causing choking, and rendering the patient unable to swallow. 
As the name indicates, this affection is met with in hysterical per¬ 
sons, and consists simply of a spasmodic contraction of the circular muscu- 
. lar fibres of the oesophagus. The contraction may exist for several days, 
or may last only a few moments. It usually comes on during eating. In 
some cases there seems to be a reversion of the action of the oesophagus, 
so that, as the patient says, when he attempts to swallow, “ the muscles 
work the wrong way.” Remedies calculated to relieve congestion of the 
nerve centers are usually sufficient to dissipate this unpleasant symptom. 
We have found the application of ice to the back of the neck and be¬ 
tween the shoulders, and the application of galvanism, to be successful. 
When the contraction continues to exist in spite of other measures, it 
may in most cases be relieved by passing a flexible tube down the oeso¬ 
phagus. 


ACUTE INFLAMMATION OF THE STOMACU. 


887 


Paralysis of the (Esophagus is an affection which usually exists 
in connection with general paralysis, being very rarely a primary affec¬ 
tion. A\ hen incomplete, the patient can swallow with difficulty, liquid 
food being taken better than solid. In cases of complete paralysis, 
swallowing becomes impossible. The use of electricity is the only rem¬ 
edy which promises a favorable result. As in most other affections of 
the oesophagus which interfere with nutrition, life may be maintained 
by the use of nutritive enemata. 

DISEASES OF THE STOMACH, 

ACUTE INFLAMMATION OF TIIE STOMACH—GASTRITIS. 

SYMPTOMS.—Pain and heat at the pit of the stomach, pain increased by pressure ; 
great nausea, with violent retching and vomiting; great thirst; desire for cold drinks, 
which are vomited as soon as swallowed; high fever and rapid pulse ; quick breathing I 
bowels constipated; urine scanty and high-colored; tongue white and heavily coated; 
great prostration. 

Causes. —This disease rarely occurs except when produced by poisons 
taken into the stomach as by swallowing mineral poisons,—alkalies, anti¬ 
mony, arsenic, etc. Cases have occurred in which gastritis was produced 
by taking boiling liquids into the stomach. Probably the most common 
cause is the use of alcoholic stimulants taken on an empty stomach. 
We have also seen it produced by eating animal food or excessive 
quantities of food when convalescing from a fever. It is a frequent ac¬ 
companiment of delirium tremens. The disease is a very serious one 
indeed, and not infrequently ends fatally. 

Treatment. —The first and most important measure of treatment is, 
as nearly as possible, absolute rest for the stomach. For drink, give the 
patient small bits of ice to hold in the mouth. If thirst is very great, 
let him take small quantities of cold mucilaginous drinks, as iced slip¬ 
pery-elm water. The thirst can in most cases be relieved by large in¬ 
jections of tepid water, which should be retained as long as possible. A 
sponge or towel should be held against the lower end of the bowels to 
prevent the water from passing away before being absorbed. It is ol 
no use to trouble the stomach with food, as it will be almost certain to 
be vomited soon after it is swallowed, and if it is retained, will not be 
digested, as the secretion of the gastric juice is suspended while the 
stomach is in a state of inflammation. For nutritive enemata, nothing 
is better than good strong beef-tea made without the addition of water. 


888 


DISEASES AND THEIR TREATMENT. 


It may be injected in quantities of from two to eight ounces several 
times a day. At least two pints of good beef-tea should be taken in 
twenty-four hours. Beef-tea freshly prepared from meat should be 
used and not the extracts sold in stores, as those contain very little 
nourishment, being chiefly stimulating in character. Another excellent 
preparation, which has been elsewhere referred to, consists of equal parts 
of sweet cream and an infusion made from pancreas ground and macer¬ 
ated in a little water for a couple of hours, and strained through a col¬ 
ander. Nutritive enemata should always be about blood-warm when 
used. Ice-cold compresses should be applied to the stomach constantly, 
being renewed as frequently as is necessary to maintain their effect. 
When the acuteness of the inflammation has been subdued, warm poul¬ 
tices or fomentations may be applied to the stomach with advantage. 
When the fever is high, cool sponging and the use of large injections 
into the bowels should be resorted to. Emetics, laxatives, cathartics, 
and everything irritating should be sedulously avoided. There should 
not be too much haste about troubling the stomach with food. We 
have sustained patients suffering with acute gastritis for several weeks 
by means of nutritive enemata ■without difficulty. The first articles 
taken should be very bland in character and unstimulating, such as 
well-boiled and strained oatmeal gruel, well-boiled rice, milk, or milk 
and lime-water in the proportion of one part of lime-water to five of 
milk. Meat and flesh-foods of all kinds should be carefully avoided 
until tenderness of the stomach has entirely disappeared. 

ACUTE CATARRH OF THE STOMACH—BILIOUS ATTACK. 

SYMPTOMS. — Indigestion; heaviness at the pit of the stomach; dizziness; furred 
tongue and bad taste in the mouth; “sick headache;” tormenting pain in the forehead 
and temples, extending toward back of head; flashes before the eyes on stooping; feel¬ 
ing that the head will burst; vomiting of foul and acrid matters, and finally of yellow 
or greenish bile; in some cases, griping of the bowels and diarrhea. 

A fact not generally known but well established is that catarrh .of 
the stomach is the commonest of all forms of stomach disease. The 
digestion of each meal requires an unusual accumulation of blood in 
the mucous membrane of the stomach and an increased production of 
mucus. All that is required for the production of gastric catarrh is a 
slight exaggeration of this physiological process. The disease is com¬ 
mon to all ages of life, and is particularly frequent in children. Fortu¬ 
nately, it is not very serious in its results, as it quickly subsides, and 


BILIOUS ATTACK. 


880 


disappears in a few days. The symptoms given above are those char¬ 
acteristic of the disease in its most marked forms. Yery frequently 
the symptoms are so slight in character as to be scarcely observable 
otherwise than by loss of appetite, coated tongue, feeling of lassitude, 
and perhaps heaviness of the stomach. 

In what is generally known as a “ bilious attack,” in which the 
liver is supposed to be chiefly affected, the real difficulty is with 
the stomach, the affection really being gastric catarrh. The pain 
felt under the border of the ribs on the right side, and attributed 
to the liver, is due to an extension of the disease from the stom¬ 
ach to the duodenum. In some cases, jaundice is present, which 
also confirms the popular notion respecting the liver; but this 
is due to obstruction of the excretory duct of the liver through 
swelling of the mucous membrane at its point of entrance into the 
duodenum. Sometimes, also, the catarrh extends into the bile duct, 
thus completely obstructing the flow of bile, and occasioning its 
absorption into the system, which gives rise to the yellowish ap¬ 
pearance of the skin and dingy yellow color of the whites of the 
eyes seen in jaundice. Bilious attacks nearly always follow some in¬ 
discretion in eating. For instance, if a person subject to the dis¬ 
ease eats a late supper, he will be quite sure to awake in the morning 
with what is termed a “ splitting ” headache, bad taste in the mouth, 
coated tongue, and no appetite. Soon after he gets up, if he attempts 
to rise, he begins to feel sick at his stomach and soon vomits acid and 
very foul-tasting matters,—decomposed remains of his last meal, and 
perhaps of one or two preceding meals. As the vomiting continues, he 
begins to throwup bitter, yellowish matter, which is almost directly after 
followed by an intensely bitter, greenish fluid, easily recognized as bile. 
The yellow matter is also bile discolored by the gastric juice. It only be¬ 
comes green after the gastric juice has been neutralized. The vomiting 
is believed by patients to be caused by “ bile on the stomach,” and it is 
thought necessary to employ an emetic, or a laxative to carry it away 
by means of the bowels. Both of these measures are unnecessary and 
in the highest degree mischievous. The bile was not in the stomach 
when the vomiting commenced, but was brought into it by the violent 
retching, which reverses the action of the small intestine for a short 
distance below the stomach so that the bile is carried upward instead 
of downward. As the stomach is already in a state of great irritabil¬ 
ity, it is evident that both emetics and laxatives will be decidedly 
deleterious rather than beneficial. 


890 


DISEASES AND THEIR TREATMENT. 


Causes. —The principal exciting causes of the disease are the 
following:— 

1. Overeating. More food being taken than cart he digested, it 
undergoes decomposition, and the irritating products of fermentation 
excite congestion, which finally produces catarrh. The catarrhal symp¬ 
toms do not usually occur until some hours after the overloading of 
the stomach, usually not until next day, as some time is required for 
the diseased condition to become established. Children frequently 
suffer from this cause, bein°f allowed to nurse too loner or to take too 
large a quantity of milk at a time. Generally, the infantile stomach 
repels a portion of the food when a larger quantity is taken than can . 
he digested, retaining only the proper quantity; hut in some cases 
vomiting does not occur easily, and then an excessive quantity may he 
retained, which, undergoing decomposition, occasions gastric catarrh. 

It is this fact which has given rise to the popular notion that it is a 
good sign for children to vomit often and easily, it being observed that 
such children sicken less readily than others. 

2. Another common cause of gastric catarrh is the use of indigesti¬ 
ble articles of food in even moderate quantities. As articles of this 
class may be mentioned all kinds of fat foods, fried foods, pastry, 
sweet-meats, preserves, ices, hard-boiled eggs, hash, and many other 
articles well known to be difficult of digestion.. Animal fats are espe¬ 
cially productive of catarrh, not only on account of being difficult to di¬ 
gest, but owing to the fact that they are not affected by the gastric 
juice they interfere with the action of this digestive fluid unon other 
portions of the food. 

3. Another active cause of gastric catarrh is the use of foods which 
have begun to undergo decomposition. Game, meat that has been 
kept for some time until it has reached the condition technically 
known by epicures as “ high,” stale vegetables, rancid butter, and milk 
which has begun to sour, are all very likely to occasion acute gastric 
catarrh. Feeding infants with milk which has begun to sour, even in 
a very slight degree, is a great cause of infant mortality in the summer. 
Not infrequently, fermentation of milk is set up by contact with a 

' nursing-bottle which has been imperfectly cleansed. The tubes com¬ 
monly used in connection with nursing-bottles are absolutely danger¬ 
ous, as it is almost impossible to cleanse them so thoroughly as to pre¬ 
vent possible injury in this way. Children also suffer from the neg¬ 
lect of nurses to cleanse the mouth after food is taken. This should 


CA USES OF GASTRIC CATARRH. 


891 


invariably be done, as milk will decompose in the mouth, and the next 
time the child is fed, the germs of fermentation will be communicated 
to the fresh milk taken, and fermentation will occur in the stomach. 
Neglect to take the simple precautions necessary to prevent fermenta¬ 
tion in the stomach is one of the most active causes of disease in chil¬ 
dren in the warm season of the year. 

4. Still another cause of acute 'gastric catarrh is irritation of the 
stomach from the use of very hot or very cold foods or drinks. The 
use of tea, iced-water, and ices in general, is especially objectionable for 
this reason. Drugs of various sorts, alcoholic drinks, and spices are 
especially productive of this disease. Spices and other condiments, 
when used in small quantities, at first excite digestion, but by increas¬ 
ing the process beyond its natural activity a reaction follows, which 
leads to gastric catarrh. 

5. Stimulants and narcotics are particularly productive of gastric 
catarrh, first, by direct irritation of the stomach; second, by diminish¬ 
ing the secretion of gastric juice. Opiate and narcotic drugs also les¬ 
sen the activity of the stomach, by which means food is too long re¬ 
tained in it, and irritation is thereby produced. The use of tobacco in 
any of its forms, also of tea and coffee, are very common causes of gas¬ 
tric catarrh, or bilious attacks. We have seen people relieved of the 
disease entirely, after having suffered almost constantly for many 
years, by discontinuing these habits. 

6. Still another cause of gastric catarrh is “ taking cold,” one of the 
most common causes of catarrh. 

Gastric catarrh is frequently produced in weakly children and 
adults who are just convalescing from some exhausting disease by 
causes which would not affect a healthy person injuriously. It is also 
frequently excited in children by using cow’s milk without sufficient 
dilution, by the use of meat and vegetables for which the stomach is 
not prepared, especially by the use of confectionery and sweet-meats, 
with which they are often supplied as a means of keeping them quiet. 
Taking a hearty meal when the system is exhausted is a not infre¬ 
quent cause of this disease. Sometimes the disease assumes an epi¬ 
demic form, appearing in a large number of cases about the same time 
without any apparent cause. The exact causes in these cases are not 
yet well determined. 

Treatment. —Give the stomach rest. The patient should take no 
food for twenty-four hours, or, at the most, nothing but a few sips of 


892 


DISEASES AND THEIR TREATMENT. 


water-gruel or something of a very light, starchy character. The warm 
full bath will greatly mitigate the patient’s suffering by relieving the 
congestion of the head. Care should be taken to keep the feet thor¬ 
oughly warm by means of hot jugs, bricks, etc. Very hot, or alternate 
hot and cold applications may be made to the head, as in many cases 
the application of the two will give most prompt relief. Fomenta¬ 
tions over the stomach and bowels should be applied for several hours 
at the beginning of the attack. It is generally not best to administer 
remedies to stop the vomiting, at any rate at first, as it is a remedial 
effort of nature to remove from the stomach the offending matters 
which would do great harm if allowed to remain. The violence of the 
retching may be greatly relieved, and the stomach more quickly and 
thoroughly emptied, by making the patient drink large quantities of 
lime-water. When the character of the matter vomited shows that 
the stomach has been emptied of the decomposing food which it con¬ 
tained, the patient may be allowed to take a few sips of hot water or 
very weak tea, or to swallow bits of ice or sips of iced-water, as may 
be most grateful and is best tolerated by the stomach. The vomiting 
may be checked almost immediately in this way. It is well also to 
administer large warm enemata for the purpose of relieving the bowels 
as quickly as possible. They are almost always found to be obstinately 
constipated in these cases. Persons subject to frequent attacks of 
gastric catarrh have what is known as bilious dyspepsia, and must 
carefully avoid all the causes enumerated if they would recover health. 
All kinds of articles of food difficult of digestion, especially fat meats, 
fried foods, and most animal foods, together with butter, sugar, hot 
drinks, spices, and condiments, must be discarded from the dietary. 
As the digestion is very slow, meals should be placed sufficiently far 
apart to give the stomach plenty of time for digestion. Two meals a 
day are for such a person far preferable to more. Nothing should be 
taken under any circumstances after five o’clock in the afternoon, and 
nothing after four o’clock if the patient is in the habit of retiring early. 
Most patients will derive great advantage from a diet composed al¬ 
most wholly of fruits and grains, avoiding meats, and coarse vege¬ 
tables. About the only vegetables which are tolerated by persons 
subject to gastric catarrh are potatoes and asparagus. The wearing of 
the umschlcig, or wet girdle, constantly during the night is an excel¬ 
lent curative measure which may be adopted with benefit by per¬ 
sons suffering from this distressing affliction. When catarrh of the 


CHOLERA MORBUS. 


893 


stomach is the result of taking cold, the most prompt and efficient 
measure is a sweating bath of some kind, as the warm blanket pack, 
the vapor or Turkish bath. 

CHOLERA HORBUS. 

SYMPTOMS. — Vomiting, soon followed by purging; watery, acrid or acid discharges 
from the bowels; colicky pains, cramp in the feet and limbs; hiccough; rapid and feeble 
pulse; cold skin, often bathed with clammy sweat; voice feeble and hollow, 

This disease is nothing more in fact than an extension in a severe 
form of the preceding, the watery discharges resembling those which 
not infrequently occur in catarrhal affections of the mucous membrane. 
The disease most frequently occurs in hot weather, and is generally ex¬ 
cited by errors in diet, as the use of green fruit. Sometimes the dis¬ 
ease assumes an epidemic form, a large number of persons being at¬ 
tacked at about the same time. Attacks most frequently come on 
during the night, the first symptom being a feeling of pressure at the 
pit of the stomach, which is shortly followed by nausea and vomiting. 
The matter vomited first usually consists of undigested food. After 
a time, a pale yellow or greenish fluid, intensely acrid, bitter, or acid, is 
vomited. Griping pains in the bowels are also present. The dis¬ 
charges from the bowels are at first pulpy in character, but soon be¬ 
come liquid, enormous quantities of fluids passing from the body. The 
result of this great discharge of fluids is a rapid shrinking of the tis¬ 
sues, giving to the features and other parts of the body a pinched ap¬ 
pearance. The nose is pointed, the eyes sunken, and the skin appears 
dry and shriveled. It is always cold, and sometimes covered with a 
clammy perspiration. The discharges from the bowels sometimes have 
the appearance of thin rice-water or thin gruel, which gives the dis¬ 
ease a close resemblance to cholera. The oppression of the patient is 
very great, the voice becoming hollow, and sometimes being lost al¬ 
together. Notwithstanding the serious aspect of the disease, it usu¬ 
ally subsides in a few hours, the patient making rapid recovery. 
Sometimes, however, particularly in the cases of very old people and 
infants, the exhaustion becomes so great that the patient does not 
rally, and passes into a relapse. The discharges become involuntary, 
the pulse disappears, and the patient finally dies of exhaustion. 

Treatment. —At the beginning of the affection, drink freely of 
warm liquids to facilitate evacuation of the stomach. Large, warm 
enemata wfill also be found serviceable. When the vomited matter no 


DISEASES AND THEIR TREATMENT. 


S94 


longer shows traces of food, efforts should be made to stop the vomit¬ 
ing as soon as possible. Give the patient small bits of ice from the 
size of a bean to that of a filbert, allowing him to swallow the bits 
every few minutes. This is one of the most successful means of stop¬ 
ping vomiting. At the same time apply hot fomentations over the 
stomach and bowels. In cases in which hot applications to the bow¬ 
els do not seem to give any relief, very cold compresses may be ap¬ 
plied instead. If the patient suffers much from cramp, put him into 
a warm bath. Do not be alarmed if the vomiting and purging are not 
checked at once. The unpleasant symptoms will almost certainly dis¬ 
appear after a few hours. If the case is an unusually severe one, 
or the patient is far advanced in years, or a young child, a physician 
should be called at once, as it may become necessary to employ an 
opiate to check the vomiting. We have never lost a case in the treat¬ 
ment of this disease, and have very rarely found it necessary to employ 
other than the simple measures mentioned. It is very important that 
the patient should be careful in his diet for some time after the sever¬ 
ity of the attack has passed away, as a relapse may be brought on 
very easily by indiscretion. The diet should consist chiefly of cooked 
fruits, avoiding seedy fruits, and grains. Animal foods and coarse 
vegetables should be wholly avoided until the stomach is fully re¬ 
stored to its natural condition. 

CHOLERA INFANTUM. 

SYMPTOMS .— Vomiting and purging, sometimes almost incessant; spasmodic pain in 
stomach and bowels; great prostration; bowels bloated or sunken; other symptoms 
mentioned in connection with the preceding disease. 

This affection is also undoubtedly catarrhal in character. It is 
closely allied to cholera morbus, and is probably essentially the same 
disease, being modified by the age, and the character of the food upon 
which children are usually fed when they are most susceptible to the 
disease. It is quite probable that the great cause of the disease in 
children is the fermentation and decomposition of food in the stomach. 
This may be due to slowness of the digestion, to overloading the 
stomach, or to feeding with milk which has begun to sour, or has be¬ 
gun fermentation through inattention to thorough cleanliness in the 
care of the nursing-bottle, neglect to wash the child’s mouth, etc. The 
disease is frequently preceded in children by a diarrhea, which often 
continues for several days before the disease makes its appearance. 


CHRONIC GASTRIC CATARRH. 


895 


At the beginning of vomiting, the milk thrown up is in a fluid condi¬ 
tion instead of beino- well coagulated as is the case in health, which 
shows that the stomach is not active, there being little or no secretion 
of gastric juice. This is frequently a fatal disease, especially when it 
attacks young infants, or those who are of a feeble constitution. 

Treatment. —The treatment should be essentially the same as that 
described for cholera morbus. The application of cold to the stomach 
is very beneficial. Where the child cannot swallow ice, iced-water may 
be given in very small quantities every few minutes. A matter of 
very great importance in the treatment of cholera infantum is giving 
the stomach entire rest. No attempt should be made to feed the child 
for at least twenty-four hours. There will be no suffering for want 
of food if it is withheld as long as the stomach is in such a condition. 
If the patient has an appetite, well-diluted milk may be given in small 
quantities after the vomiting has been quieted for some time. The 
milk should be diluted very considerably, at least two parts of water 
to one part of milk being employed at first. Also add a little lime- 
water if cow’s milk be used. In case this is vomited, well-made beef- 
tea may be used. The beef-tea should be entirely free from fat. In 
case this is rejected, the patient may be nourished by means of the 
white of egg dissolved in cold water, or with beef tea enemas. If pos¬ 
sible, the egg should be beaten to a froth, as it is more easily digested 
in this condition. Great care should be taken to keep the extremi¬ 
ties warm and dry. With proper care and the application of the meas¬ 
ures suggested, cholera infantum will not often prove a fatal disease. 

CHROMIC GASTRIC CATARRH. 

SYMPTOMS.—Pressure and fullness at the stomach after eating; flatulence; heart¬ 
burn ; little or no appetite; vomiting; water-brash ; tenderness at the pit of the stom¬ 
ach ; slimy tongue; bad taste in the mouth; obstinate constipation; occasional jaun¬ 
dice ; mental depression ; lassitude; pains in the limbs and face; sleeplessness. 

This disease is much more common than is generally supposed, and 
includes quite a large proportion of cases which are usually classed 
under the ambiguous head, dyspepsia. The most troublesome symptoms 
of this disease are due to deficient secretion of the gastric j uice, dependent 
upon the congested state of the peptic glands, and the choking of the folli¬ 
cles with mucus. The great abundance of mucus also interferes with the 
action of the gastric juice by rendering it alkaline, and by coating over 


89G 


DISEASES AND TIIEIR TREATMENT. 


the food, and rendering it impermeable by the digestive fluids. Defi¬ 
cient muscular activity of the stomach is also occasioned by the partial 
paralysis of the walls of the stomach consequent upon long-continued 
congestion. The disease is often long-continued, the patient rarely recov¬ 
ering without the employment of some special measures adapted for his 
relief. Its results, when long-continued, are thickening of the mucous 
membrane of the stomach, sometimes to an enormous extent, gastric 
ulcer, contraction of the pylorus, and enlarged stomach. Patients 
rarely die of the disease itself, life being cut short by other diseases 
which are produced by the great exhaustion and debility caused by 
the defective nutrition. Consumption very frequently follows gas¬ 
tric catarrh 

Causes. —The causes are the same as have been mentioned as pro¬ 
ductive of acute gastric catarrh, by far the most important being errors 
in diet, the use of alcohol, drugs, tea, coffee, tobacco, and frequent ex¬ 
posure to heat and cold. The disease is very frequently the result of re¬ 
peated attacks of acute gastric catarrh, but is occasionally gradually 
developed in the chronic form from the start. We have met many 
cases which seemed to have been produced by long-continued acidity of 
the stomach occasioned by dietetic errors. Gastric catarrh is frequently 
dependent upon other diseases which obstruct the venous circulation of the 
mucous membrane of the stomach, as diseases of the liver, organic dis¬ 
ease of the heart, empyema, and chronic pleurisy. 

Treatment. —Of first importance in the treatment of this disease, as 
in nearly all other serious affections, is entire discontinuance of all the 
causes which may have produced it. This is absolutely necessary ; and 
it is impossible to effect a cure unless the patient is willing to deny him¬ 
self and observe a strict regimen until the stomach is restored to a 
normal condition. The diet must be restricted to such articles of food as 
will be easy of digestion, will not overtax the stomach, and do not easily 
undergo fermentation. Sugar, butter, and condiments of all sorts, must 
be avoided. Vegetables, flesh foods, and all articles of food known to 
be difficult of digestion, must be excluded from the dietary. Gross and 
irritating food of all sorts must be avoided. On this account, cracked 
wheat, graham flour, and the whole-meal preparations in general, are 
not well tolerated in this disease, on account of the excessive irritability 
of the mucous membrane of the stomach. In cases in which there is 
little or no acidity of the stomach, or heart-burn, bland farinaceous ar- 


CHRONIC GASTRIC CATARRH. 


807 


tides are the best, such as well-boiled and strained oatmeal gruel, fruits 
not seedy in character, baked apples, and similar foods. 

It is well to avoid the use of meat when the patient can be other¬ 
wise sustained. At the most, a little of the white meat of fish or fowls 
may be used now and then. Soft-boiled eggs, with dry toast, well mas¬ 
ticated and softened before being allowed to enter the stomach, agree 
well with most patients. In cases in which there is great acidity, 
starchy articles of food must be mostly avoided. For these persons a 
nitrogenous diet, or a bread and meat diet, is to be preferred. Very little 
fluid should be taken. No single article of food agrees so well with a 
large number of persons as milk. Not infrequently the disagreement of 
this article of food is due to bad association with other foods, as 
meat, vegetables, and fruits. If meat is taken largely as an article of 
food, little else should be eaten but well-baked, stale white bread. It is 
better that the bread should be toasted until brown and crisp. When 
milk disagrees with a patient, undergoing fermentation or forming large 
hard curds, it may be mixed with lime-water, in the proportion of one 
part of lime-water to four of milk; or it may be used in the form of 
buttermilk. The latter article seems to agree remarkably well with 
some cases of gastric catarrh. In the worst cases, however, no article is 
well received by the stomach, owing to the detention in that organ of 
undigested and partially decomposed food, which readily induces de¬ 
composition in whatever is eaten. In these cases one of two things 
must be done ; either the stomach must be allowed to rest until it has 
become thoroughly emptied, and the mucous membrane has lost some¬ 
thing of its irritability, or the stomach must be artificially emptied of 
its decomposing contents. 

The stomach may be given rest by means of nutritive enemata, by 
the use of which life may be prolonged for an indefinite period. Ex¬ 
perience shows that food injected into the rectum, although not di¬ 
gested in that part of the alimentary canal, is carried up into the small 
intestine by a reversed peristaltic movement of the bowels. We not 
long ago treated a patient for gastric catarrh to whom it became nec¬ 
essary to administer along with the food some remedies of a peculiar 
color and flavor, as nothing could be retained by the stomach. We 
were shortly surprised to hear the patient complaining of tasting the 
medicine administered. We at first supposed the difficulty to be wholly 
due to the patient’s imagination, but upon examination of the matter re¬ 
gurgitated from the stomach we found it to present unmistakable evi- 

57 


DISEASES AND THEIR TREATMENT. 


898 

dence of the presence of medicine injected into the rectum a short time 
before. The patient continued to expel portions of the medicine by 
the mouth so long as it was employed and for a few days afterward, 
the quantity gradually growing less. Physiological experiments have 
now established the fact above referred to, and nutritive enemata may 
be employed with the fullest confidence that if they are sufficiently 
nourishing and properly employed in sufficient quantity the patient 
will be adequately nourished thereby. Any one of the preparations 
described under the head of nutritive injections (page 737) may be em¬ 
ployed for this purpose. On account of the ease with which it may 
be prepared, the beef-tea and egg preparation is to be very strongly 
recommended. 

In Germany the stomach- 
pump is much used in these 
diseases for the purpose of 
cleansing the stomach from 
its decomposing contents, the 
stomach beiim washed out 

O 

each morning before break¬ 
fast. The rapidity with which 
a cure may be accomplished 
by this means is often sur¬ 
prising. Although to most 
patients the remedy may seem 
to be a harsh one, it is by no 
means so unpleasant as might 
be supposed, the flexible tube 
passing into the stomach with 
very little difficulty after one 
or two trials. In Fig. 275 is 
illustrated a method of wash¬ 
ing the stomach, preferable to the use of the stomach-pump. A little 
study of the cut will show the opei’ation of the device. The elevated 
reservoir contains the tepid water used for the purpose, which passes 
through the upper tube to the mouth, and thence through the stom¬ 
ach-tube, the upper end of which is shown at a, into the stomach, the 
water being prevented from passing into the pail below by pressure 
;upon the lower tube with the hand. After the stomach has been filled 



Fig 1 . 275. Improved Stomach-Pump. 










CHRONIC GASTRIC CATARRH. 


899 


by this method it may be readily emptied by closing the upper tube by 
pressure of the fingers, and opening the lower one. The pressure upon 
the stomach by the abdominal walls will force the liquid through the 
lower tube into the pail, thus starting the current, which, acting upon 
the syphon principle, will quickly empty the stomach. By repeating 
this process several times, the stomach may be thoroughly washed- 
In a short time the patient learns to perform the operation himself, and 
each morning washes his stomach as he would his face. We first saw 
this method employed by a patient suffering with cancer of the stom- 
ach who came under our care. This measure is, of course, necessary in 
only the most severe cases, and should be employed only under the 
supervision of a skillful physician. 

In cases caused by frequently taking cold or long exposure to a 
damp, chilly climate, the patient should be treated with warm baths, 
and should take great pains to clothe the body, especially the trunk, 
very warmly, extra clothing to be worn over the stomach and bowels. 
Such general measures of treatment should be adopted as will im¬ 
prove the general tone of the system, as the general application of 
•electricity, massage, tonic baths not too frequently repeated, etc. 
Wearing the moist abdominal bandage, called by the Germans the 
umschlag, will be found very excellent in many of these cases. 
The bandage should be worn night and day for two or three weeks, 
until a slight eruption appears.on the skin, when it may be dis¬ 
continued for a few days to allow the eruption to disappear. There 
is no advantage in establishing large, suppurating sores about the 
body, as was done in the old-fashioned water-cure practice and is 
still recommended and practiced by some unscientific hydropaths. 
Hot fomentations over the stomach for a few minutes just before 
or just after a meal are useful for these cases. Probably the best 
of all simple measures is the use of alternate hot and cold applica¬ 
tions to the spine, just back of the stomach. A celebrated London 
physician recommends the use of large linseed poultices covering the 
stomach and bowels an inch thick, to be worn during the night. We 
have never found it necessary to resort to this method, believing that 
the same effect is obtained by the use of the abdominal bandage. In 
cases of great acidity of the stomach the patient will often find much 
relief by the use of finely pulverized charcoal, or charcoal crackers. 
The dry pulverized charcoal is, however, much the best. It may be 
taken as powder, or stirred in a little water. A tablespoonful of char¬ 
coal taken immediately after the meal will frequently prevent acidity. 


900 


DISEASES AND THEIR TREATMENT. 


Not infrequently decomposition of the food may be prevented by 
eating one or two charcoal crackers after the meal. The charcoal 

O 

should be freshly burned to be of any value ; hence that found at the 
drug-stores is rarely of much utility. In obstinate cases of chronic 
catarrh of the stomach the application of galvanism in the form known 
as central galvanization is a very excellent measure of treatment. 

DILATATION OF THE STONIACn. 

SYMPTOMS. — Water-brash ; heart-burn; flatulence; cramp; fickle appetite; consti¬ 
pation; abdominal enlargement; occasionally vomiting of great quantities of sour matters 
resembling yeast. 

Causes. —Dilatation of the stomach usually results from some oin¬ 
struction to the passage of food into the intestine. This may be due to 
contraction of the pyloric opening, or to inactivity of the muscular 
walls of the stomach, which do not contract with sufficient force to 
expel the contents of the organ. This condition is a frequent accom¬ 
paniment of cancer of the stomach. It is also sometimes the result of 
chronic gastritis. It occurs most often in gluttons and drunkards. 

Treatment. —This disease is an obstinate one, and in many cases 
cannot be cured. Much can be done to relieve the patient, however, 
and by persistent and thorough treatment a cure can sometimes be 
effected. The patient should eat only the most simple foods, such as 
are easy of digestion, and in the smallest quantity capable of sustain¬ 
ing life. Soups, and liquid foods of all kinds, should be avoided, as the 
absorption of fluids in this condition is very slow. The diet should 
consist chiefly of dry food which requires very thorough mastication. 
Vegetables should be wholly avoided, together with fat meats, and 
pastry of every sort. The patient should eat no fermented bread. 
The dyspeptic bread, or water-crackers, are excellent in this condition. 
In many cases, nutritive enemata may be advantageously used, giving 
the stomach a good opportunity for rest. The most prominent indica¬ 
tion for active treatment is thorough and frequent emptying of the 
stomach. This may be accomplished in two ways: first, by drinking 
large quantities of water containing a little salt or carbonate of soda 
in the morning an hour before meal-time. Sufficient should be taken 
to excite vomiting, if possible, although, of course, if vomiting is not 
induced after several glasses have been taken, the patient should not 
continue to overload the stomach with liquid. The water should be 
sufficiently warm to be nauseating. Vomiting should be encouraged 


NEURALGIA OF THE STOMACH. 


901 

by tickling the throat with a feather or the finger. By far the most 
efficient means of relieving the stomach of its decomposing contents is 
the stomach-pump or syphon arrangement already described in con¬ 
nection with the treatment of chronic gastritis. Powdered charcoal 
may be taken with advantage after each meal, in quantities of from a 
teaspoonful to two tablespoonfuls. Some benefit will be derived from 
the use of electricity, both galvanic and faradic, applied locally. A 
bandage worn in such a position as to support the distended stomach 
frequently adds much to the patient’s comfort. Constipation should 
be relieved by enemas and manipulations of the bowels. The other 
symptoms should be treated as directed for the treatment of chronic 
gastritis and other disorders of the stomach in which the same symp¬ 
toms occur. 

GASTRAL(iIA, OR NEURALGIA OF TIIE STOMACH. 

SYMPTOMS.—Severe pain of the stomach, at times extending back; stomach distended 
or retracted; vomiting, either at the beginning or close of the attack ; sometimes a 
slight relief by pressure. 

The pain of this disease is most acute. The patient fears that he 
is dying. In severe cases, patients complain of a clutching, tearing 
pain. It seems to begin at the lower part of the breast-bone. Vomit¬ 
ing may occur either at the beginning or the close of the attack. It 
lasts from a few minutes to several hours, leaving the patient thoroughly 
exhausted. Notwithstanding the excessive pain suffered, however, the 
attack is never fatal. 

Causes. —Neuralgia of the stomach is generally produced by errors 
in diet, such as overeating, eating indigestible food, insufficient mastica¬ 
tion of food, hot drinks, iced cream, tea and coffee, and alcoholic liquors. 
The disease is very frequent in Sweden, owing to the great use of sph'its 
and coffee hi that country. It is also induced by excessive venery and 
masturbation. Malaria is not infrequently a cause of the disease. It is 
frequently present in hysteria and other nervous diseases, and is often an 
accompaniment of catarrh of the stomach. It also results from chronic 
ulcer of the stomach, dyspepsia in its various forms, and diseases of the 
generative organs. It is most common in females. 

Treatment. —The patient must take a simple, unstimulating diet, ab¬ 
staining entirely from alcoholic drinks of all sorts, and from tea and cof¬ 
fee. If addicted to the use of tobacco, the practice must be discontinued. 
All the known causes of the disease must of course be avoided. Every 


902 


DISEASES AND THEIR TREATMENT. 


measure should be taken to improve the general health. Upon the oc¬ 
currence of an attack, the pain may be much lessened by hot applica¬ 
tions to the stomach and abdomen. Also apply heat to the extremities. 
The full or sitz bath will often give relief where other measures fail. In 
extreme cases, it sometimes becomes necessary to apply an opiate of some 
kind. In such cases, of course, a physician should be called in. Even 
these cases will generally yield to the application of electricity. The pos¬ 
itive pole should be placed over the spine, just back of the stomach, and 
the negative over the seat of pain. Both galvanic and faradic currents 
may be used, but we prefer the former. 

CHROMIC ULCER OF TIIF STOMACH. 

SYMPTOMS.—Pain in stomach and in spine opposite, increased by food, especially hot 
drinks and sugar; tenderness of abdomen, particularly over the stomach ; violent beat¬ 
ing at pit of stomach ; vomiting; tongue ridged and furred; often great thirst; constipa¬ 
tion. 

Ulcer of the stomach is a much more common disease than is erener- 
ally supposed. Many cases supposed to be merely neuralgia of the 
stomach are really chronic ulcer, it being very easy to confound the two- 
diseases. The ulcer may be very small in size, not more than one-fourth 
of an inch in diameter, or may extend until it becomes as large as the 
palm of the hand. Sometimes the ulcer encircles the stomach like a band. 

Causes.—The chief causes of ulcer of the stomach are obstruc¬ 
tion of the circulation and errors in diet, particularly the use of very 
hot or cold food, and of liquor, tea, and coffee. 

Treatment.—The disease is rarely a fatal one. The patient some¬ 
times dies of hemorrhage, perforation of the walls of the stomach, or 
peritonitis. Unless efficient treatment is applied, the disease is liable to 
continue for many years. The dietetic treatment of the disease is of the 
greatest importance. The patient must avoid all kinds of irritating food, 
particularly hot and cold drinks, sugar, acids, and food which is capable 
of producing mechanical irritation, such as vegetables, bread made from 
coarse flour, etc. The diet should consist of such plain foods as milk, 
either alone or with fine-flour bread, soups, oatmeal gruel, well boiled 
and strained, beef-tea, etc. In very serious cases, entire rest must be 
given, the patient being nourished by nutritive enemata. (The other 
measures of treatment have been fully described under chronic gastritis.) 
This measure may be resorted to either in connection with the restricted 
diet, or as an exclusive means of sustaining the patient. Perhaps there 


HEMORRHAGE OF THE STOMACH . 


90S 


is no way by which so speedy a cure can be effected as by giving the 
stomach entire rest. When there is gas in the stomach, it may often be 
relieved by the use of freshly burned charcoal taken in powder. Some 
eminent physicians employ the stomach-pump, as recommended in chronic 
gastritis. 

The other symptoms which accompany this disease should be treated 
in accordance with the suggestions already, made in connection with the 
treatment of disorders of digestion. \\ hen perforation occurs, death is 
the almost certain result. It should be remarked that pain will often 
continue for some time after the ulcer is healed, owing to the formation 
of cicatrices, which cause contraction of the walls of the stomach. 
When hemorrhage occurs, which is not infrequently the case in this 
disease, it should be treated as described in the following - section 

O 

IIEltORKIIAUG OF TIIE STOMACH. 

SYMPTOMS.—Blood vomited in considerable quantities; blood not frothy, and of 
dark color ; blood usually in clots, and mixed with portions of food; uneasiness or other 
symptoms pointing to the stomach and bowels. 

Vomiting of blood is the most characteristic symptom. Usually 
blood coming from the stomach is mixed with portions of food, 
which is also a means of distinguishing it from hemorrhage of the 
lungs. Notwithstanding the apparent loss of immense quantities of 
blood in hemorrhage from the stomach, the majority of patients recover 
under the employment of proper measures. 

Causes. —Hemorrhage of the stomach is most commonly caused by 
the rupture of blood-vessels, due to ulceration. In chronic ulcer of the 
stomach, and cancer, this is a prominent symptom. It may also be 
caused by intense congestion due to pressure, and by mechanical obstruc¬ 
tion of the circulation in the chest, caused by disease of the lungs and 
pleura. It is also an occasional symptom in scurvy. 

Treatment. —The patient should be given absolute rest. No food 
should be taken for at least forty-eight hours, and in severe cases the 
stomach must be given entire rest for some time, at least until the symp¬ 
toms of bleeding have entirely disappeared, the patient being nourished 
in the meantime by nutritive enemata. The best measure of treatment 
is cold. It should be applied externally by means of ice compresses; in¬ 
ternally, by giving the patient small pieces of ice to swallow, or frequent 
sips of iced water. The patient may also be allowed to take lime-water 


901 


DISEASES A HD THEIR TREATMENT. 


or the serum of milk which has been coagulated with lime. Very little 
good generally comes from the use of astringents, however, as they are 
almost invariably vomited as soon as swallowed. Bleeding and the use 
of morphia are dangerous measures to employ, and their adoption in 
this disease has often proved fatal. The direction frequently given to 
purge the patient directly after hemorrhage is a very mischievous one, 
as it will be likely to bring on a relapse. 

All the good effects supposed to be derived from bleeding may be 
obtained by the use of Junod’s boot, elsewhere described, or by lig¬ 
ating one or both limbs near the body, by means of which a quan¬ 
tity of blood may be temporarily removed from the circulation. 
Ligation, of course, should not be too severe, and should not be 
maintained sufficiently long to produce complete stagnation of the 
circulation in the limbs. In extreme cases, where the patient has 
lost so much blood that death is imminent, the chances for life mav 
sometimes be increased by the practice of the transfusion of blood, 
elsewhere described. Hemorrhage from the stomach should not be 
mistaken for bleeding from other organs, as from the lungs or air- 
passages. Not infrequently blood is vomited which had been swal¬ 
lowed during bleeding at the nose, sometimes during sleep. 

CANCER OF TIIE STOMACH. 

SYMPTOMS.—Pam at the pit of the stomach of a burning or gnawing character, in¬ 
creased by food: tenderness on pressure over the stomach: nausea and frequently 
vomiting, the vomited matters often resembling coffee grains: hard, pulsating tumor 
felt near the pit of the stomach: great emaciation: tawny yellow complexion: symp¬ 
toms of enlargement of the stomach : great exhaustion: swelling of the ankles: some¬ 
times general dropsy. 

The disease is often somewhat obscure, very few of the char¬ 
acteristic symptoms mentioned being present. Sometimes the only 
symptom observable is gradual emaciation which does not yield to any 
treatment. In such cases, of course, diagnosis is impossible. In many 
cases a positive diagnosis is very difficult, the most skillful physicians 
not infrequently making a mistake after the most careful examination. 

No other organ of the body is so frequently affected by cancerou s 
disease as the stomach, but the causes of cancer of this organ are not 
well understood. , It is probable that the true causes are chronic gas¬ 
tritis, ulcer, and dietetic abuse of the organ, particularly the use of al¬ 
coholic liquors. 

The disease seems to be hereditary in some families. The father 


PEPTIC DEGENERATION. 


905 


of Napoleon I., his sister, and himself, all died of this disease. Cancer 
of the stomach also frequently occurs subsequent to cancer of some 
other organ. We have frequently observed this in cancer of the 
breast, particularly after operations for removal of the breast in 
cancerous disease. 

Treatment. —Cancer of the stomach is most likely to be con¬ 
founded with chronic gastritis and ulcer of the stomach, from which 
it is sometimes very difficult to distinguish it. The disease is, of 
course, incurable, but by careful treatment the patient’s life may be 
prolonged and his suffering greatly mitigated. As there are no 
curative measures which can be used with any prospect of success, 
we are confined to the use of palliative remedies. The same measures 
of treatment should be employed in this disease which have been rec¬ 
ommended in extreme cases of chronic catarrh, enlargement of the 
stomach, and gastric ulcer. When the disease has progressed to a con¬ 
siderable degree, the offensive discharges may be very much diminished 
by the free use of finely powdered charcoal. The patient’s sufferings 
are often so great that the use of opiates for relief is advisable. They 
should, of course, be given under the direction of a physician. The 
stomach-pump or syphon apparatus is exceedingly serviceable, as by its 
use the stomach may be cleansed of foul matters, which are usually 
absorbed into the system to a considerable extent, hastening a fatal 
result by general poisoning. Constipation of the bowels should be 
relieved by injections of tepid water. 

DEGEISKIUTIOS OF TIIE PEPTIC GLANDS. 

SYMPTOMS.—Loss of appetite : impaired digestion : gradual emaciation and increas¬ 
ing debility: morbid condition known as degeneration of the glands which secrete the 
gastric juice : death by exhaustion. 

The only morbid symptoms are those mentioned. No special 
causes of this disease have been determined, but there is no doubt that 
the use of alcoholic liquors and tobacco, together with the causes which 
produce degeneration in other organs, cause degeneration of the pep¬ 
tic glands. 

Treatment .—Little can be done for patients suffering with this 
disease. The treatment should consist in attention to the general 
health and the exercise of great care in the regulation of the diet so 
as to tax the digestive organs as little as possible. Only the most 
simple and easily digested foods should be employed. 


90G 


DISEASES AND THEIR TREATMENT. 


DIAKKIIKA. 

SYMPTOMS. — ACUTE : Looseness of the bowels; pain in abdomen, either colicky 
or continuous; purging; nausea; vomiting; coated tongue; foul breath; flatulence; 
eructations of gas; loss of appetite ; headache ; sometimes chill followed by fever. 

CHRONIC: Diarrhea, alternating with constipation; discharges from the bowels 
thin, greenish-yellow or nearly colorless, usually containing considerable mucus ; some¬ 
times, cylindrical casts ; thirst; high-colored urine; discomfort after eating; emaciation. 

Intestinal catarrh, generally known as enteritis, is a very common 
disease, especially in warm climates and in temperate climates during 
the warm season. The inflammation most commonly affects the small 
intestine, either of the three portions of which, the duodenum, the 
ileum, or jejunum, may be affected separately or together. The disease 
is sometimes confined to the large intestine and is known as colitis, or 
to the lower part of the caecum, when it is called typhlitis. When it 
affects the rectum only it is known as proctitis. Occasionally the 
whole intestinal tract is affected at once. 

Causes.— Chiefly irritation from indigestible or improper food, as 
unripe fruit, stale vegetables, food which has begun to undergo de¬ 
composition, poisons, irritating medicines, etc. Among the causes 
may be mentioned the irritation produced by retained feces, as in 
chronic constipation. Mechanical injuries to the bowels, as from 
blows or straining, may produce intestinal catarrh. We have good 
reason for believing also that it is produced by “taking cold,” like- 
catarrh of the air-passages. Among other causes may be mentioned 
congestion of the liver, diseases of the heart and kidneys, and con¬ 
sumption. Sometimes severe intestinal inflammation occurs after ex¬ 
tensive injury to the skin by burning. Malarial poisoning has been 
observed to be a cause of chronic intestinal catarrh. The disease is- 
especially frequent in infants. Notwithstanding the influence of cold 
in producing the disease, it is much more common in hot weather and 
tropical climates. The catarrhal affections of different portions of tho 
intestinal canal are indicated by characteristic symptoms, which we 
have not space to mention here, with the exception of those of— ■ 

Typhlitis .—This is a form of the disease in which the lower part 
of th ecsecum, often including the appendicular vermiformis, presents a 
swelling low down on the right side which is accompanied by consid¬ 
erable pain and obstinate constipation. Usually, the swelling finally 
disappears, the contents being discharged into the bowels ; but some¬ 
times the wall of the intestine is perforated and the contents dis- 


DIARRHEA. 


907 

charged into the abdominal cavity, which is a fatal accident. In other 
cases the perforation is external, the contents being discharged through 
a fistulous opening. 

Catarrh of the rectum, which very frequently occurs, closely re¬ 
sembles dysentery. 

The disease is not dangerous except in infants and persons ad¬ 
vanced in years. 

Treatment. —The regulation of the diet is of the first importance 
in this as in most diseases of the digestive organs. He should 
abstain entirely from the use of vegetables, cheese, meat, corn- 
bread, and bread made of coarsely ground graham flour. The patient 
should subsist chiefly on milk, the yolk of egg, oatmeal, pearl barley, 
and similar food. Fats of all sorts should be carefully avoided. Next 
in importance as a measure of treatment, is the proper employment of 
enemata. We have seen more benefit derived from the injection of 
large quantities of hot water—as hot as could be borne, and in as. 
large quantities as could be retained—than from any other single 
measure of treatment. Fomentations to the bowels should be applied 
once or twice a day, and the abdominal girdle should be worn night 
and day. The patient should take great care to thoroughly clothe 
himself, wearing woolen undergarments the year around. Cathartics 
and emetics should be scrupulously avoided. When the disease is 
produced by cold, it is best treated by sweating baths, as the Russian, 
Turkish, vapor, or hot-water bath. The warm-blanket pack is also 
an excellent remedy in these cases. The hot or cold water used in 
injections should be employed in considerable quantities, either as hot 
as can be borne or quite cool. Dr. Mesmer, an eminent physician, 
employs cold-water injections altogether. We have used both hot 
and cold water successfully in both acute and chronic diarrhea, some¬ 
times one and sometimes the other being best adapted to the particular 
case. If one does not give relief, the other should be tried. The phy¬ 
sician mentioned employs in acute diarrhea about one quart of iced water 
at a time, injecting it slowly, and having it retained as long as possible. 
Cool sitz baths employed daily for from fifteen to thirty minutes, 
the temperature being gradually lowered from 92° to 85°, are an ex¬ 
cellent means of treatment in chronic intestinal catarrh. In the acute 
form of the disease, when fever is present, and there is evidence of 
considerable inflammation, the cool wet-sheet pack, and continuous, 
application of cold compresses over the bowels, are excellent measures 


90S 


DISEASES AND THEIR TREATMENT. 


of treatment. Vomiting and other symptoms should be treated as 
when they occur in connection with other diseases. When symptoms 
of typhlitis, or catarrh of the rectum, appear, applications of ice com¬ 
presses should be made to the parts affected during the first stages of 
the disease, but after it becomes evident that suppuration must take 
place, the ice compresses must be exchanged for fomentations, so as to 
hasten suppuration, and thereby terminate the disease. 

ACUTE DYSENTERY. 

SYMPTOMS. — Diarrhea; chilliness or rigor, followed by fever; severe pain in the 
bowels; constant desire to stool; burning pain in the rectum; watery or mushy dis¬ 
charge, with considerable quantityof tough mucus, which is often streaked with blood ; pain, 
not removed by movement of the bowels; jaundice; headache, dizziness, ringing in the 
ears; inability to sleep; little appetite; great thirst; tongue at first white, afterward 
smooth and slimy; bowels painful to the touch; putrid discharges. 

Causes. —Acute dysentery occurs in two forms,—in isolated cases, 
in which the disease originates spontaneously, and is not communi¬ 
cated to others ; and in epidemics, in which large numbers of persons 
are affected at once, the disease seeming to be communicated from one 
to another. The symptoms in the course of the two diseases are es¬ 
sentially the same, the isolated cases generally being milder in char¬ 
acter, however. The principal causes of dysentery are decayed or ir¬ 
ritating food, unripe fruit, imperfect mastication, indigestion, consti¬ 
pation of the bowels, and taking cold. Epidemic dysentery is sup¬ 
posed to be excited by some specific poison, probably of the nature 
of germs, though this point has not been determined as yet. All of 
the causes mentioned as giving rise to the simple form of dysentery, 
and also to catarrh of the bowels, are predisposing causes of epidemic 
dysentery, as they prepare the way for the action of the germs of 
the disease. 

Treatment. —The disease is generally quite easy to manage if 
taken in time and treated vigorously. In the treatment of cases of 
epidemic dysentery the first thing to look after is the prevention of 
the extension of the disease to those not yet affected by it. This may 
best be done by thoroughly disinfecting the discharges of the patient 
by chlorate of lime, or permanganate of potash, and requiring the ob¬ 
servance of careful dietetic rules. All kinds of food which occasion 
constipation of the bowels, such as fine-flour bread, potatoes and other 
starchy vegetables, and, in some cases, milk, must be avoided alto- 


ACUTE DYSENTERY. 


909 


gether. At the beginning of the disease, where there is evidence of 
the presence of undigested food in the stomach, the stomach should be 
relieved by the use of a large warm-water emetic. The quantity of 
food should be restricted to the smallest amount compatible with 
comfort. Ripe fruits, especially grapes, and most stewed fruits, may 
be used in abundance to keep the bowels regular. Salads, spices, and 
other condiments, fats, fried foods, and large quantities of meat, should 
be strictly avoided, together with tea, coffee, and all other stimulants 
and narcotics. 

The patient should remain quiet, preferably in bed, although he 
feels able to go about the room. He should be carefully protected 
from changes of temperature. The diet should consist chiefly of sim¬ 
ple soups, well-boiled oatmeal gruel, egg beaten up with water or a 
little milk, and similar foods. No cold foods should be taken. In 
many cases, regulation of the diet is sufficient. Care respecting the 
diet should be exercised over the patient not only during sickness but 
in convalescence, the patient being confined to the simplest articles of 
food and required to abstain from the use of meat until health is fully 
restored. Colicky pains in the bowels should be treated by means of 
fomentations. They should be applied as often as possible. Ice-cold 
compresses are also recommended. This is a useful remedy, but more 
are benefited by the use of hot applications than by cold. Either the 
hot or the cold enema may be employed as recommended for diarrhea. 
Both plans are successful. In the children’s hospital in Vienna, in¬ 
jections of iced water into the rectum is a favorite remedy. 

The use of opium, which is exceedingly common in this disease, is 
not advisable, as it produces a feverish condition of the system, de¬ 
cidedly prejudicial to recovery. Herrvner, an eminent German phy¬ 
sician, very strongly discourages the use of opium in this disease. If 
the other treatment is applied thoroughly, it will rarely be thought 
necessary. 

In mild cases, the wet abdominal bandage, sometimes called Nep¬ 
tune’s girdle, is all that is necessary to relieve the abdominal pain and 
check the disease process. In cases in which absolute rest is not de¬ 
manded, the shallow, cool sitz bath may be used with great advantage 
several times a day. 


DISEASES AND THEIR TREATMENT. 


1)10 


CHRONIC DYSENTERY. 

SYMPTOMS.—Looseness of the bowels, with discharges of mucus; burning pain in 
the rectum ; abdominal dropsy; emaciation. 

Chronic dysentery is usually the result of an attack of dysentery 
from which the patient has partially recovered, though sometimes the 
disease comes on insidiously. The general principles of treatment are 
the-same as those in the acute form of the disease. In addition, as¬ 
tringent injections may be used with much advantage, such as solu¬ 
tion of tannin, sulphate of zinc, alum, or nitrate of silver. The latter 
is an excellent remedy, and should be used in the proportion of about 
four grains of nitrate of silver to a goblet of hot water. Chlorate of 
potash is also an excellent remedy. It may be used in the proportion 
■of ten grains to an ounce of hot water. Soothing injections are like-' 
wise of great service, especially in the acute form of the disease, such 
as linseed tea, thin starch, or mucilage-water enemata. Everything 
should be done to maintain the patient’s general health, as in many 
«ases the diseased condition is maintained by malnutrition, and can 
be cured only by improvement of the general condition of the patient. 

COEIC—ENTERAICIIA. 

SYMPTOMS.—Griping pain in the bowels, especially about the navel; pain, spasmodic 
in character, generally relieved by pressure ; no tenderness of the bowels; frequent vom¬ 
iting ; bowels usually constipated, and frequently flatulent; no fever; pulse generally 
slower than usual; skin cold. 

The term colic is properly applied to a spasmodic muscular contrac¬ 
tion of the walls of the intestines, but on account of the difficulty of 
distinguishing the two conditions, it is often also applied to a neuralgic 
affection of the intestines known as enteralgia. The disease is usually 
caused by indiscretions in eating, as of unripe fruit, stale or decaying 
vegetables or other food, certain kinds of fish, or by taking cold, etc. The 
disease is often a very painful one, leaving the patient much prostrated, 
but is never fatal. The application of hot fomentations or dry heat to the 
abdomen, and the use of large hot enemata, rarely fail to give speedy re¬ 
lief. In cases of chronic enteralgia such as are sometimes met with, 
nothing is so effective as the use of electricity in the form of a mild far- 
adic current or galvanism. 


CONSTIPATION OF THE BOWELS. 


911 


LEAD COLIC. 

SYMPTOMS .— The usual symptoms of lead-poisoning; skin dingy ; teeth discolored; 
bad breath ; metallic taste in the mouth; obstinate constipation. 

The most successful treatment of lead-poisoning is that of a prevent¬ 
ive character. Lead pipes or vessels should not be used for conveying or 
holding water. Workmen engaged in industries which expose them to the 
fumes of lead or to fine particles of lead in the air, should protect themselves 
by good ventilation, respirators, etc. Particular pains should be taken to 
prevent the entrance of the poisonous metal into the throat, or the food and 
drink. In cities where lead pipes are used, water should be allowed to 
run some time before using, in order to empty the pipes of the water 
standing in them. Tin vessels used for containing milk should be care¬ 
fully tested before being used. Vessels lined with enamel should be tested 
before they are used for cooking purposes. Tin cans in which fruits arc; 
put up should also be submitted to the test, as they are frequently made 
of the poorest kind of lead tin. The bowels and excretory organs should 
be kept open by water-drinking. Warm baths, especially the electro¬ 
thermal bath, should be assiduously employed. It has been stated on 
good authority that in cases of lead-poisoning, lead has been found in the 
water in which the patient had taken the bath, the metal having been 
eliminated from the system by the aid of the galvanic current. Biliary 
colic and renal colic will be referred to in connection with diseases of the 
liver and kidneys. 

CONSTIPATION OF TOE BOWELS. 

SYMPTOMS.—Inactive condition of the liver ; movement of the bowels infrequent or 
wholly suspended without artificial aid; inactive condition of liver and kidneys, indicated 
by scanty urine and pale color of feces; skin dry and sallow; breath foul; mind de¬ 
pressed ; headache; neuralgia; palpitation of the heart. 

Constipation of the bowels is one of the most frequent disorders of 
the digestive organs. The principal causes of the disease are sedentary 
habits, concentrated diet, and the use of tea, coffee, tobacco, and beer. 
Some of the most obstinate cases of constipation are produced by the 
long-continued use of opiates. It is also frequently the result of other 
disorders of these organs, as chronic intestinal catarrh, stricture of the 
intestines, partial paralysis or inactivity of the muscular walls of the in¬ 
testines, etc. Another cause which is worthy of mention is neglect to 
evacuate the bowels when the desire is felt. The contents of the bowels 


912 


DISEASES AND THEIR TREATMENT. 


are gradually carried down to the rectum, and when they reach this 
point there is generally a desire to relieve the bowels. If the duty is at 
once attended to, the habit of evacuating at a regular hour soon becomes 
fixed. If the call of nature is unheeded, however, the feces are carried 
upward by peristaltic action into the colon again, so that the desire 
passes away. By long neglect, the bowels may get into such an ab¬ 
normal condition that the desire to relieve them will never be felt. 
The bowels act very differently in different persons. In the majority of 
cases the bowels move about once each day. Others require two move¬ 
ments a day. In still others the interval is prolonged to two or three 
days. In occasional instances the bowel movements occur but once a 
week, notwithstanding the person enjoys perfect health. It is sometimes 
astonishing to see how long the contents of the bowels may be retained. 
While a student in Bellevue Hospital, New York, we learned of the 
case of a man who had no movement of the bowels for three months. 
He was then obliged to devote himself to the duty of emptying the 
bowels for three or four weeks, and lost in that time forty pounds which 
he had accumulated. Last, but not least, among the causes of constipa¬ 
tion should be mentioned the habitual use of laxatives or cathartics in 
the shape of “ dinner pills,” “ purgative pills,” etc. 

The results of constipation of the bowels are often very serious. The 
accumulation of fecal matter in the bowels obstructs the portal circula¬ 
tion and induces disorder of nearly all the abdominal organs. The liver 
and kidneys become inactive through mechanical obstruction, the stom¬ 
ach becomes affected, and the pancreas and spleen participate in the gen¬ 
eral disorder, having their functions very greatly impaired. The circu¬ 
lation in the lower limbs is also interfered with by pressure on the large 
veins which return the blood from the lower part of the body, occasion¬ 
ing numbness and coldness of the feet and legs, which is an almost con¬ 
stant accompaniment of this disease. Absorption of the decomposing 
fecal matter also takes place to some extent, giving rise to foulness 
of breath; and the poisoning of the nerve centers occasions great mental 
depression, headache, confusion of thought, neuralgia, and a great vari¬ 
ety of symptoms. One of the most common and painful results of 
chronic constipation is hemorrhoids , or piles. They arise from obstruc¬ 
tion of the circulation due to fecal matter in the bowels. As these gen¬ 
erally require the use of surgical measures for relief, we notice them but 
briefly here. 

Treatment.—Even the most obstinate constipation not dependent 


CONSTIPATION OF THE BOWELS. 913 

on structural lesion of the intestines, can generally be relieved by thor¬ 
ough rational treatment. In the first place, all the causes of the dis¬ 
ease must be carefully avoided. If the patient’s habits have been 
sedentary, he must take abundant exercise by walking, riding, etc. 
Horseback riding is particularly useful in this disease. Another ex¬ 
cellent measure in such cases is vigorous kneading and percussing of 
the abdomen several times a day for five or ten minutes at a time. 
Many obstinate cases of constipation have been cured by this means 
alone. Eating an orange before breakfast, or drinking a glass or two 
of cold water, are simple measures which have sometimes proved ef¬ 
fective. The diet should be carefully attended to. Unless there is 
some disease of the stomach, such as ulcer or painful dyspepsia, coarse 
food should be used. Very little animal food should be taken. The 
diet should consist of fruits, unbolted meal, or grains. A regular time 
should be appointed to relieve the bowels, whether there is any in¬ 
clination or not. The time at which movement is most likely to be 
secured is after breakfast. With some persons, however, the move¬ 
ment occurs immediately upon rising. Hot applications to the abdo¬ 
men, the use of alternate hot and cold applications to the lower part of 
the spine, the employment of the abdominal girdle, and cool sitz baths 
daily, or every other day, are measures of great value in the treat¬ 
ment of this condition. In the treatment of obstinate cases, we have 
often secured great benefit by the employment of electricity and 
Swedish Movements. Electricity should be applied directly to the 
bowels sufficiently strong to occasion slight contraction of the abdom¬ 
inal muscles. When the patient has been for a long time dependent 
on laxatives of some sort, enemata of tepid water should be substituted 
while the effect of remedial measures of a more radical character is 
being obtained. The bowels should not be allowed to move when the 
contents have become hardened by long retention without taking large 
enemata. In very bad cases the patient will find great relief by evac¬ 
uating the bowels while sitting over a vessel filled with water as warm 
as it can be borne. By means of the simple measures mentioned above 
we have relieved cases in which there has been no natural movement 
of the bowels for from ten to twenty years, the patient having been 
wholly dependent upon cathartics. 

58 


914 


DISEASES AND THEIR TREATMENT. 


INTESTINAL HEMORRHAGE. 

SYMPTOMS. — Bloody discharges from the bowels, either pure or mixed with natural 
discharges; when the bleeding is excessive, fainting and other symptoms will usually re¬ 
sult from loss of blood. 

The most common cause of intestinal hemorrhage is hemorrhoids, 
or piles. Hemorrhage from the bowels also frequently occurs in con¬ 
nection with ulcer of the stomach, cancer of the bowels, typhoid fever, 
dysentery, and some other diseases. If the bleeding is severe, it prob¬ 
ably originates from some other cause than hemorrhoids. It is im¬ 
perative that the most complete rest should be maintained. Ice com¬ 
presses should be applied to the abdomen, and iced water should be in¬ 
jected into the rectum. The patient may be allowed to swallow small 
bits of ice, but little good can be accomplished by remedies taken into 
the stomach, as they will not be likely to reach the seat of hemorrhage 
until too late to be of any value. When the bleeding comes from 
piles, the application of ice compresses or of bladders tilled with iced 
water should be made to the affected part. When bleeding is habitual, 
it is very important that the patient’s diet should be regulated care¬ 
fully. He should abstain from meat almost entirely; the less eaten, 
the better. Eggs may be eaten once a day, but vegetables, fruits, and 
grains should be the principal diet. If the bleeding is supposed to 
come from plethora, the suggestions made for the relief of that condi¬ 
tion should be carefully followed. It is of especial importance that 
the patient should abstain from all kinds of spirituous liquors, fat 
meats, and, in fact, meats of all kinds. The diet should be restricted 
to as small an amount as is consistent with comfort, and the strength 
of the patient. Patients of this class are generally excessive eaters. 

INTESTINAL OBSTRUCTIONS. 

SYMPTOMS.—Persistent vomiting ; vomiting of fecal matter; extreme pain ; disten¬ 
sion of the bowels with gas ; hiccough; constipation of the bowels; mental depression ; 
great prostration; tumor, which can be felt through the abdominal walls. 

The causes of intestinal obstruction may be divided into six 
classes, as follows :— 

Compression. —This cause of mechanical obstruction of the intes¬ 
tines may result from morbid growths of any sort, as various forms of 
tumor, including cancer, or from a displaced uterus. We have within 
a week of the date of this writing met with a remarkable case in 


INTESTINAL OBSTRUCTIONS. 


915 


which the last mentioned cause occasioned the most obstinate consti¬ 
pation for many years. The lady had received treatment from many 
physicians for a period of eight years, but without relief. During this 
time there had rarely been a movement of the bowels without the em¬ 
ployment of laxatives of some kind. She was in the habit of taking 
senna at night for the purpose of securing an evacuation of the bow¬ 
els the next morning. Upon making an examination of the womb, it 
was found to be completely retroverted, or tipped backward, thus 
pressing upon the rectum in such a way*as to form an obstacle to the 
downward passage of the contents of the bowels. 

Contraction. —One of the worst forms of obstruction is due to 
stricture or contraction of the intestine, caused by chronic catarrh, dys¬ 
entery, cancer, or chronic ulcer of the intestine. This kind of obstruc¬ 
tion occurs most frequently in the rectum or lower part of the bowels. 
It is indicated by great difficulty in moving the bowels and the small 
size of the stools, when formed. 

Twistiiig. —In some manner not easily understood, the small intes¬ 
tine sometimes becomes twisted upon itself so as to form an obstruc¬ 
tion. So slight a degree of twisting as one-half rotation is said to be 
sufficient to close the canal. 

Internal Strangulation. —This is one of the worst forms of me¬ 
chanical obstruction, as it consists in the entanglement of an intestine 
in a fissure between bands of inflammatory tissue, or the formation of 
a sort of knot in the intestine itself. 

Intussusception. —This form of obstruction is produced by the in¬ 
testine being invaginated, or folded into itself. One cause of this acci¬ 
dent is chronic diarrhea. It is most frequent in children, especially 
in children suffering with hydrocephalus. The occurrence of this ac¬ 
cident is usually indicated by severe pain felt over a certain spot in 
the abdominal cavity. A tumor may also be generally felt at the seat 
of pain indicating the point of obstruction. 

Hardened Feces. —This cause of obstruction is one which should 
not be overlooked, as it is one which is not infrequent. Cases are often 
met in which the feces accumulated in the lower part of the bowels 
are so hard and dry that they cannot be dislodged by the ordinary ef¬ 
forts of nature. Occasionally, also, stony concretions form in the in¬ 
testines, of sufficient size to obstruct the intestinal canal. These are 
generally the result of the use of chalk or magnesia in large quantities, 


91G 


DISEASES AND THEIR TREATMENT. 


or of accumulations the nucleus of which consists of gall stones or 
foreign bodies which have been swallowed, such as coins, cherry or 
plum pits, seeds of raisins, etc. Rupture, or Hernia, is another 
cause of intestinal obstruction, but as this properly comes under the 
head of surgery it will not be considered here. 

Treatment. —The treatment of intestinal obstruction depends, of 
course, upon the cause. If the obstacle consists in morbid growths 
within the abdominal cavity, little can be done to ameliorate the pa¬ 
tient’s condition. If it is simply a retroverted or displaced uterus the 
remedy is simple and easy of application when the nature of the diffi¬ 
culty is understood. Contractions situated near the anus can be re¬ 
lieved by dilatation. When out of reach, nothing can be done except 
to confine the patient to a fluid diet, which will have a tendency to 
produce thin and pulpy stools. Milk and lime-water, beef-tea, eggs 
beaten with milk, and similar food should compose the diet. For 
twisting, internal strangulation, and intussusception, the best mode of 
treatment is distension by means of air or cold water. This remedy is 
of no account unless used very thoroughly. It is generally necessary 
to pump into the intestine a very large quantity of air or water. If 
the patient is a child, it is generally best to place him in a dependent 
position, with the head downward, as by this means the weight of the 
water may be made to act most advantageously in relief of the ob¬ 
struction. Several eminent German physicians depend almost wholly 
upon this mode of treatment in intussusception. 

When symptoms of inflammation occur, as indicated by the pulse, 
rise of temperature and local pain, ice compresses should be applied to 
the abdomen continually. The danger of death in these cases is very 
largely increased by the use of laxatives or purgatives, as remedies of 
this kind will be sure to increase the difficulty. When the obstruc¬ 
tion is produced by accumulations of fecal matter in the rectum or 
colon, it is generally necessary to remove the obstruction by inserting 
the finger, handle of a spoon or any convenient instrument. After an 
opening has been worked through the accumulated mass, a copious in¬ 
jection of warm soap-suds made from castile soap may be made by 
means of the syphon syringe, or any other convenient instrument. The 
injected fluid should be retained as long as possible, and then expelled. 
Repeated injections may be employed if necessary. 


ABDOMINAL DROPSY-ASCITES. 


917 


PERITONITIS. 

SYMPTOMS. —ACUTE: Pain in the abdomen; chill or chilliness followed by fever ; 
great tenderness over whole abdominal wall, increased by muscular action and by slight 
pressure; constipation of the bowels; vomiting; hiccough ; patient lies on the back with 
the knees drawn up ; cold, clammy sweats. 

CHRONIC: Slight pain in abdomen ; obstinate diarrhea; occasional attacks of colic ; 
abdomen rigid, swollen, and tender; emaciation. 

Peritonitis is inflammation of the serous membrane which lines 
the cavity of the abdomen and covers the intestines. The causes of 
the disease are the same as those which occasion inflammation of other 
serous membranes, as of the pleura of the lungs. It frequently also 
results from perforation, or from inflammation and ulceration of the 
mesenteric glands. 

Treatment.— The acute form of the disease requires absolute rest, 
together with remedies calculated to lower the inflammatory action. 
The abdomen should be covered with cold compresses which should be 
wrung out of ice-cold water and changed every ten minutes. Cool in¬ 
jections into the bowels may also be employed for the same purpose. 
Some cases are more readily relieved by the application of hot fomenta¬ 
tions to the bowels and hot enemas. The treatment should be applied 
very thoroughly. The diet should be simple, consisting by preference of 
milk and lime-water, beef-tea, etc. Solid animal food should be with¬ 
held, also vegetables. The diet should be very light until convales¬ 
cence is fully established. For the chronic form of the disease the 
same general plan of treatment should be followed. Much good may 
be derived from fomentations applied two or three times a day. For 
breaking up adhesions which may have formed, the alternate hot and 
cold applications in the form of compresses, the douche, or spray are an 
excellent measure of treatment. Daily hot enemas are also useful. 

ABDOMINAL DROPSY—ASCITES. 

SYMPTOMS:—Abdomen enlarged; skin tense and shiny; a sensation of fluid when 
felt by the hand; short breath ; generally swelling of the lower extremities ; weakness; 
emaciation, especially of the upper part of the body; loss of appetite; sleeplessness, 
patient cannot lie down on account of disturbance of breathing. 

Dropsy of the abdomen is not itself a real disease, being simply a 
symptom of disease. It is most commonly found in general dropsy, 
but in this connection we refer to cases in which it is present without 
general dropsy. These cases are the result either of obsti uction to the 


918 


DISEASES AND THEIR TREATMENT. 


portal circulation from disease of the liver, obliteration of the portal 
vein, or degeneration of the peritoneal membrane, as in cancer or tu¬ 
berculosis of the peritoneum. The most common cause of abdominal 
dropsy is hardening or cirrhosis of the liver, or other forms of degen¬ 
eration of that organ, which most commonly result from the use of al¬ 
coholic liquors. Abdominal dropsy should be carefully distinguished 
from simple accumulations of fat in the' abdominal walls, which is very 
frequent in advanced life in people of a lymphatic temperament, accu¬ 
mulations of gas in the intestines, and, in females, ovarian dropsy 
We have met with cases in which each one of these conditions has 
been mistaken for dropsy of the abclomen. The first condition is very 
easy to distinguish from accumulations of fluid in the abdominal cav¬ 
ity. The same is true of accumulations of gas in’the intestines. By 
simply placing one hand on the abdominal wall and tapping upon one 
finger with the finger of the other hand, a drum-like resonance will be 
observed which indicates the presence of gas instead of fluid. Care 
should be taken, however, to observe whether the resonance extends to 
the space between the lower ribs and the upper part of the hip-bone. 
When no fluid is present there is resonance at this point on both sides of 
the body, but in cases of dropsy of the abdomen the water settles down 
into this part as the patient lies on his,back, the inflated intestines float¬ 
ing and producing a resonance only at the upper part. It is most difficult 
to distinguish cases of ovarian dropsy or cystic tumor of the ovary from 
this disease. The best distinctive sign is a reversal of the order just de¬ 
scribed, the fullness being at the upper part of the abdomen, while reso¬ 
nance is found in the space described between the hip-bone and lower 
ribs, showing that the fluid is inclosed in a sac separate from the gen¬ 
eral cavity of the abdomen. In cases in which there is any doubt as to 
the presence of fluid in the abdominal cavity the question can be easily 
settled by means of a hypodermic syringe. 

It is sometimes difficult to decide which one of the two principal 
causes of abdominal dropsy is active in any particular case. It may be 
said, however, that when there are other evidences of disturbed action of 
the liver it is safe to attribute the dropsy to disease of this organ. Dis¬ 
ease of the liver is frequently indicated by dark-colored urine which 
upon chemical examination is found to contain bile. In cases in which 
none of these symptoms occur, the dropsy is generally due to degenera¬ 
tion of the peritoneum. 

Treatment. —The treatment of ascites should be, of course, to re- 


MESENTERIC CONSUMPTION. 


919 


move the cause as far as possible. In many cases, unfortunately, this 
cannot be done, as in degeneration of the peritoneum and cirrhosis of the 
liver. Much, however, can be done for the relief of the patient, and not 
infrequently a cure can be effected. Attention should first be given to 
the general health of the patient. The diet should be carefully regu¬ 
lated. The food should be nourishing but unstiniulatinof in character, 
free from fats, condiments, and excessive quantities of sugar, so as to re¬ 
lieve the liver as much as possible in cases in which that organ is chiefly 
involved. The general regimen of the patient should be strictly in ac¬ 
cordance with the rules of hygiene. If he has been accustomed to the 
use of stimulants or narcotics of any kind, these may be wholly discon¬ 
tinued. To produce absorption of the fluid, tight bandaging of the abdo¬ 
men and the daily application of electricity afford the best results. An 
eminent physician recently reported a large number of cures from the ap¬ 
plication to the abdomen of dropsical patients of a strong faradic cur¬ 
rent. We have used the same remedy for a number of years with 
marked success. When the obstruction to breathing becomes so great as 
to greatly disturb the patient, and the accumulation of fluid is evidently 
increasing, tapping or aspiration may be resorted to as a means of with¬ 
drawing the fluid. The operation itself is a trivial one,-attended by no 
danger whatever, but it has been observed that the patient generally un¬ 
dergoes emaciation much more rapidly after the operation than before, as 
the fluid is almost certain to return quite rapidly, thus robbing the blood 
of some of its most valuable constituents and so interfering with the nu¬ 
trition of tissue. Some physicians recommend that tapping should be 
deferred until the symptoms have become so urgent as to threaten the 
life of the patient, but we do not hesitate to perform the operation 
much sooner, and repeat it if necessary. In most cases, by means of the 
measures indicated, a return of the dropsy may be either delayed or 
wholly prevented. 

CONSUMPTION OF TIIF BOWELS—MESENTERIC 

CONSUMPTION. 

SYMPTOMS.—Pain in the bowels, more or less constant, sometimes severe, causing 
the patient to draw up his limbs toward the abdomen to relieve the tension; irregular ac¬ 
tion of the bowels; alternation of constipation and diarrhea; when the bowels are loose, 
stools very offensive, abdomen swollen; loss of strength; deep red color of the Ups; 
small ulcers about the mouth; fissures in the Ups. 

Consumption of the bowels is by no means so common a disease as is 
generallv supposed, being almost wholly confined to children, adults be- 


920 


DISEASES AND THEIR TREATMENT. 


mg rarely affected, except when suffering with consumption of the lungs 
also. It is a somewhat obscure disease, and hence has been seized upon 
by quacks as a means of frightening patients so as to obtain an influ¬ 
ence over them. We have had under our care many patients who had 
previously consulted physicians whose hobby seemed to be consumption 
of the bowels, and have found in nearly every case that the diagnosis 
had been “ consumption of the bowels ” either already present or threat¬ 
ening. In not one case, however, of those referred to, have we found 
any symptom of this disease. Chronic intestinal catarrh and scrofulous 
degeneration of the glands of the intestine, are quite likely to be mis¬ 
taken for mesenteric consumption, and it is undoubtedly the frequency 
of these diseases which has given rise to the supposed frequency of ab¬ 
dominal consumption. 

Treatment. —As in consumption of the lungs, the first attention 
should be given to the prevention of this disease, which, when well estab¬ 
lished, is by no means easy of cure. The preventive measures are essen¬ 
tially the same as those mentioned elsewhere for the prevention of con¬ 
sumption, and hence need not be fully recapitulated. They may be 
briefly enumerated as being an abundance of out-of-door exercise, expos¬ 
ure to sunlight, constant supply of pure fresh air, frequent bathing to se¬ 
cure activity of the skin, proper clothing, protection from colds, and a 
generous but unstimulating diet. In the case of children, care should be 
taken to secure milk from healthy cows. A mother suffering with 
the symptoms of consumption of the bowels should not nurse her child, 
as she will be very likely to communicate to it the germs of the disease. 
It should also be borne in mind that cows not infrequently suffer from 
tuberculosis, and communicate the disease in this way. As consumption 
is a contagious disease, it is evidently unwise to allow small children to 
be closely associated with persons suffering from any form of tubercu¬ 
lous affection. Great attention should be paid to the regulation of the 
diet, the patient being supplied with an abundance of nourishing, simple, 
and unstimulating food. As the disease is often attended by weakness 
of the stomach and various disorders of digestion, it is important to give 
these points prompt and careful attention. The general treatment 
should be the same as has already been given for chronic catarrh of the 
bowels and general scrofulous disease. The abdominal pain may usually 
be relieved by the use of fomentations and the wet abdominal bandage. 
The bandage should be wrung as dry as possible and covered with a dry 
woolen cloth. Great care should be taken to keep the extremities warm, 


DYSPEPSIA. 


921 


the feet of the patient becoming chilled very quickly especially after 
bathing. In cases in which there is considerable emaciation and dryness 
of the skin, an inunction with vaseline, olive-oil, or any other good un¬ 
guent, is a very efficient and often essential measure of treatment. We 
have employed various unguents for this purpose, and have been best sat¬ 
isfied with the results obtained from the use of refined Chinese cocoa-nut 
oil imported from Canton. 

DYSPEPSIA. 

SYMPTOMS. — Uneasiness at the stomach; flatulence; acidity; heart-burn ; water- 
brash; pyrosis; nausea; vomiting; regurgitation; gripes ; colic; weight; pain at stom¬ 
ach ; tenderness at pit of stomach ; biliousness; coated and fissured tongue; sore mouth ; 
throat ail; sour or other bad taste in the mouth ; constipation ; diarrhea ; unnatural ap¬ 
pearance of the feces ; sediment in the urine; dry skin; night sweats; nervousness; 
headache; sick-headache; cold hands and feet; congestion of the head; pain between 
shoulders or under shoulder-blade; vertigo; disturbances of vision and hearing; drowsi¬ 
ness; sleeplessness; confusion of mind, and even more serious mental disorders. 

Dyspepsia may be classified, first, as acute and chronic. One of 
the most important differences between an acute and a chronic case 
of indigestion is that acute dyspepsia will cure itself in time, usually 
in a very short period, by the unaided efforts of nature; while a 
chronic case of the disease continues from bad to worse, or without 
material improvement, indefinitely. 

Chronic dyspepsia is generally much less active in its symptoms 
than is the acute form of the disease. It usually begins slowly, in¬ 
sidiously making its advances, and thus for a long time eluding ob¬ 
servation, in many instances until well established. This is one reason 
why the diagnosis of the disease is often very obscure. Very fre¬ 
quently it is overlooked for years, being mistaken for some other dis¬ 
ease through the special prominence of certain symptoms, which, as 
before intimated, may simulate almost any disease. 

Basing the classification of chronic dyspepsia upon the most promi¬ 
nent symptoms observed in different cases of the disease, by far the 
greater part of the number may be included in the following five 
classes; viz., simple or slow, acid, foul or bilious, painful, and nervous 
dyspepsia. Each of the classes named has its characteristic symptoms, 
though any given case may combine the symptoms of one or of each 
of the different 1 classes. 


922 


DISEASES AND THEIR TREATMENT . 


Causes.—Before mentioning in detail the various causes which 
may be considered most active in occasioning disorders of digestion, it 
is important that we call attention to a general principle which ap¬ 
plies to all cases of functional disease of the organs of digestion. In 
the study of digestion in health it is found that the two essential 
things are secretion and muscular action. So we find, correspond¬ 
ingly, that the two primary morbid conditions are defective secretion 
and disordered muscular action. The defect in the digestive secre¬ 
tions may be either in quantity or in quality, or may be both com¬ 
bined. The disordered muscular action may he either increased or 
diminished muscular activity; in the great majority of cases it is the 
latter condition. The special causes which will be mentioned are 
more or less active as agents productive of dyspepsia, just in propor¬ 
tion as they disturb these two essential functions of digestion, secre¬ 
tion and muscular action. 

Errors in Diet. —There is no room to doubt that errors in diet, in 
manner of eating, in quantity or quality of food, are by far the most 
active causes of indigestion in this country, as well as in most others. 
Among the most prominent of dietetic errors may be mentioned the 
following: Hasty eating ; drinking at meals; hot drinks; cold drinks, 
ices, etc.; use of cold food; eating too frequently; eating between 
meals; irregularity of meals; eating when weary; violent exercise 
just after eating; sleeping soon after eating; late suppers; hot or cold 
bathing shortly before or soon after eating; overeating; eating too 
little; unseasonable diet, as the use of highly carbonaceous and heat¬ 
ing foods in summer, as fat meats, lard, butter, and excessive quanti¬ 
ties of fats at any time; badly cooked food; fried food; pastry; 
poor bread ; fat meats ; “ rich f-ood ”; too free use of sugar and sweet 
foods; soft food; too many varieties at a meal; condiments, as mus¬ 
tard, pepper, pepper-sauce, cinnamon, vinegar, excess of salt, etc.; 
pickles; preserves; tea and coffee ; alcohol; tobacco ; hard water; 
alkalies, as in the use of baking powders, soda, saleratus, ammonia, 
etc.; decayed food; adulterations exposing the stomach, as well as the 
Avhole system, to the deleterious action of lead, zinc, arsenic, copper, 
sulphuric acid, etc., etc.; use of indigestible substances, as of clay, 
chalk, slate, and sundry other substances equally innutritious and in¬ 
digestible in character. 

Among causes not related to food or diet may be mentioned, Press¬ 
ure upon the stomach ; mental worry, care, and anxiety; mental im- 


DYSPEPSIA. 


923 


pressions; drugs; sexual abuses; disease of other organs; worms; in¬ 
herited dyspepsia; electrical and other meteorological changes, and 
numerous other influences which are as yet but imperfectly understood 

General Treatment. —As dyspepsia is not usually a fatal disease, 
thousands of people allow themselves to suffer from its pains and in¬ 
conveniences for years without making serious efforts to recover. If 
anything is done, it is most likely to be a trial of some quack nostrum 
advertised on the fence or heralded in the daily newspaper as a “ sure 
cure ” for indigestion, its merits certified by a long list of fictitious or 
purchased testimonials. Every effort of this sort, of course, makes the 
disease worse in the end, even though there may be apparent tem¬ 
porary relief. Failing in several attempts, perhaps, the sufferer settles 
down in despair to the melancholy conclusion that he must remain as 
he is, that his malady is incurable; and so he lives along in a wretched 
way until consumption, that dread disease which often follows close 
on the heels of the hydra-headed malady we are considering, claims 
him as a victim and ends his misery. 

The importance of giving to the treatment of this disease most 
serious attention is further seen by the fact that many organic affec¬ 
tions which when once well established are impossible to cure, have 
their origin, in many cases, in indigestion. This is undoubtedly true 
of tuberculous degeneration of the lungs and other parts, together 
with other degenerative changes. The same may also be said of vari¬ 
ous nervous affections. This accounts, in part at least, for the almost 
constant association of impaired digestion with consumption, and with 
various organic affections of the liver, kidneys, and other organs. In 
most of these cases, the best, and often the only hope for a cure, lies 
in the treatment and cure of the digestive disorder; and, without 
doubt, if this could be accomplished sufficiently early, many cases of 
hopeless organic disease of the lungs and other organs might be pre¬ 
vented altogether. Although each variety of this disease, and indeed 
each individual case, requires a special plan of treatment in some re¬ 
spects different from what is required by any other variety or case, 
there are certain measures which are equally applicable to nearly all 
classes and cases of this disease. To these we will now call attention. 

Removal of Causes .—If the dyspeptic would recover, he must seek 
carefully for each one of the causes of his disease, and carefully re¬ 
move them. It is of no use to hope for recovery without doing this. 
If the cause is in the manner of eating, let him take care to eat prop- 


924 


DISEASES AND THEIR TREATMENT. 


erly. If he has erred in eating too much, or in eating improper arti¬ 
cles of food, let him make a thorough reform in this regard. If the 
difficulty has been in overwork, too much anxiety, too little time to 
digest, or too sedentary habits, he must get away from his care, his 
business, his writing-desk, and seek health in out-of-door exercise, 
coupled with happy, cheerful associations. The careworn, burdened 
mother must have relief from the tedium of her rputine life. A jour¬ 
ney, a visit to a friend, or some other means of diversion, must be 
adopted. Whatever the cause has been, it must be removed. No 
medicine known, no matter how potent, nor how skillful its adminis¬ 
tration, can antidote the effects of the transgression of physical laws. 
Nature is inexorable. She demands obedience, and will not be put 
off with any sort of subterfuge. 

To the great army of dyspeptics, to which almost the whole Ameri¬ 
can nation belong, and a large proportion of other nationalities, we 
would say, You can get well if you wish to, if you care enough about 
health to make the effort, and we are about to point out the way; but 
the man who has been a dyspeptic for years must not expect to get well 
in a week, nor in a month. He must be willing to persevere in his ef¬ 
forts after he has started in the right direction, never relaxing for a mo¬ 
ment his determination to get well. He must also make up his mind to 
deny his appetite of all things harmful, to wage a constant warfare 
against the things which have made him ill. 

Hygienic Remedies .—In the treatment of this disease, attention to 
hygiene and the application of what are by some termed “ hygienic reme¬ 
dies,” are of first importance. Indeed, it is by these agents that nature 
is aided in her restorative work more than by any others, and upon 
these the most skillful and successful of those who have given great at¬ 
tention to the treatment of the functional diseases of the stomach find it 
safest to rely. Undoubtedly there are cases and circumstances which 
may be benefited, and the work of cure hastened, by the employment of 
medical agents ; nevertheless we feel quite confident that the abuse of 
drugs is so very great, and has been the direct cause of so many bad 
cases of confirmed dyspepsia, that it would be far better to do without 
them altogether than to use them as they are not infrequently employed. 
An eminent writer on this subject, in referring to the treatment of dys¬ 
pepsia says, “ My main object in the treatment is to prevent the sufferers 
from resorting to drugs, which, in such cases, not only produce their own 
morbid conditions, but also confirm those already existing.” 


DYSPEPSIA. 


925 


The extensive and often habitual use of alkalies for acidity, of purga¬ 
tives for constipation, nervines and opiates for sleeplessness, and after- 
dinner pills to goad into action the lagging stomach, has been a potent 
factor in the production of a large class of most inveterate dyspepsias. 
This kind of treatment for dyspepsia cannot be too much deplored, nor 
too often discouraged. Especially to be discountenanced is the wholesale 
employment of “liver pills,” “stomach tonics,” “anti-bilious pills,” “bit¬ 
ters,” and the whole genus of quack nostrums and proprietary drugs. 

Diet .—In the treatment of this disease, proper diet and regimen are 
of first importance. The diet is of special importance. It is necessary, 
however, that it should be most carefully adapted to the wants of each 
individual case, as nothing could be more true than the adage that 
“ what is one man’s meat is another’s poison ” when referring to cases of 
dyspepsia. The common plan of recommending some special dietary to 
all dyspeptics indiscriminately is a most pernicious one. We hear much 
of the grape cure, the beef cure, the fat cure, the cod-liver-oil cure, the 
milk and sundry other special diet cures, of dyspepsia, as well as the veg¬ 
etarian cure. Each of these diets may be of special service to some spe¬ 
cial case, but all are totally unfitted for all cases alike. We have seen 
many persons become dyspeptics by the adoption of a vegetarian diet ; 
but we have seen many more cured by exchanging a diet of fat meats, 
sweets, etc., for a plain diet of fruits, grains, and vegetables. 

It is not an easy matter to induce individuals suffering with dyspep¬ 
sia to deny the demands of appetite. In many cases, the will is weak¬ 
ened by long-continued disease, and the appetite is perverted, so that the 
patient loses self-control, and thus himself stands as the most difficult ob¬ 
stacle in the way of his recovery. It must be insisted, however, that the 
directions to be given shall be followed implicitly. In no other way can 
a bad dyspeptic hope for recovery. All but one or two requirements 
may be conformed to, but the failure in one particular may be sufficient 
to make all other efforts useless. 

Although, as before remarked, there is no such thing as a universal 
diet for dyspeptics, there are certain articles of diet that must be dis¬ 
carded by all persons who have a weak digestion, and certain dietetic 
rules which must be conformed to by all. To the most important of 
these we will now call attention. 

1. Eat slowly, masticating the food very thoroughly, even more so, 
if possible, than is required in health. The more time the food spends 
in the mouth, the less it will spend in the stomach. 


926 


DISEASES AND THEIR TREATMENT. 


2. Avoid drinking at meals ; at most, take a few sips of warm 
drink at the close of the meal, if the food is very dry in character. 

3. In general, dyspeptic stomachs manage dry food better than 
that containing much fluid. 

4. Eat neither very hot nor cold food. The best temperature is 
about that of the body. Avoid exposure to cold after eating. 

5. ' Be careful to avoid excess in eating. Eat no more than the 
wants of the system require. Sometimes less than is really needed 
must be taken when digestion is very weak. Strength depends not on 
what is eaten, but on what is digested. 

6. Never take violent exercise of any sort, either mental or phys¬ 
ical. either just before or just after a meal. It is not good to sleep 
immediately after eating, nor within four hours of a meal. 

7. Never eat more than three times a day, and make the last meal 
very light. For many dyspeptics, two meals are better than more. 

8. Never eat a morsel of any sort between meals. 

9. Never eat when very tired, whether exhausted from mental or 
physical labo«\ 

10. Never eat when the mind is worried or the temper ruffled, if 
possible to avoid doing so. 

11. Eat only food that is easy of digestion, avoiding complicated 
and indigestible dishes, and taking but one to three kinds at a meal 

12. Most persons will be benefited by the use of oatmeal, wheat 
meal, or graham flour, cracked wheat, and other whole-grain prepara¬ 
tions, though many will .find it necessary to avoid vegetables, espe¬ 
cially when fruits or meats are taken. 

On pages 927, 372,373, may be found tables showing the length ol 
time required for the digestion of various foods, the quantity necessary 
for health, suggestions for the proper combination of foods, the most 
easily digestible articles, etc. They will be found of great value in 
the treatment of this disease if carefully studied. We would in addi¬ 
tion offer the following as practical suggestions:— 

1. The flesh of wild game is usually more easy of digestion than 
that of domestic animals, and is less likely to be diseased. 

2 . Fats are injurious to dyspeptics almost without exception. If 
eaten at all, butter is the only form admissible, and this should never 
be eaten cooked, but cold, on bread. 

3. Broiling is the best mode of cooking meat. 

4. “ High ” meat should never be eaten, as it has begun to decay. 

5. Meat and vegetables do not agree well together. 

o o o 


DYSPEPSIA 


927 


6. Fruit and vegetables often disagree. Some cases must be re¬ 
quired to discard vegetables altogether. 

7. Milk does not agree well with either vegetables or fruits. 

8. Milk is easier of digestion when boiled than in its natural state. 

9. Warm food is easier of digestion than cold, with the exception 
of fermented bread, which should be eaten stale. 

10. Cold meat and meat that has been “warmed over” are not 
easy of digestion. 

As it is important to all persons with weak digestion to know 
what articles are easv of digestion and what are not, we give here the 
following 

o 


TABLE 

SHOWING THE LENGTH OF TIME REQUIRED FOR THE DIGESTION OF VARIOUS ARTICLES 
OF FOOD IN THE STOMACH, ACCORDING TO THE OBSERVATIONS OF DR. 
BEAUMONT ON THE STOMACH OF ALEXIS ST. MARTIN. 


H. MIN. 

Rice, boiled,. 1 .. 00 

Sago, boiled,. 1 .. 45 

Tapioca, boiled,. 2 .. 00 

Barley, boiled,.2 .. 00 

Milk, boiled,. 2 .. 00 

Milk, raw,. 2 .. 15 

Venison Steak, broiled,.. 1 .. 35 

Turkey, domestic, roasted,.... 2 .. 30 

Turkey, domestic, boiled,. 2 .. 25 

Goose, roasted,. 2 .. 30 

Lamb, fresh, broiled,. 2 .. 30 

Eggs, fresh, hard boiled,. 3 .. 30 

Eggs, fresh, soft boiled,. 3 .. 00 

Eggs, fresh, fried,. 3 . . 30 

Eggs, fresh, raw,. 2 .. 00 

Eggs, fresh, whipped,. 1 .. 30 

Custard, baked,. 2 .. 45 

Codfish, cured, dry, boiled,... 2 . . 00 
Trout, Salmon, fresh, boiled,.. 1 .. 30 
Bass, striped, fresh, broiled, .. 3 . . 00 

Salmon, salted, boiled,. 4 . . 00 

Oysters, fresh, raw,. 2 .. 55 

Oysters, fresh, roasted,. 3 . . 15 

Oysters, fresh, stewed,. 3 . 30 

Beef, fresh, lean, rare, roasted, 3 . . 00 

Beef, fresh, dry, roasted, ..... 3 . . 30 

Beef, steak, broiled,. 3 . . 00 

Beef, with salt only, boiled,... 2 . . 45 

Beef, with mustard, etc., boiled, 3 .. 30 

Beef, fresh, lean, fried,. 4 . . 00 

Beef, old, hard, salted, boiled, 4 . . 15 

Pork-steak, broiled,.3 . . 15 

Pork, fat and lean, roasted,... 5 . . 15 
Pork, recently salted, fried,. .. 4 . 15 

Mutton, fresh, roasted,. 3 . . 15 


H. MIN. 

Mutton, fresh, broiled,. 3 . . 00 

Mutton, fresh, boiled,. 3 . . 00 

Veal, fresh, broiled,.. 4 . , 00 

Veal, fresh, fried,. 4 . 30 

Fowls, domestic, boiled,. 4 ., 00 

Fowls, domestic, roasted,.4 . . 00 

Ducks, domestic, roasted,.4 . . 00 

Duck, wild, roasted,. 4 . . 30 

Butter, melted,. 3 . 30 

Cheese, old, strong, raw’,.3 . 30 

Soup, marrow bones, boiled, .. 4 . 15 

Soup, beans, boiled,.3 .. 00 

Soup, barley, boiled,. 1 . . 30 

Soup, mutton, boiled,.3 .. 30 

Green corn and beans, boiled,. 3 . . 45 

Chicken soup, boiled,. 3 . . 00 

Oyster soup, boiled,. 3 .. 30 

Hash, meat and vegetables, 

warmed,. 2 . 30 

Beans, pod, boiled,.2 .. 30 

Bread, wheaten, fresh, baked,. 3 . 30 

Bread, corn, baked,.3 . . 15 

Cake, corn, baked,.3 . 00 

Dumpling, apple, boiled,.3 . 00 

Apples, sour and hard, raw, ... 2 . 50 

Apples, sour and mellow’, raw, 2 .. 00 

Apples, sweet and mellow, raw, 1 .. 30 

Parsnips, boiled,. 2 .. 30 

Carrot, orange, boiled,.3 .. 15 

Beet, boiled,.. 3 . . 45 

Turnips, flat, boiled,. 3 .. 30 

Potatoes, Irish, boiled,...3 . . 30 

Potatoes, Irish, baked,.2 . . 30 

Cabbage, head, raw,. 2 . 30 

Cabbage, head, boiled,. 4 .. 30 























































928 


DISEASES AND THEIR TREATMENT. 


Exercise .—This is of first importance as a general renovator of vital 
action. The secretion of gastric juice is, under ordinary circumstances, 
proportionate to the amount of nourishment which the system is pre-' 
pared to assimilate. Exercise creates a demand for food, and so stimu¬ 
lates both assimilation and secretion. The best forms of exercise are 
those which will secure the most uniform activity of the several parts 
of the muscular system. Riding, walking, rowing, and especially horse¬ 
back riding, are to be recommended as excellent. Gymnastic exercises 
and the judicious use of the “health lift ” are also good; and for persons 
who from lack of time, or other cause, cannot adopt the other methods, 
these may be considered as almost indispensable. Such exercises as run¬ 
ning, jumping, base-ball playing, “walking matches,” and other violent 
exercises, cannot be recommended. Trapeze exercises must also be dis¬ 
countenanced on the same grounds. Agriculture, especially the raising 
of small fruits and the cultivation of flowers, cannot be too highly rec¬ 
ommended as forms of exercise for dyspeptic patients. For that large 
class of sallow-skinned, weak-backed, dyspeptic young ladies who have 
been made dyspeptics by idleness and too much “ coddling ” by fond 
mothers, who sacrifice themselves to the monotonous drudgery of the 
cook-stove and the sewing-machine, and their daughters to sentimental 
idleness and fashionable piano-thrumming,—for the indigestion of these 
poor victims of mistaken maternal care, the varied exercise necessitated 
by domestic labor is a most admirable panacea. And for the gaunt, 
hollow-cheeked, sunken-eyed, slab-sided, cigar-worshiping young man 
whose chief occupation is cultivating a mustache, smoking cigarettes, 
and swinging a gold-headed cane, a little wholesome experience in earn¬ 
ing a subsistence by the sweat of the brow, instead of leaning upon rich 
relatives, will prove a specific for “ softening,” which begins in the brain 
and extends to every part of the system. 

Exercise before breakfast, while excellent for some, cannot be too 
much condemned for others. Persons who suffer with “ goneness,” 
“ faintness,” “ sinking,” and allied pains when the stomach is empty, and 
especially in the morning, must avoid exercise to any considerable ex¬ 
tent before eating. Disregard of this rule occasions loss of appetite and 
weakening of digestion. Persons who are very weak must also avoid 
exercise before eating in the morning. 

As before remarked, only gentle exercise can be taken soon after 
eating, or immediately before, without injury. Persons who feel a con- 


DYSPEPSIA. 


929 


stant “ sinking ” or weakness in the stomach and bowels will derive ben¬ 
efit from wearing about the body a broad band of flannel. 

Rest and Sleep .—It is of great importance that sufficient sleep be ob¬ 
tained, though sometimes this seems impossible on account of the nerv¬ 
ousness occasioned by this disease. It is generally best to retire early, 
but there is no virtue in getting up in the morning at an early hour 
unless the body is recuperated by rest. Sleep must be obtained, and on 
many accounts it is better to take it in the fore part of the night; but 
if not secured then, it should be taken at other times. Sleeplessness in¬ 
duced by anxiety is often a cause of dyspepsia. It is a great obstacle in 
the way of successful treatment. 

Some cases of dyspepsia require a large amount of rest, besides the 
hours allotted to sleep. We have had a number of cases in which we 
found absolute rest for an hour or two after each meal essential to in¬ 
duce good digestion. Some cases require the maintenance of the recum¬ 
bent posture at least three-fourths of the time. In such cases the amount 
of exercise essential to good assimilation must be secured by means of 
passive exercise, as massage, or Swedish Movements. 

Traveling .—Many physicians are in the habit of recommending 
patients upon whom they have exhausted their skill, to seek health by 
traveling. Thousands annually leave their homes and at great expense 
visit various watering-places, mineral springs, etc., in this country and 
Europe, in consequence of this advice. Some return much benefited; 
the majority are no better except from rest. This is due to the fact 
that traveling does not remove the real cause of the difficulty, and may 
often increase it. In general, while traveling it is next to impossible to 
secure either regularity of diet or other habits, or a proper quality of 
food. This, of course,.in great degree counteracts the benefit to be de¬ 
rived from gentle exercise and freedom from care. 

O 

The advantage of special climates is undoubtedly overrated in a very 
great degree, though a cool climate may generally be considered as best, 
especially for those suffering with “ bilious dyspepsia.” With nervous 
dyspeptics, a warm climate seems to agree better, as it occasions less dis¬ 
turbance of the circulation. 

Mental and Moral Treatment .—This is too important a part of 
a successful plan of treatment to be neglected. The gloomy despondency 
must be steadily combated by a determination to be cheerful. The dis¬ 
position to fret and worry, and to dwell upon the unpleasant or painful 
59 


I 


9;30 • DISEASES AND THEIR TREATMENT. 

features of the disease, must be fought against with firmness and resolu¬ 
tion. The dyspeptic who allows his mind to constantly dwell upon his 
stomach, and who speculates upon the probabilities respecting the diges¬ 
tion of each morsel of food as he swallows it, will be certain to remain a 
dyspeptic. This unfortunate tendency on the part of dyspeptics is a 
great impediment to recovery in many cases. The mind must be di¬ 
verted from self as much as possible at all times, and especially while 
eating. The habit many dyspeptics have of talking constantly about 
themselves, sometimes amounting almost to a monomania, cannot be too 
strongly condemned. Too great solicitude about the stomach, diet, etc., 
is worse than none at all. 

Di 'ess. —In addition to wearing the clothing loose, so as to give every 
organ perfect freedom of action, it is of greatest importance that the ex¬ 
tremities be kept thoroughly warm. Cold hands and feet are very com¬ 
mon with dyspeptics. It will generally be found necessary to wear flan¬ 
nel under-garments throughout the year, graduating the thickness to the 
temperature. It will sometimes be necessary to change the clothing 
once or twice a day to accomplish this in extreme cases of disturbed cir¬ 
culation. Great pains must be taken to keep the extremities warm. 

General Measures of Treatment. —The general indications for 
treatment are, 1. To increase the general vigor of the system by tonic 
remedies; 2. To balance the circulation; 3. To increase the demand for 
food, and thereby improve the quantity and quality of the digestive 
juices. This can be best accomplished by the following means in addi¬ 
tion to the measures already mentioned:— 

Baths .—Water baths are of course useful to keep the skin free from 
impurities and to increase its activity. Too frequent bathing, however, 
will be found harmful, as will also, in most cases, bathing in cold water, 
especially in the morning, before breakfast. The’latter practice has 
been much recommended, and has been employed by many. We have 
heard people boast of having taken a cold shower-bath every morning, 
summer and winter, for years. Some even went so far as to claim to 
find enjoyment in springing out of bed on a winter morning before day¬ 
break and after running a few rods, with no protection from the frosty 
air and snow, taking a plunge in a lake or stream through a hole cut 
in the ice for the purpose. Hundreds have been greatly injured by such 
foolish practices. A person in pretty good flesh may take with advan¬ 
tage a hand bath with tepid water, every morning upon rising. But 
the average dyspeptic will not do well to bathe so often. Two or three 


DYSPEPSIA 


931 


times a week are enough in summer, and half as frequently in winter. 

For those who are quite gross, with inactive skins, sluggish livers 
and bowels, there is nothing better than the Turkish bath when given 
with discretion. This is one of the most active stimulants to activity 
of the skin which can be employed. The vapor and Russian bath, 
and the wet-sheet pack, rank next in value. These measures must 
not be employed too frequently, however, as they are powerful deple- 
tents when injudiciously used, though most energetic vital stimulants 
if properly employed. 

The tepid or cool spray is also a valuable remedy used prudently. 
Sea bathing, so much lauded, is often overdone. If the patient is 
chilled in taking the bath, it is decidedly harmful. 

The vigorous rubbing and manipulation of the skin and muscles 
which properly follow the baths referred to, are as beneficial as the 
baths themselves, and are especially needful to secure a good reaction. 

Inunction .—To encourage the surface circulation, the oil bath, or 
inunction, is a most admirable remedy. It is especially serviceable in 
cases in which there is dryness of the skin. Under the influence of 
inunctions of fine olive-oil, vaseline or refined cocoa-nut oil, applied 
one to three times a week, the skin grows moist, supple, and warm, 
and the patient will usually increase in weight as well as improve in 
color and in general vigor. In weakly patients who are unable to 
take sufficient exercise, this remedy is of great value, especially when 
coupled with massage, a system of rubbing which in some cases secures 
surprising results. Simple dry-hand rubbing morning and night is 
useful, and often seems to benefit the patient more than anything else 
that can be done. 

Water-Drinking .—In cases of obstinate constipation, due to in¬ 
activity of the liver, water-drinking is of advantage, when the stom¬ 
ach will bear it. The quantity of water to be taken must vary from 
a single glassful taken before breakfast to a half-dozen glasses a day 
in the intervals between the meals. Repeated experiments by the 
most eminent physiologists have shown that the liberal use of water 
as a beverage is a great promoter of vital activity, not only of the 
liver but of other vital organs. This must not be carried to excess, 
and must be discontinued if it disturbs digestion. 

Special Measures of Treatment. —The special indications to be 
met by treatment in dyspepsia are, 1. To increase the quantity and 
quality of the gastric juice, and of the other digestive fluids: 2. To 


932 


DISEASES AND THEIR TREATMENT. 


increase the muscular activity of the stomach and bowels; 3. To palli¬ 
ate the various other symptoms which grow out of derangements of 
these two important functions. 

To Increase the Secretion of Gastric Juice. —Any measure which 
will improve the tone of the stomach will accomplish this result. We 
may mention, as useful for this purpose,— 

1. Taking a few sips of cold or hot water just before or just after 
eating. A larger quantity may be taken half an hour before a meal 
with good effect. A few sips of hot drink taken an hour after eating 
is a very useful measure in slow digestion. 

2. The application of hot fomentations to the pit of the stomach 

stimulates the activity of the gastric glands. Alternate hot and cold 
applications made to the portion of the spine just back of the stom¬ 
ach has a similar effect, and often in a remarkable degree. In some 
of the worst cases a fomentation applied a half-hour after each meal 
will have a most decidedly beneficial effect. The alternate hot and 
cold spray or douche may be employed instead of fomentations and 
compresses, and with greater benefit in some cases. The application 
should be at quite extreme temperatures, and alternated every few 
seconds. It should not be continued more than two or three minutes. 
Care must be taken to avoid chilling the patient. If the douche can¬ 
not be employed, an alternate hot and cold rubbing may be substituted, 
applying the heat and cold with cloths wrung out of hot and cold 
water alternately. A piece of ice wrapped in a thin cloth is a very 
good means of applying cold by rubbing. x 

3. The application of fomentations night and morning, and wear¬ 
ing a warm abdominal compress through the night, or for a few hours 
after each meal, are measures of very great utility. Moist warmth 
applied to the surface is a powerful stimulant of secretion in the stom¬ 
ach, as well as in the liver and other secreting organs. 

Measures to Increase Muscular Action. —The measures just de¬ 
scribed are equally useful in exciting muscular activity. In addition 
may be mentioned gentle manipulation of the bowels, or kneading of 
the abdomen, especially its upper portion. By this means the local 
circulation is stimulated, and the natural muscular action of the bow¬ 
els is both imitated and encouraged. This is an excellent remedy, and 
can be employed to advantage each night and morning, and for half 
an hour or more after each meal. 

If the patient is able, he should himself make a practice of knead- 


DYSPEPSIA. 


i 


933 


ing and percussing the abdomen for fifteen or twenty minutes night 
and morning. This is a powerful stimulus of muscular activity. 
Many years ago a quack doctor in New York City made a fortune by 
curing dyspeptics with this mode alone. He put every patient under 
an oath of secresy, and required certain wholesome restrictions of diet, 
which of course aided in the cure. 

Flatulence .—Stomach flatulence, occasioned by the formation of 
carbonic acid gas, may usually be relieved by swallowing a small 
quantity of quite hot water and applying hot fomentations to the 
stomach with gentle kneading. A little camphor, peppermint, or 
winter-green added to the hot water increases its efficiency. Some¬ 
times gulping a small quantity of air will liberate the imprisoned gas 
by causing relaxation of the muscular fibres at the lower end of the 
oesophagus. Flatulence of the bowels, together with the pain which 
sometimes accompanies it, is relieved in the same way. Occasionally 
a hot sitz bath for ten or fifteen minutes, at 100° to 110°, is required. 
A copious warm enema will be required in some cases which are ac¬ 
companied by obstinate constipation. The employment of freshly 
burned and pulverized charcoal taken in capsules is often an effective 
remedy for flatulence. Charcoal crackers are useful, though not so 
efficient, for the same purpose. 

Acidity .—One of the best remedies for acidity, and one which is 
likely to do no harm while it does much good, is pulverized charcoal. 
It must be very finely pulverized, being sifted through a cloth, must 
be of the best quality, and fresh. That made of boxwood or cocoa- 
nut shells is best. It may be taken in powder, in doses of a half tea¬ 
spoonful, with water; but the dry powder, taken in capsules, is best. 
Charcoal may be combined with the food, in crackers, rolls, biscuit, 
and other articles; and when thus used is often very efficient in pre¬ 
venting sourness; but its value is greatly lessened by mixture with 
other substances. When old it is almost valueless. As large a quan¬ 
tity as two or three ounces has been taken after a meal without injury. 

Heart-burn may be treated as directed for acidity. 

Vomiting .—When present, this symptom is sometimes very 
troublesome. If there is evidence from other symptoms that there is 
something in the stomach which needs to be expelled, the efforts of 
nature should be encouraged by copious draughts of tepid or milk- 
warm water, which will lessen the painful retching, as well as secure 
thorough emptying of the stomach. When the matters vomited give 
no evidence of sourness or decomposition, and the symptom is evi- 


934 


DISEASES AND THEIR TREATMENT 


dently due to nervous conditions or to an irritable state of the stom¬ 
ach, a few sips of hot water will usually afford relief, especially if 
coupled with a hot fomentation over the stomach. In cases which are 
not thus relieved, ice pills, or small sips of iced water, with cold to the 
stomach and warm to the spine, will almost always succeed. In bil¬ 
ious vomiting, when the matters vomited are of a green color, mild 
acids, as lemon or lime juice, will be found excellent, sometimes giving 
almost instant relief. The same remedies recommended as palliatives 
of vomiting are the proper remedies for nausea. Sometimes electricity 
will give prompt relief when all other measures fail. 

Constipation .—Inactivity of the bowels is often one of the most 
troublesome difficulties with which the dyspeptic has to contend. 
Two of its most potent causes we have not before mentioned, but call 
attention to them here as they have an important bearing on treat¬ 
ment ; viz., the use of purgatives, and carelessness respecting the ob¬ 
servance of the calls of nature. The latter cause is especially common 
with women, particularly those who reside in the country, where ac¬ 
commodations for the purpose are by no means so convenient as in the 
larger cities, where indoor conveniences are almost universal. With 
most people, the bowels naturally move in the morning, before or just 
after breakfast. If the duty is neglected when it should be performed, 
the bowels become in some degree tolerant of their contents, so that 
the call is less vigorous ; and the neglected organs may become so dor¬ 
mant that they may cease to demand relief. The most obstinate cases 
of constipation are produced in this way. 

The proper measures for the relief of constipation have already 
been given elsewhere. See pages 912 and 913. 

Other symptoms which are present in dyspepsia in common with 
other diseases of the digestive organs, as pain, hiccough, foul breath, 
unnatural appetite, etc., are considered in the section devoted to symp¬ 
toms at the close of the section on the diseases of the digestive organs. 

i & to 

Symptoms dependent upon derangement of the nervous system, the 
circulation, etc., are dwelt upon in their proper connections. 

We will now point out with greater definiteness than heretofore 
the distinguishing features of the several forms of the disease, and the 
general line of regimen and treatment necessary to effect a cure in 
each class of cases. 


ACUTE DYSPEPSIA. 


935 


ACUTE DYSPEPSIA. 

SYMPTOMS. — Weight, fullness, or pain at the pit of the stomach; nausea and per¬ 
haps vomiting, or diarrhea; usually more or less fever; pain in the head; prostration ; 
coated tongue; unpleasant taste in the mouth; generally little or no appetite. 

Acute dyspepsia, when accompanied by considerable fevei’, is often 
termed “ gastric fever,” an incorrect term, however, as the fever is only 
a symptom of the local disease. In severe cases there is an actual 
catarrh of the stomach, an affection which has been already described. 

Causes. —Most cases of acute dyspepsia are the result of excess 
in eating, taking food at an unseasonable hour, or partaking of very 
unwholesome and indigestible substances, or the accidental ingestion 
of some highly irritating substance, as poisoned or decayed food, or 
some similar irritant. 

Treatment.— The most that is needed in the majority of cases is 
abstinence from food for twenty-four hours, and the use of only the 
most simple foods, as boiled rice, oatmeal gruel well boiled, and similar 
food, for two or three days afterward. Animal food should be ab¬ 
stained from altogether, as the stomach is unprepared to digest such 
food. In addition to regulation of the diet, the patient may be bene¬ 
fited by some simple measures of treatment. When there is nausea, 
give copious draughts of warm water to encourage vomiting, so that 
the stomach may be thoroughly evacuated of its irritating contents. 
When the stomach is emptied of solid matter and the vomited matters 
become wholly fluid and assume a yellow or green color, due to the 
presence of bile, the vomiting should be checked by the use of ice or 
iced water, which the patient should be allowed to swallow in small 
quantities. Sometimes ice applied over the stomach externally se¬ 
cures prompt relief, but generally hot fomentations secure the best re¬ 
sults. The hot applications should be made thoroughly, as hot as the 
patient can well bear, and frequently renewed. If they give relief, 
they should be continued several hours, the stomach being constantly 
covered with a warm moist flannel compress. It is also well to give 
a large, warm water enema. If there is pain in the bowels, the water 
employed for the enema should be as hot as can be borne comfortably, 
and the enema should be as large as the patient can retain, for which 
reason it should be administered slowly, with the patient lying upon 
his back. 

The use of purgatives for the relief of acute dyspepsia, especially 


936 


DISEASES AND THEIR TREATMENT. 


the employment of some preparation of mercury, is much to be depre¬ 
cated. While these remedies often seem to give relief, the same relief 
and greater may be obtained by other means which are infinitely su¬ 
perior because perfectly harmless, while those mentioned almost inva¬ 
riably aggravate the disease in the end, making its recurrence more 
frequent. 

SIMPLE DYSPEPSIA, 051 SLOW DIGESTION. 

SYMPTOMS.—Sensation of having eaten too much, when only a small amount has 
been taken; weight and oppression an hour or two after eating; appetite fair, though 
patient often does not care for food until he begins to eat; flatulence of stomach, with 
tasteless and odorless eructations; often pain between shoulders or beneath shoulder- 
blade; in some cases pain in region of heart; palpitation, often occurring in the night; 
disturbed and unrefreshing sleep; tongue foul in morning and bad taste in mouth ; bow¬ 
els usually constipated; unnatural sleepiness, especially after meals; lack of energy; 
symptoms all aggravated by a hearty meal. 

This affection is often the cause of what is mistaken, even by phy¬ 
sicians, for softening of the brain. It may also be mistaken for heart 
disease, great alarm being not infrequently created by the occurrence 
of severe palpitation in the night, suddenly awakening the patient 
from sleep with an impression of impending death. Slow digestion is 
the most common of all forms of dyspepsia, and many people suffer 
from it without understanding the real nature of their disease. . 

Causes. —The disease may be caused by any of the numerous 
causes of dyspepsia which have been enumerated. It is more common 
in men than in women, and especially affects sedentary persons and 
those nervous individuals who eat rapidly, swallowing their food with¬ 
out proper mastication. It is also common in persons whose teeth are 
defective. Its immediate cause is deficient activity of the muscular 
walls of the stomach and intestines, and also deficient quantity or 
quality of gastric juice. 

Treatment. —Slow digestion is benefited by the two-meal plan of 
eating, as by this means the stomach is given more time for its work. 
Six or seven hours should intervene between the meals. The more 
closely the patient confines himself to the articles included in the table 
of foods easy of digestion, given on page 736, the better progress he 
will make. The special measures of treatment useful are those de¬ 
scribed as useful to increase the secretion of gastric juice and mus¬ 
cular action in the stomach and bowels. 


ACID DYSPEPSIA. 


937 


ACID DYSPEPSIA. 

SYMPTOMS.—Same as in simple dyspepsia, exaggerated; particularly heart-burn; 
regurgitation of very sour liquid from the stomach; sour eructations; tongue coated 
white, usually fissured transversely, flabby, and showing marks of teeth at the edges; 
sour taste in mouth, causing rapid decay of the teeth ; grinding of teeth at night; bowels 
loose or constipated; reddish sediment in urine; usually pain at pit of stomach, and 
soreness on pressure. 

Patients suffering with this form of dyspepsia are usually very 
thin and bloodless. Occasionally, however, we meet a case of the op¬ 
posite kind, in which there is an abundance of tissue, though of a 
loose, flabby texture. Starchy food, sugar, fruits, and especially veg¬ 
etables of all kinds, cause great increase of acidity and heart-burn. 
In some cases, even bread and all sorts of preparations from gi’ains 
will disagree. Sugar, or any food containing it, will give rise to great 
distress. A meal consisting of animal food almost entirely, may be 
digested without difficulty, though milk frequently sours. 

Causes. Same as those of slow digestion, with which it usually 
begins. The digestion being very slow, portions of fermenting food 
remain in the stomach from one meal to another, so that acidity be¬ 
comes habitual. Women usually suffer from acidity more than men. 

Treatment. —Acid dyspepsia is aggravated by the use of starchy 
foods and those containing sugar. Vegetables must be discarded for a 
time. Sugar and all articles containing it must be wholly discarded. 
The idea many people have that sugar neutralizes acids, is quite a mis¬ 
take. The grains can be taken better than starchy vegetables, such as 
potatoes. Often fermented bread cannot be eaten without distress. 
Aerated bread, or light unleavened bread in the form of rolls, crisps, 
or crackers,* is much preferable. Toasting until crisp and slightly 
brown renders bread much less likely to sour. Fermented bread 
should never be eaten until it is a day or two old. The measures sug¬ 
gested for the relief of acidity must be adopted, together with the 
same measures of treatment recommended for simple dyspepsia. 

BIEIOUS OR FOIL DYSPEPSIA. 

SYMPTOMS.—Those of slow digestion with occasional acute attacks in which there 
is loss of appetite ; nausea and vomiting or regurgitation of bile; undefined distress or 


* Recipes for this kind of bread and many other wholesome foods for dyspeptics will be 
found in a work by the author, entitled, “Healthful Cookery:” Good Health Pub. Co., 
Battle Creek, Mich. 



938 


DISEASES AND THEIR TREATMENT. 


uneasiness at the stomach; soreness under lower border of ribs on right side ; bowels 
sometimes constipated, often loose ; bitter taste in mouth; tongue coated, usually creamy 
or yellowish color ; fetid eructations; throbbing pain in forehead and temples, often de¬ 
scribed as “ splitting pain in eyes; countenance sallow. 

The term “ bilious ” is used to distinguish this form of indigestion, 
not because either the liver or the bile is the immediate cause of it, but 
because of the bilious vomiting and jaundiced appearance of the skin 
which usually occur in this class of cases. This is what is generally 
known as “ biliousness.” Acute dyspepsia of the same sort is termed 
“ a bilious attack,” or “ sick-headache.” This is not real sick-headache, 
however, as it is often termed, that difficulty being of a neuralgic char¬ 
acter, and affecting only one side of the head at a time. 

As in acid dyspepsia, this form of indigestion differs from slow di - 
gestion chiefly m the exaggeration of the morbid conditions present in 
that disease. Digestion being still slower than in acid dyspepsia, the 
characteristic symptoms occur more remote from the time of eating. 
The usual time for the appearance of the most marked symptoms is the 
morning, before breakfast. Headache, great flatulence, a very foul 
tongue, a bitter taste in the mouth, with nausea and finally vomiting 
of undigested and partially decayed food in a very foul state, indicate 
the inactivity of the digestive organs present in this form of dyspepsia. 
When vomiting is continued, bile is generally expelled, the duodenum 
becoming affected and taking part in the expulsive action. Diarrhea 
often accompanies, and in some cases replaces, the vomiting. 

Owing to this thorough clearing out of the stomach and bowels, 
these attacks do not occur at very brief intervals. They are often peri¬ 
odical, however, recurring sometimes as often as once or twice a week, 
and again not more often than once in two to four weeks. 

Farinaceous foods give much less trouble than meats, especially fat 
meats. Vegetables eaten with fat, pastry, oily nuts, meat which has 
been kept too long, sometimes eggs, especially those not perfectly fresh, 
with albuminous and fatty foods generally, increase the symptoms pe¬ 
culiar to bilious dyspepsia, and bring on the attacks. 

Causes. —This form of dyspepsia, like the preceding, grows out of 
slow digestion, a form of decomposition known as butyric acid fer¬ 
mentation taking place instead of the acetous fermentation present in 
acid dyspepsia. The most common exciting causes are the use in excess 
of sugar and sweet foods, fats, flesh food, tea and coffee, tobacco, and al¬ 
coholic liquors. The attack is usually excited by overeating, eating 


PAINFUL DYSPEPSIA. 


939 


warm bread and butter, sweet foods, fried foods, rich pastry, and 
similar foods. 

Treatment. —In this form of indigestion, the greatest simplicity in 
diet is necessary. Complicated dishes, stews, etc., must be wholly inter¬ 
dicted. Pastry is practically synonymous with poison, for these patients. 
Fats, as butter, lard, etc., and fat meats, together with nuts and fruits 
containing oils, must be entirely discarded. Sweets of all sorts are 
about equally injurious. Many persons suffering with this form of dys¬ 
pepsia can trace the cause of the attack to eating freely of sugar or 
sweetmeats. 

Vegetables, being difficult of digestion, are very productive of gas, 
and hence should be for a time avoided by persons subject to bilious dys¬ 
pepsia. Grains, as oatmeal, wheat meal, rice, and ripe fruits, are adapted 
to this class of cases. Meat should be taken sparingly, and in many 
cases can be advantageously discarded altogether for a time. The other 
treatment should be that recommended for acute dyspepsia at the time 
of the attacks, to be followed by the treatment suggested for slow di¬ 
gestion. The most important measure of treatment is the regulation of 
the diet and the avoidance of all the causes of the disease. 

Pim’l L DYSPEPSIA. 

SYMPTOMS.—Most characteristic is pain at the pit of the stomach, with tenderness 
on pressure just at the lower end of the sternum; also tenderness on right side under 
lower border of ribs; pain in stomach, described as “ tearing," “burning," “gnawing," 
or “rasping," coming on soon after taking food, and ceasing when digestion is com¬ 
pleted; when due to congestion of mucous membrane, all-gone feeling when stomach is 
empty, relieved by bland food; pulsation at pit of stomach or below. 

Causes. —Painful dyspepsia may be developed from acid or bilious 
dvspepsia. It is most often the result of gastritis. Not infrequently the 
congestion to which this pain is sometimes due is caused by compression 
of the abdominal organs, obstructing free circulation. Hence, women 
who wear corsets are very liable to be affected by it, though they will 
rarely admit the cause, and still more rarely can be induced to remove 
it. It is also sometimes due to the pressure of some firm object against 
which the individual leans in his daily business ; in this way various 
trades are productive of painful dyspepsia. 

Treatment. —Meat and all coarse vegetables must be carefully 
avoided in this affection. Preparations from the grains, as farina, corn¬ 
starch, well-boiled oatmeal porridge, and other farinaceous substances, as 


940 


DISEASES AND THEIR TREATMENT. 


sago, tapioca, etc., agree best. It should be borne in mind, however, that 
in this class of cases such articles as cracked and crushed wheat, samp, 
graham bread, and other foods containing the coarser parts of the grain, 
are likely to do harm, the outside woody parts of the grain acting as a 
mechanical irritant to the sensitive mucous membrane of the stomach. 
It is this fact that has given the seeming occasion for a class of ignorant 
individuals who have mercenary ends to serve, to declaim so loudly 
against the use of whole-wheat flour. The fact that the coarser parts 
of the grain can be removed with advantage for this class of cases is no 
evidence against its utility in many other forms of indigestion. 

In extremely bad cases, it is often necessary to put the patient on 
extremely simple diet. In cases of this sort, nothing generally answers 
the indications so well as milk. It should be taken fresh as possible, and 
should be given to the patient about as warm as can be taken with com¬ 
fort, unless there is considerable fever, when it may be taken in small 
quantities iced. In extreme cases, the irritability may be so great that 
the food will be rejected if taken in any considerable .quantities. In 
these cases, it becomes necessary to take the food, milk by preference, in 
very small quantities often repeated. If necessary, so small a quantity 
as one or two spoonsful may be given once an hour at first, gradually 
increasing the quantity and the intervals, until the necessary quantity 
is taken at the usual intervals for meals. Then a little well-boiled and 
strained oatmeal or graham gruel may be added, the quantity being in¬ 
creased until the patient can bear semi-solid food. Many lives have 
been saved by this plan when death seemed imminent from inability to 
digest sufficient nourishment. In some cases, we have found even milk 
intolerable, and have then secured the most successful results by the use 
of the white of egg beaten to a froth, and made palatable by the addi¬ 
tion of a few drops of lemon juice or wine. In the worst cases we have 
even found the employment of nutritive enemata necessary for a short 
time until the irritability of the stomach subsided sufficiently to tolerate 
nourishment. # 

In many cases of this form of dyspepsia, the patient feels a terrible 
faintness as soon as the stomach is empty, which is in some degree re¬ 
lieved by taking proper food. This often leads the patient to resort to 
frequent eating when there is no requirement for so doing, and with 
great detriment. The difficulty referred to occurs particularly before 
breakfast ; and the unpleasant sensations sometimes become so great 
that the appetite is destroyed. While the faintness described is not real 


NERVOUS DYSPEPSIA. 


941 


hunger, it is best to relieve it sometimes by the taking of somo simple 
food, or a little warm drink. When troublesome at night, the patient 
may take a few sips of warm milk ; or if inconvenience is experienced 
from this, a little very weak hot lemonade may be taken. It should bo 
made by pouring boiling water on a slice of lemon or a little lemon peel. 
Add very little sugar, better none at all. Drink after allowing it to 
stand a few minutes. A few sips of cold water will often relieve the 
difficulty. In many cases a cup of warm drink may be taken an hour 
before breakfast with great advantage. 

Further treatment consists in the employment of hot fomentations 
over the stomach two or three times a day, and if necessary after each 
meal. Hot and cold applications to the spine, just opposite the stomach, 
are also a valuable means of relief. All measures calculated to improve 
the general health should be thoroughly employe 

NERVOUS DYSPEPSIA. 

SYMPTOMS. — Frontal headache; pain described as pressure in the back part of the 
head; peculiar sensations at the top of the head; pain in the eye-balls; sometimes pain 
in the upper part of neck, or extending down the spine between the shoulders; pain in 
spine, back of stomach, or beneath shoulder-blades; neuralgia; palpitation of heart; 
cold extremities; general debility; confusion of thought; loss of memory; irritability; 
great nervousness; fidgets; morbid sensibility; melancholy; tendency to insanity; 
stomach cough ; vertigo: blurring of vision; appearance of dark or bright spots, es¬ 
pecially upon stooping; unnatural drowsiness, especially after meals; sleeplessness at 
night; languor in morning, feeling best in afternoon or evening. 

The mutual sympathy between the stomach and the brain is very 
marked. Disease of the stomach may be produced by mental disor¬ 
ders, and various mental and nervous affections may arise from dis¬ 
ease of the stomach. Cases sometimes occur in which the most prom¬ 
inent symptoms of dyspepsia manifest themselves through the nervous 
system, by which alone the disease may be made out. Such cases are 
included under this head. The stomach symptoms of indigestion are 
sometimes so very slight that they can hardly be distinguished; yet 
there is undoubtedly a serious fault in these cases in the elaboration of 
the food. The process of digestion is left incomplete, and the blood 
becomes full of crude, unelaborated material, which not only does not 
impart to the tissues new life and vigor, but is a direct source of irri¬ 
tation. The brain, being the most sensitive part of the nervous sys¬ 
tem, of course suffers most, and hence we have abundant cause for the 
mental depression, unbalanced mental action, confusion of ideas, vacil- 


942 


DISEASES AND THEIR TREATMENT. 


lation of judgment, perversity of disposition, and other kindred dis¬ 
turbances from which the nervous dyspeptic suffers. 

Many persons, finding themselves in this wretched state, and not 
realizing the influence of physical conditions upon the mind, fall into 
hopeless despair, even when no outbreaking sin or intentionally wrong- 
act has been committed. At first, there will be observed simply an 
exaggeration of real difficulties or misfortunes; but after a time the 
individual settles into a state of gloom, despondency, and mental de¬ 
pression in which he will suffer with troubles that are purely imagin¬ 
ary, Of these hypochondriacal persons, Dr. Cullen gave a very 
graphic description which we quote as follows:— 

“ In certain persons there is a state of mind distinguished by the 
following circumstances: a languor, a listlessness or want of resolution 
with reference to all undertakings; a disposition to seriousness, sad¬ 
ness, and timidity as to all future events; an apprehension of the 
worst or most unhappy state of them; and therefore, often upon 
slight grounds, an apprehension of great evil. Such persons are par¬ 
ticularly attentive to the state of their own health, to every smallest 
change of feeling in their bodies; and from any unusual feeling, per¬ 
haps of the slightest kind, they apprehend great danger, and even 
death itself. In respect to all these feelings and apprehensions, there 
is commonly the most obstinate belief and persuasion/' 

Nervous dyspeptics often suffer much in mind from a morbid sen¬ 
sitiveness. They imagine themselves the subject of criticism or ridi¬ 
cule, become morose and irritable, and exceedingly unhappy. Occa¬ 
sionally they find themselves haunted with evil thoughts, with almost 
irresistible impulses to commit improper or criminal acts, as blas¬ 
phemy, suicide, etc. They are almost always certain to imagine them¬ 
selves the subjects of many different diseases, usually of some incura¬ 
ble malady. 

It is observed that mental disorders of the character described are 
often the result of intestinal dyspepsia, a form of the disease in which 
the local symptoms are less prominent than are those which relate to 
the stomach, but equally grave. 

Causes. —The causes of this form of dyspepsia are somewhat less 
obvious than those of the other varieties mentioned; but a causative 
relation has been traced in a sufficient number of cases to enable us to 
say that the disease is undoubtedly induced by sedentary habits, ex¬ 
cessive brain labor with too little sleep, by unhappy social surround- 


DYSPEPSIA—MIXED CASES. 


943 


ings, by disappointment, by misfortune, by grief or anxiety, as well as 
by numerous dietetic errors, particularly the use of stimulating food, 
excessive quantities of animal food, tea, coffee, wine or other forms of 
alcoholic drinks, tobacco and other narcotics. 

Treatment. —Nervous dyspeptics rarely complain of much diffi¬ 
culty with digestion, yet the most careful observance of strict dietetic 
rules is of great importance in this class of cases. The diet must be 
plain/unstimulating, but very nutritious. It is of special importance 
that the patient make a free use of the whole-grain preparations. 
Oatmeal is a specially good article of food, as are also graham and 
cracked wheat. Pepper, spice, mustard, and all other irritating condi¬ 
ments must be scrupulously avoided. There is usually a slow diges¬ 
tion in these cases, and hence the suggestions made respecting the diet 
in that form of stomach disease also apply to this. 

Fomentations and the various other local applications for the relief of 
pain must be employed as necessary. In many cases fomentations over 
the stomach will be found very useful, though in some cases the nervous¬ 
ness will be aggravated by this application. Wearing the abdominal 
bandage is a very excellent means of increasing the activity of the stom¬ 
ach, and also of promoting sleep. Patients of this class usually need a 
great amount of rest, and judgment must be used in advising exercise. 
A change of occupation is essential in many cases, even after a cure has 
been effected, in order to prevent a relapse. We are certain, however, 
that a change of this kind is often advised when a change of diet is all 
that is required. We have not infrequently been consulted by literary 
persons who feared that their minds were becoming so seriously affected 
that they should be obliged to abandon their professions; but with few 
exceptions we have been able to say to them that a careful regulation of 
the diet and regimen was all that was required, and have been gratified 
to see the result all that could be desired. 

MIXED CASES. 

It not infrequently happens that cases of dyspepsia exhibit the symp¬ 
toms which belong to two or more classes of the disease. In cases of this 
sort it is of course necessary to conform to the special indications so far 
as can be done. The most frequent combination is acid and painful dys¬ 
pepsia. These cases are often very troublesome to manage. None but a 
careful discerning physician is competent to successfully pilot safely out 
of his doubly perplexing difficulties such a sufferer as this; but sufficient 


944 


DISEASES AND THEIR TREATMENT. 


care, patience, perseverance, and well-directed effort will secure certain 
success. 

An Important Caution. —It is of great importance to recollect 
that the special directions for the diet in different forms of dyspepsia 
which we have given are not intended as rules to be followed for any 
great period of time. In many cases it is necessary to adhere strictly to 
the special dietary only for a few days, when the diet may by degrees 
be made to include a larger variety of foods. We would, however, im¬ 
press upon the mind of the dyspeptic this fact; that when he finds him¬ 
self well again, he must not make the error to suppose that the princi¬ 
ple “ once in grace always in grace ” in any sense or in the smallest de¬ 
gree applies to the improved state of his digestion. Although the stom¬ 
ach may be restored to a sufficient degree of health and vigor to enable 
it to do its duty well under favorable circumstances, it will be certain 
to fail and relapse into a diseased state again as soon as those conditions 
are no longer supplied. 

DEPR IVED APPETITE. 

SYMPTOMS.—Unnatural craving for either wholesome or unwholesome foods and 
drinks ; general decline in health, conditions varying according to the particular phase of 
the disease. 

Polyphagia, or voracious eating, is a symptom which not infre¬ 
quently accompanies diseases of the digestive organs. It is also fre¬ 
quently observed in various nervous diseases, as epilepsy and various 
mental disorders. In the form of gluttony it is merely a bad habit 
which is increased by cultivation. Persons affected by this dis¬ 
order, for it must be considered a diseased condition, sometimes eat 
almost incredible quantities of food, raw meat, tallow candles, and 
in fact almost everything susceptible of mastication, being greedily de¬ 
voured as long as the passage to the stomach will admit. In the 
majority of cases, voracious eating soon gives rise to serious indiges¬ 
tion, which protects the patient from the injuries which occur when 
excessive quantities of food are digested and absorbed into the sys¬ 
tem, such as fatty degeneration of the blood-vessels and various or¬ 
ganic changes. The proper treatment for this condition is a rigid re¬ 
striction of the dietary, the patient being placed, if necessary, upon a 
regular allowance, and carefully watched to prevent his taking too 
large a quantity. Not infrequently this morbid tendency constitutes 
one of the most serious obstacles to recovery, particularly if the pa- 


DEPRAVED APPETITE. 


945 


tient is suffering with some other serious disease. We have frequently- 
had patients who were evidently very desirous of recovering health, 
yet who appeared to he totally unable to control their appetites. If 
allowed to sit at the table with others they would commit gross 
breaches of propriety in appropriating to themselves the whole of 
some favorite article of food without regard to the wants of others, 
eating with a rapidity and voracity more consistent with the charac¬ 
ter of a hungry beast than of a human being. In these cases the 
morbid tendency rarely disappears without a removal of the disease 
of which it is a symptom. 

Malacia and Pica are terms applied to a perversion of appe¬ 
tite consisting in a morbid craving after particular substances; the 
first, for substances of a nutritious character; the second, for sub¬ 
stances which are wholly innutritious. Patients of the first class are 
frequently seen in what are commonly known as the “ longings ” of 
pregnancy, and frequently similar peculiarities are observed in cases 
of hysteria. Examples of pica are seen in the “ dirt eaters ” among 
the negroes of the Southern States, and the clay-eating tribes which 
inhabit the valley of the Amazon. 

The treatment for malacia and pica must vary according to the in¬ 
dividual case. When occasioned by pregnancy, the morbid condition 
will not disappear until the removal of the special cause. The form 
of the disease often seen in young ladies who manifest a great fond¬ 
ness for such unwholesome and innutritious substances as clay, chalk, 
slate, charcoal, etc., can be treated successfully only by ascertaining 
the morbid condition upon which the disease is really dependent. 

Polydipsia is a disease characterized by a craving for particular liq¬ 
uids. If water is the liquid craved, it will frequently be drank in quan¬ 
tities of several gallons in twenty-four hours. A patient who came un¬ 
der our care not long since asserted that he habitually took one gallon 
of water before breakfast. When such great quantities of fluid are 
taken, the urine is very clear, appearing almost like water, and the 
quantities passed are very great, which may lead to the suspicion that 
the patient is suffering with diabetes. A chemical examination, how¬ 
ever, shows that this is not correct, by demonstrating the absence of 
sugar. The cause of this peculiar difficulty is not understood, and 
nothing can be done except to improve the general health and re¬ 
strict the amount of water taken as much as possible. Fortunately, 
GO 


946 


DISEASES AND TIIEIU TREATMENT. 


the large amount of water taken does not seem to interfere in very 
great degree with the general health. This morbid condition accom¬ 
panies both forms of diabetes. 

Inebriety is a condition in which there is an insatiable desire for 
alcoholic drinks. It is generally produced by long-continued habitual 
use of spirituous liquors, a diseased condition finally being established 
which renders the will almost powerless to control the appetite. 

INTESTINAL PARASITES. 

According to Heller, of the fifty parasites which infest man, twenty- • 
one are found in the intestinal canal. The principal of these are of 
two kinds, known as tape-worms and round-worms. Three varieties 
of the former, and five of the latter, together constitute the principal 
parasites which inhabit the alimentary canal in man. The names of 
these several varieties are, of tape-worms, taenia solium, taenia sag- 
inata or mediocanellata and bothriocephalus latus; of round-worms, 
ascaris lumbricoides, oxyuris vermicularis or thread worm, tricoce- 
phalus dispar or whip worm, anchylostomum duodenale, and tri¬ 
china spiralis. 

The occurrence of parasites in the intestinal canal is much more 
frequent than is generally supposed, as they often remain for many 
years undiscovered. It not infrequently happens, on the other hand, 
that people imagine themselves to be inhabited by worms of various 
sorts when they are wholly free from parasites of any kind. Less fre¬ 
quently persons become possessed with the idea that they have within 
their stomachs frogs, lizards, or other reptiles or small animals, a no¬ 
tion which is wholly without foundation, as it would be impossible 
for one of these creatures to live a day in the stomach or intestines. 

TAPE-WORM. 

SYMPTOMS.—Colic pains in lower part of the abdomen, especially after fasting, re¬ 
lieved by a full meal; ravenous hunger; distension of the bowels with gas; alternate 
constipation and diarrhea ; sensation of something moving in the bowels; itching about 
the anus; tickling of the nose; vomiting; headache; night sweats; palpitation; heart¬ 
burn; cramps; in children, convulsions; numbness; deafness; blindness; the passage 
of portions of the worm. 

Of the various symptoms mentioned above, the last is the only 
positive sign of the presence of tape-worm. All the others are never 


TAPE WORM 


947 


present in any one case; and very often no symptoms whatever occur 
except the passage of portions of the worm and of its eggs (see Figs. 
276 to 278). There are no means of distinguishing by general 
symptoms the different varieties of tape-worm which inhabit the 



Fig-. 276. 

Egg of T;vnia Saginata. 



Fig. 277. 

Egg of Ttenia Bothriocepbalus Latus. 



Fig. 278. 

Egg of Taenia Solium. 


human body; the variety can be determined only by examination of 
the portions of the worm which are expelled, or their eggs, with a 
microscope. This is not, however, a point of great practical impor¬ 
tance, as the same remedy is efficient for all varieties. In some cases, 
various other symptoms are developed, particularly those which are 
due to the development of hydatids in the liver, the brain, the 
muscles, and other organs. This may occur in consequence of self- 
infection with the embryos of the worm through the introduction of 
its eggs into the stomach by means of violent retching or vomiting. 

Cause. —The only, cause of this disease is the reception into the 
system of the embryo of the tape-worm. * These embryos are only to 
be found in the flesh of other animals. The principal sources of 
human infection are beef and pork. The embryos are found in the 

muscular tissue, or lean meat, in¬ 
closed in little cysts, as shown in 
Fig. 155 on page 395. In Figs. 279 
and 280 the embryo of the tape-worm, 
known as cysticercus, is shown of 
natural size and slightly magnified. 
Plate IX shows the head of an em¬ 
bryo such as is found in the flesh of the hog, greatly magnified. 
When flesh containing the embryos is eaten, the cyst is digested off by 
the gastric juice, and the embryo attaches itself to the mucous mem¬ 
brane of the small intestine, by means of its hooks and suckers. In 
a short time a small body is formed, which is quickly duplicated, and 
the process continues until from an insignificant beginning the for- 



Fig. 279. Fig. 280. 

Small Embryo. Large Embryo 


948 


DISEASES AND THEIR TREATMENT. 


midable length of fifteen, twenty, and even forty or fifty, or more, 
feet is formed. Thus the worm, when fully developed, is really a 
chain of living creatures, each link being a separate individual, pro¬ 
ducing eggs in vast numbers, which pass out of the body in the dis¬ 
charges, and, finding entrance into the stomach of some other animal, 
develop into embryos, to be again eaten by man, or some other animal, 
in whom the fully developed worm will be produced. 

Treatment. —No patient should ever be treated for tape worm 
without the positive signs of the presence of the worm are first de¬ 
tected. It generally happens that segments of the worm are broken 





nramn: 


Fig:. 281. 

Segments of Taenia Solium, of natural size. 


F ~ ~ 



_ - 

M 

<;- -i 


> /I t » A 




Fig-. 282. 

Sections of Taenia Saginata. 


off and expelled at intervals; but when this does not occur spontane¬ 
ously, portions may be obtained by giving the patient a mild laxative, 
as a small dose of castor-oil. The discharges from the bowels should 
be carefully examined for several days, if segments such as are shown 
in Figs. 281 and 282 are not'discovered sooner. Persons who are well 
skilled in the use of the microscope may examine the discharges for 
eggs of the worm, which are always present in great numbers when 
the worm is present. We must not omit to add here the caution that 
portions of undigested food, masses of mucus, etc., often resemble 
worms or portions of worms when cursorily examined. The inspec¬ 
tion should be sufficiently careful to avoid such an error as this. 
Many persons are unnecessarily frightened by appearances of this sort. 
Although many persons have suffered almost untold miseries under 
the hands of quacks without having a cure effected, it may be consid¬ 
ered as positively demonstrated that the worm can in every case be 
expelled, provided that proper treatment is applied. 

Preparatory Treatment .—This occupies two days. Give the pa¬ 
tient only such food as will not produce much residue, as white bread, 
meat, beef tea, and milk. Graham bread, oatmeal, cracked wheat, 
vegetables of all kinds, fruits,—especially seedy fruits, and eggs, 

















TAPE- WORMS. 


940 


should be wholly avoided. The patient should drink several glasses 
of cold water within an hour before each meal, and should apply fo¬ 
mentations and percussions to the abdomen for the purpose of causing 
the bowels to become as loose as possible. Large hot enemas should 
also be used twice a day. (See p. 603 for directions for giving large 
enema.) The second day, the patient may eat freely of onions for the 
purpose of sickening the worm. Some recommend salt herring for the 
same purpose, to be eaten with onions. 

Curative Treatment. —The third morning after beginning treat- 
ment let the patient take for breakfast a little milk or bran coffee and 
dry white bread toast. Some recommend that the patient shall fast; 
but it is better to allow a small quantity of food, as the tendency to 
vomit is less. The most effective medicine is koosso. This kills the 
worm ; and after it has acted, the dead worm must be expelled by means 
of a dose of castor-oil. The quantity of koosso necessary to kill the 
worm is five to seven drams for an adult. It should be given in small 
capsules, or may be taken in decoction, the whole being drunk. For 
children, the dose should be proportionately smaller. Two hours after 
the koosso has been taken, administer two tablespoonfuls of castor-oil. 
Male fern, pomegranate root, kaineela, and turpentine are also used for 
the cure of tape-worm, and with success. The seeds of the common 
pumpkin have also been successfully used for the same purpose. 
Bruise two ounces of pumpkin seeds in a mortar with a little water. 
Add enough water to make up to a half pint. 

Strain through a coarse cloth. This is for one dose. 

Repeat daily for several days in succession. This 
remedy has the advantage of being perfectly harm¬ 
less, if it does not destroy the worm. 

It should be remarked that many people im¬ 
agine themselves to be the possessors of tape-worms 
when they are wholly free from anything of the 
sort. It not infrequently happens, also, that the 
general symptoms of the disease continue for a time 
after the worm is expelled. In order to assure pa¬ 
tients with confidence that a cure has been effected, 
it is necessary to examine the discharges from the 
bowels with great care so as to find the head of the worm, which may 
be distinguished by its form, as seen in Fig. 283. On account of its 
small size it should be sought with great care. If the head is not ex¬ 
pelled, the worm will be likely to grow again. 



Fig. 283. 

Head of Tape-worm. 








950 


DISEASES AND THEIR TREATMENT. 



Fig:. 284. Round 
Worm, natural size. 


Prevention. —The only sure means of prevention is 
the entire avoidance of the use of meat. It has been 
supposed that the principal source of infection is the 
use of raw pork ; but the observations of Dr. Leidy of 
Philadelphia, and the eminent Prof. Cobbold of Eng¬ 
land, have shown very clearly that the most common 
source of infection is raw beef. Neither salting nor 
smoking will destroy the embryonic parasites. They 
will resist the action of both cold and heat in an ex¬ 
traordinary degree. They are only destroyed by a tem - 
perature exceeding 160° F., and require exposure for 
some little time. This necessitates that meat should 
be thoroughly cooked in order to secure immunity 
from infection with these loathsome parasites. 

KOI XD WOBMS.-ASCARIS LUMBRICOIDES. 

SYMPTOMS.—Itching of nose ; colic pains; boring pains in ab¬ 
domen ; fickle appetite ; distension of stomach; diarrhea, with pas¬ 
sage of mucus tinged with blood; dark eyelids; face swollen; foul 
breath ; unequal dilatation of pupils ; unpleasant dreams ; starting 
during sleep as if frightened; grinding of teeth ; pains in limbs; ir¬ 
regular pulse; general wasting; also many of the symptoms de¬ 
scribed as indicating tape-worm; only positive sign, expulsion of 
worms, 

Other symptoms not mentioned above are some¬ 
times produced by the migratory tendencies of the 
worm. It seems to have a special fondness for get¬ 
ting into narrow places. The worms have been found 
in the oesophagus, the nose, the Eustachian tube, the 
nasal duct, the air-passages, the pancreatic and gall 
ducts, and even in the bladder and uterus, as well as 
in the stomach and intestines, where they are chiefly 
found. They do not usually remain long in the stom¬ 
ach, the irritation produced by their presence inducing 
vomiting. The disposition round worms have for 
squeezing themselves through very small openings has 
been taken advantage of by an ingenious physician 
in the construction of a “ worm-trap.” This worm is 
represented of natural size in Fig. 284. 








s 

*. 


« 

THREAD-WORMS. • 951 

Cause.— The only cause for round-worms is the reception of their 
eggs into the system. It is supposed that they are introduced into the 
stomach by the use of celery, salads, raw vegetables, and perhaps 
fruits. They may also be introduced by drinking water which has 
been contaminated with the soakings from privies, etc. The eggs 
will retain their vitality for many years, and are not destroyed by 
freezing or drying. The embryo, also, when partially developed, shows 
almost equal tenacity of life. The worm inhabits the small intestine. 

It is cylindrical in form, of a dirty reddish yellow or light brownish 
color, and seven to ten inches in length, the females being a little 
longer than the males. This parasite is very common in some coun¬ 
tries, quite a large proportion of the inhabitants being affected. 

Treatment. —The best remedy is santonin. Give in doses of one- 
third of a grain to infants, and one-half grain to a grain and a naif to 
adults, to be given in capsules or in a syrup four times in one day. 
The last dose should be followed by a laxative dose of castor-oil. 

Another very useful remedy which we have often used with suc¬ 
cess is the following: FI. Ex. of senna and FI. Ex. of spigelia, equal 
parts. Dose : one to four teaspoonfuls three times a day, according to 
the age of the patient. Continue this treatment for two or three 
days. If no worms appear in the bowel discharges, there are probably 
none present. 

THREAD-WORM.-OXYIBIS VERMICULARIS. 

SYMPTOMS.—Severe itching and tickling just within the anus, especially at night; 
unnatural sexual excitement; in males, frequent erections, and even seminal emissions; 
presence of the worms in the bowel passages. 

Many other symptoms have been attributed to the presence of this 
worm, but the above are the most important. Contrary to the gener¬ 
ally received opinion, the worm does not inhabit 
chiefly the rectum, but the large intestine, and 
especially the caecum. Its natural size may be 
seen by reference to Fig. 285. In Fig. 286 is 

seen the worm greatly magnified and in the act Fig . 285 Thrcad Worm 
of shedding its skin. The symptoms in the rec- of natural size, 
turn are produced by the motions of the worms in this part, as they 
go down into the rectum to deposit their eggs. Sometimes they 
crawl out upon the skin about the anus, but in such cases soon die, 
as they cannot return. 



952 


• DISEASES AND THEIR TREATMENT. 


Cause.—The thread-worm is undoubtedly produced from eggs, 
which each worm produces in prodigious numbers. How they get 

into the stomach is not well known, 
but it is undoubtedly through neglect 
of proper cleanliness. 

Treatment.—All the text-books 
prescribe treatment for the rectum ; 
but this mode of treating the disease 
has been notoriously unsuccessful. 
The treatment, in order to be of any 
real value, must reach the large in¬ 
testine and especially the caecum. 
According to Heller, the best remedy 
is a copious enema of water, or of a 
solution of castile soap in proportion 
of a dram of soap to a quart of water. 
From two to four quarts of water 
should be injected into the bowels at once. For method of giving 
large enema, see page 663. A handful of quassia chips may be boiled 
in the water instead of using soap. The remedy usually requires 
repetition for a few times. We have found it successful when 
thoroughly applied. 



Fig. 286 . Thread-Worm shedding its 
skin. Greatly magnified. 



Fig. 287. 

W T hip Worm. 
Slightly magniii’d 


WHIP-WOBM.-TBICOCEPHALUIS DISPAR. 

SYMPTOMS.—Only reliable symptom, expulsion of worm or eggs. 

Not a very common parasite. The form of the worm 
is shown in Fig. 287. 

Treatment.—Same as for the preceding. 

STROAGYLFS DFODEMLIS. 

SYMPTOMS. — Anaemia; pallor; exhaustion; dyspepsia; disturb¬ 
ances of the circulation; fickle appetite; morbid appetite for mortar, 
wood, coal, etc.; pain and heaviness in the stomach; shortness of 
breath; quick pulse; giddiness; ringing in ears; black spots before 
the eyes; dropsy ; diarrhea and vomiting. 

This worm occurs only in warm countries, and in this 
country is confined to the Southern States. The worm 
lives on the blood sucked from the blood-vessels of the 
mucous membrane to which it attaches itself. It is this 


that leads to the great amemia and prostration met in this disease. 








DISEASES OF THE LIVER. 


953 


Cause.—The cause is the same as that of other parasitic diseases 
of the intestinal canal; viz., the reception into the stomach, in food or 
drink, of the eggs or embryos of the parasite. 

Treatment. —In bad cases recovery is very doubtful. The reme¬ 
dies best to employ are those already recommended for other worms. 
Oil of turpentine is stated to be very efficacious. It should be given 
in milk in two tablespoonful doses, quite a quantity of milk being 
taken afterward. As it is probable that the eggs of this worm are in¬ 
troduced into the body in drinking water, it is important that the 
greatest care should be taken to secure pure water. In case there is 
any possibility of danger from this source, water should be carefully 
filtered or boiled. It is stated upon good authority that intestinal 
parasites are very rare in Paris, which is attributed to the fact that 
in that city nearly all the water drank is filtered. 

FTlIiFS. 

The fluke is a parasitic worm which inhabits the duodenum and 
biliary passages in man. It is very common in sheep, occasioning 
what is known as “ liver-rot,” a disease from which many thousands 
of sheep often die in a single epidemic. In Egypt a variety of the 
parasite is found which gives rise to a very formidable disease. In 
this country, fortunately, the parasite is so seldom met with in man 
that it is of no medical importance. 

DISEASES OF THE LIVER, 

In ancient times derangements of the liver were supposed to be a 
fundamental condition in nearly all diseases. In the humoral theory 
of disease, great stress was laid upon the condition of the bile, yellow 
bile being supposed to produce inflammation, while black bile induced 
opposite conditions together with hypochondria and insanity. In 
modern times, the tendency has been to the opposite extreme. When 
it became thoroughly established that the liver was not the seat of 
the mind, as was once supposed, and especially when Harvey made 
the discovery that the heart instead of the liver was the center of the 
circulation, medical men began to look upon the liver as of far less im¬ 
portance than it had for ages been supposed to be. Even among the 
common people the liver has come to be regarded as merely an organ 
for making bile, and it is rare that any diseased condition, besides 


954 


DISEASES AND THEIR TREATMENT. 


structural derangements, is attributed to it except such as depend 
upon some disturbance of secretion. The most recent investigations 
have shown that the ancient theory was more nearly correct than the 
modern one, and that while the liver is neither the seat of the mind 
nor the center of circulation of the blood, it performs at least two 
other important functions besides that of secreting the bile; namely, 
elaboration of certain elements of the food, by which process they are 
fitted to form blood; and the destruction, for the purpose of removal 
from the system, of worn-out particles which become sources of dis¬ 
ease, if retained. The last-named function is independent of the secre¬ 
tion proper, which is both a secretory and an excretory product, being 
useful in the process of digestion, and at the same time containing 
poisonous elements which must be eliminated from the system. Thus 
it will be seen that the function of the liver is an extremely compli¬ 
cated one, and hence it is in the highest degree reasonable to suppose 
that its functions should be easily deranged and that such derange¬ 
ment should produce a great variety of symptoms. Diseases of the 
liver, like those of most of the other organs of the body, are chiefly 
of two classes: functional and structural; that is, those which are 
chiefly dependent on disturbed action, and those in which the morbid 
condition of the tissues of the organ is the most prominent condition. 

Functional Diseases of the Liver.— In the light of modern in¬ 
vestigations in pathology, and physiology, there is little reason to 
doubt but that disordered action of the liver is a morbid condition to 
which may be attributed a great variety of symptoms which have 
often been attributed to other organs. The ordinary classification of 
functional disorders of the liver is as follows: first, diminished secre¬ 
tion ; second, increased Secretion; third, secretion of morbid bile. As 
this classification is not in accordance with the most modern views of 
physiology it must be discarded. In treating this subject we shall 
follow very closely the classification of Murchison, one of the most re¬ 
cent, and by far the most able writer on diseases of the liver. 

TORPID LIVER. 

SYMPTOMS.—Bowels irregular, generally costive; discharges yellow, whitish, or 
drab ; disagreeable taste in the mouth, usually in the morning ; furred tongue, yellowish 
or white; loss of appetite; sallow or dingy skin; patches on the skin known as “liver 
spots; ” white of the eye yellow or dingy; flatulence; headache in the front part of the 
head; dullness and heaviness most of the time; lassitude and drowsiness after meals; 
great depression of spirits; sediment in the urine when cold; vertigo; noises in the 
ears; disturbed sleep. 


TORPID LIVER. 


055 


Causes. —Errors in diet may justly be said to be the most frequent of 
all the numerous causes of torpidity of the liver. Fashionable dinners, 
late suppers, overeating, especially the excessive use of fats, sugar, 
pastry, condiments, alcoholic drinks, and tea and coffee, may be charged 
with being the most common causes of inactivity of this organ. The 
free use of mustard, ginger, pepper, curry powder, and other irritating 
condiments in many tropical countries, leads to the almost universal 
prevalence of this disease. In addition, sedentary habits, the use of 
tobacco and other narcotics, restriction of the liver by wearing tight 
clothing, and malaria should also be mentioned as important causes of 
this very common affection. We should also remark that the pro¬ 
longed use of laxative medicines, “ after-dinner pills,” and the various 
drugs that are recommended for constipation, are most prolific 
sources of torpid liver. The same may be said of mercury, although 
this drug is less frequently used than formerly, and is seldom employed 
to such an extent as twenty years ago. The liver possesses the curi¬ 
ous property of being able to retain in its structure metallic poisons 
which may be brought to it in the circulation, so that the effect of in¬ 
juries received from a mercurial course is apt to be more or less 
permanent. 

Treatment. —In severe chronic cases of this affection the patient 
must studiously avoid the use of fats, sugar, condiments, and alcoholic 
drinks. Regulation of the diet is a positive necessity in the radical 
treatment of this disease. Tobacco, if used, must also be discontinued. 
If the patient’s habits are sedentary, he must begin a course of regular, 
systematic exercise, and should in every way possible, build up his gen¬ 
eral health. Food should be taken in moderate quantities, and should 
consist chiefly of grains and acid fruits. Some patients are obliged 
to avoid the use of milk ; with others it does not seem to disagree. In 
addition to these general measures, the patient, if not emaciated, may 
take with advantage for two or three weeks two or three vapor baths 
or packs a week. The wet girdle or umscldag should be worn night and 
day. The use of the hot and cold douche over the liver is very efficient. 
Central galvanization may also be applied with advantage. The use of 
mercury with various laxatives, purgatives, and the hosts of liver med¬ 
icines which are recommended for this very common affection, will do 
more harm than good. The best that any of these drugs could do would 
be to whip up the flagging energies of the already overworked organ 
without in any way lightening its burdens or giving it increased 


956 


DISEASES AND THEIR TREATMENT. 


strength to perform the labor required of it. The repeated use of reme¬ 
dies of this kind greatly aggravates the trouble, increasing the inactivity 
of the organ. Careful experiments scientifically conducted have also 
shown that mercury and various other remedies which have been most 
relied on to stimulate the organ to activity, either decrease the amount 
of bile secreted or have no effect upon it whatever. The apparent evi¬ 
dences of benefit derived from their use are entirely due to the fact that 
they poison the bile which is poured out into the intestines, thus render¬ 
ing it unfit for absorption, so that an unusual amount is discharged from 
the bowels, although the amount secreted is not increased, but, as has 
been shown to be the case with mercury, is actually decreased. The 
liver pads which have attained such an enormous sale within the last few 
years are utterly devoid of merit on the ground claimed, namely ; that 
they extract the disease from the system by absorption. It is possible 
that they do some little good by retaining the heat and moisture of the 
skin, and thus acting as a poultice; but for this purpose they are far infe¬ 
rior to the wet bandage. 

CO^GESTIO^f OF THE I.IVF.K. 

SYMPTOMS.—Gas in the stomach and bowels; weight and fullness in the stomach 
and in the region of the liver; heart-burn and eructation of acid matter ; furred tongue ; 
clammy, bitter taste in the mouth in the morning; nasal and pharyngeal catarrh ; bowels 
irregular ; color of stools changeable; palpitation of the heart; beating at the stomach ; 
irregular pulse; disturbed sleep ; bad dreams; disturbance of vision; vertigo; pain in 
front part of head; hemorrhoids; dry cough; urine highly colored with brick-dust 
sediment. 

All of the above symptoms are not always found in any one patient, 
but the majority of them will be observed in all patients suffering from 
acute or chronic congestion of the liver. This affection is much more 
common than is generally supposed, and it lays the foundation for a 
great variety of secondary difficulties. On account of the congested 
state of the liver, it fails to perform its work of breaking down the waste 
tissues and effecting their elimination by the kidneys; consequently, the 
whole system is contaminated by the products of imperfect elaboration, 
the chief of which are uric and oxalic acids. Gout is w r ell known to be 
due to the accumulation of uric acid in the system, and doubtless de¬ 
pends more on the inactive state of the liver due to congestion than to 
any other cause. Stone in the bladder, gall-stones, degeneration of the 
kidneys, general degeneration of the tissues of the body, local inflamma¬ 
tions of various kinds, and numerous constitutional diseases, are un- 


CONGESTION OF THE LIVER. 957 

doubtedly due to disordered action of the liver, probably chronic 
congestion. 

There are good reasons for believing that many constitutional dis¬ 
eases which are not otherwise easily accounted for, are really due to disor¬ 
dered liver. Among other disorders which may fairly be attributable to 
functional derangements of this organ, may be mentioned dyspepsia, hem¬ 
orrhoids, jaundice, nervous debility, pains in the limbs, burning or scorch¬ 
ing patches in the palms or soles, neuralgia, headache, cramp, vertigo, 
disturbances of vision, paralysis, mania, epilepsy, sleeplessness, depression 
of spirits, and nervous irritability. Various derangements of other or¬ 
gans due to functional disturbance of the liver, may be chiefly attributed 
to congestion, such as palpitation of the heart, neuralgia of the heart, 
feeble circulation, chronic catarrh of the throat, asthma, chronic bron¬ 
chitis, chronic inflammation of the bladder, together with various dis¬ 
eases of the skin, as psoriasis, eczema, urticaria, pruritis or intolerable 
itching, boils, and brown spots in the face and hands known as liver spots. 

Causes. —The causes of congestion of the liver, like those of most 
other functional diseases of the organ, include chronic catarrh of the stom¬ 
ach and intestines, and organic disease of the heart and lungs, by which 
mechanical congestion is produced. Among othei causes, errors in diet 
must be mentioned as the most important. Overeating is one of the 
most frequent causes of this affection. A careful examination will show 
that the liver becomes enlarged after a hearty meal, owing to the increased 
quantity of blood sent into it during digestion. The use of fats, sugars, 
and alcoholic drinks may rightly be regarded as among the most serious 
dietetic errors productive of this disease, as it may easily be shown that 
the size of the liver is verv greatly increased after a meal in which these 
injurious substances have been used. It has been shown also that the 
deficient supply of pure air, high temperature, prolonged mental anxiety, 
malaria, and various other conditions are productive of congestion of the 
liver. 

Treatment. —Dr. Murchison wisely remarks with reference to the 
treatment of this disease, that “ much more permanent benefit is to be 
derived from careful regulation of the ingesta [food] than from physic.” 
Dr. Bence Jones, an eminent English physician, who is good authority on 
the subject, insists that “ a minimum of albuminous [meat and eggs] food 
should be taken in order to produce less uric acid.” Sugar, butter, 
tea and coffee, condiments of all kinds and alcoholic drinks, should be 
scrupulously avoided. The food should be as simple as possible, and the 


058 


DISEASES AND THEIR TREATMENT. 


patient should be exceedingly careful to avoid overeating. The use of 
acid fruits is to be recommended. Much benefit may be derived from the 
use of water. It should be drank in considerable quantities for the pur¬ 
pose of thoroughly cleansing the tissues from the products of the breaking 
down of the system. The skin should be kept clean by daily baths. 
The vapor and Turkish baths, packs, rubbing wet sheet, and abdominal 
girdle, are excellent measures of treatment. In addition, the same meas¬ 
ures should be employed as recommended for torpidity of the liver, a con¬ 
dition in many respects closely resembling congestion. Iron, quinine, 
and the various other tonics which are frequently prescribed for persons 
suffering with congestion of the liver, always aggravate the difficulty. 
Illustrations of this fact are found in the work of Dr. Murchison already 
referred to ; and we have often confirmed it by experience. 

HEPATITIS.—INFLAMMATION OF TIIE IIVER. 

SYMPTOMS. — Tenderness on the right side near the lower border of the ribs; high 
fever similar to that of typhoid fever; enlargement of the liver, producing sensation of 
fullness on right side; pain, increased by pressing up under the ribs, also by cough or a 
deep breath; patient cannot lie on the left side; short breath; cough; vomiting; hic¬ 
cough ; white of the eye yellow ; pain pear the right collar-bone and about the shoulder ; 
occasionally, formation of abscesses which occasion great increase of pain and tender¬ 
ness, with diarrhea and dysentery. 

Causes. —The causes of inflammation of the liver are similar to those 
which produce congestion. 

Treatment. —One of the very best means which can be employed 
after regulating the patient’s diet, giving him only the most simple food, 
is the application of hot fomentations over the liver. The fomentations 
should be applied several times a day for ten to twenty minutes each 
time. They will relieve pain, and have a tendency to subdue inflamma¬ 
tion and restore the organ to a healthy condition. In the intervals be¬ 
tween the applications, a large compress should be kept upon the bowels 
over the region of the liver. The diet should be restricted to a very 
small quantity of the simplest food. The patient may be allowed to 
drink lemonade or barley-water. If an abscess continues to develop un¬ 
til suppuration occurs, serious consequences may result from its discharge 
into the abdominal cavity. Abscess of the liver may be relieved by 
aspiration. 

Chronic Inflammation of the Liver.— The disease known by this 
name is really chronic congestion. The causes, symptoms, and treatment 
are similar to those of congestion and torpidity of the liver. 


GALL-STONES. 


959 


IIFLUIMATIOK OF TIIE BIEE-DIJCTS. 

SYMPTOMS.—Tenderness at the pit of the stomach and at the lower border of the 
ribs on the right side; tightness in the same region ; nausea; slight fever ; constipation 
of the bowels; jaundice; together with the various symptoms of congestion of the liver. 

This disease is generally caused by errors in diet, and is almost al¬ 
ways preceded by symptoms of indigestion, particularly by acute ca¬ 
tarrh of the stomach, commonly known as a bilious attack. The treat¬ 
ment of this affection is precisely the same as that indicated in con¬ 
gestion and inflammation of the liver. 

GALL-STONES. 

SYMPTOMS.—Dull pain about the liver, sometimes extending to the shoulder; chills 
and fever; nausea; in severe cases, attacks of vomiting accompanied by severe pains at 
the pit of the stomach usually coming on after some slight exertion or jarring of the body ; 
jaundice; concretions found in the bowel discharges. 

Gall-stones are concretions or hard masses, which are found after 
death in the gall-bladder, or pass off* during life, and may be found in 
the discharges from the bowels. They usually consist of cholesterine, 
an abundant constituent of the bile, but contain more or less of other 
matters also. Cholesterine is a resinous substance, and when this ele¬ 
ment predominates, the concretions resemble resin and will burn when 
held in a flame. 

Causes. —The origin of gall-stones is not well understood. It is 

o o 

probable that they are caused by portions of mucus which become 
lodged in the biliary passages, and become centers for the accumulation 
of cholesterine, the coloring-matter of the bile, and various calcareous 
matters. The causes of gall-stones are chiefly catarrh of the bile- 
ducts, errors in diet, particularly the excessive use of animal food, the 
habitual use of alcoholic drinks, and sedentary habits of life. It has 
been noticed that this disease occurs very frequently in persons kept 
in close confinement in jails. It has also been observed that cows 
frequently suffer from gall-stones when kept in stables during the win¬ 
ter. There are also reasons for believing that the use of hard water 
is a common cause of the affection. The disease is most apt to occur 
in advanced life, and is more common among females than males. 

The diagnosis of gall-stones is not positive unless they are found 
in the discharges from the bowels. The only method for finding them 
is to carefully wash the discharges through a sieve with water. This 


9G0 


DISEASES AND THEIR TREATMENT. 


should be done for three or four days after the paroxysm occurs if no 
concretion is sooner found. We have a number of specimens of gall¬ 
stones. some of which are remarkably large. In one case, the gall¬ 
bladder was greatly distended and completely filled with a single bilary 
concretion. 

Treatment. —To relieve the most urgent symptoms, give the 
patient a hot sitz. vapor, or full bath, also apply hot fomentations over 
the region of the stomach and liver. To relieve vomiting;, small bits 
of ice may be swallowed. Copious drinks of hot water containing a 
little bicarbonate of soda will also give relief. If the suffering is very 
great, and not readily relieved by other means, an anodyne should be 
employed. To prevent an occurrence of the attack, all the causes of 
the disease should be avoided. The patient should take only the most 
simple foods. Fats should be avoided. For drink, only distilled or 
soft water should be used, which should be taken in abundance, six or 
eight glasses being drank each day. The usual measures of treatment 
recommended for torpid liver should also be employed. The popular 
notion that certain medicines possess the property of dissolving gall¬ 
stones is an error which has not the slightest foundation in fact, not 
being sustained by experience. Medicines taken into the stomach for 
this purpose would never reach the bile-duct in sufficient quantity to 
accomplish this, although they might be able to dissolve the concre¬ 
tions when applied to them outside the body. The only remedy of 
any value whatever is to render the bile unusually fluid by drinking 
large quantities of water, as has already been recommended. There is 
evidence to show that by this means gall-stones may be dissolved and 
the tendency to their formation checked. 

JAUIVDICE. 

SYMPTOMS.—Yellowness of the eyes and skin ; dark or saffron color of urine; day 
colored bowel discharges; itching of the skin; drowsiness; giddiness; lassitude; mental 
depression; irritable temper; bad taste in the mouth; slow pulse; general symptoms of 
dyspepsia. 

Causes. —The principal causes are the following: Obstruction 
of the bile-duct by gall-stones or tumors, or by swelling of the mucous 
membrane in consequence of catarrh of the duodenum or bile-duct, 
the effects upon the system of certain poisons, as malaria, and the 
poisons which occasion yellow fever, typhoid and typhus fevers, scar¬ 
latina, etc., together with animal poisons, snake bites, and such min- 


ENLARGEMENT OF THE LIVER. 


961 


eral poisons as mercury, silver, copper, and antimony. It also occurs 
as the result of fright, anxiety, or any other severe mental emotion; 
from an insufficient supply of fresh air, as is illustrated in persons 
of sedentary habits who confine themselves in close rooms, especially 
in the winter season; from constipation, which occasions the absorption 
of large quantities of bile from the contents of the bowels being too 
long retained. 

Treatment. —Treatment consists in removing, so far as possible, 
the causes of the disease which have been enumerated. In addition 
to this, the patient must adopt the measures of treatment recom¬ 
mended for torpid and congested liver, which we need not here repeat. 
In case jaundice is due to partial obstruction from gall-stones, the 
latter affection must be treated in the manner already described. 

ENLARGEMENT OF TIIF FIVF.it. 

Enlargement of the liver occurs, most frequently, as the result of 
morbid changes. There is more or less enlargement in all cases of 
congestion and inflammation. Enlargements of this class, however, 
are of a temporary character, lasting but for a short time. The more 
serious cases of enlargement are more or less permanent. Enlargement 
of the liver is sometimes accompanied by pain, as when it is the result 
of congestion, inflammation, abscess, cancer, or catarrh of the bile-ducts. 
In some cases there is no pain, as in fatty and waxy liver, hydatids and 
hypertrophy of the organ. The symp¬ 
toms which accompany the disease dif¬ 
fer according to the cause of the enlarge¬ 
ment and the particular form of the 
disease present. The abnormal size of 
the organ may be easily discovered by 
palpitation of the abdomen, as the pa¬ 
tient lies on his back with his knees 
drawn up so as to relieve the abdominal 
walls. In health, the lower border of 
the liver reaches only to the lower edge 
of the ribs on the right side, but in dis¬ 
ease it may be extended so as to fill up 
a considerable proportion of the ab¬ 
domen. Fig. 288 represents the normal 

61 



Shows the Natural Size ami Position 
of Liver. 




DISEASES AND THEIR TREATMENT. 


962 


size and position of the liver. Fig. 289 shows the size of the liver 
in a case which we have under treatment at the time of this writing. 

It will be observed that the organ 
is increased to several times its natu¬ 
ral size. 

TV axy Liver. —In this form of en¬ 
largement of the liver, the tissue of 
the organ becomes tilled with a peculiar 
substance, which gives to it a waxy 
appearance. The organ loses its natu¬ 
ral chocolate hue and becomes verv 

*/ 

light colored. The disease most often 
occurs in persons who have long suf¬ 
fered from the daily loss of large 
quantities of pus, as from a chronic 
abscess. It is generally accompanied 
by a similar disease of the kidneys, 
which is indicated by the presence of albumen in the urine. It also 
occurs in consumption. For treatment, see “ Waxy Degeneration of 
the Kidneys.” 

Fatty De generation. —In this affection, the tissues of the liver 
become infiltrated with fat. The disease gives very few symptoms. 
Its existence may be surmised, however, from the existence of fatty 
degeneration in other organs. It is generally accompanied by fatty 
degeneration of the heart, indicated by a weak pulse and febrile diffi¬ 
culties. The. disease is produced by overeating, and by all other causes 
which conduce to the formation of fat and interfere with the general 
health. The habitual use of alcoholic drinks will produce fatty 
degeneration of the liver and other org-ans, on account of the increased 
amount of fat in the blood. It is often found in such wasting diseases 
as consumption, chronic dyspepsia, cancer, etc. In thirteen persons 
who died of delirium tremens, Frerichs found seven who were af¬ 
fected with this disease. The influence of sedentary habits in pro¬ 
ducing fatty degeneration is shown by the fact that it is almost 
universal in the domestic cat. The fact is also well known to pathol- 
ogists that the liver of a cat is generally selected for the purpose of 
demonstrating the microscopical changes which take place in this dis¬ 
ease, when a specimen of human liver subject to this disease can not 
be readily obtained. 







V 


TUMOR OF T11E LIVER. 963 

Treatment. —The patient should avoid butter, fats, sugar, alco¬ 
holic drinks, tea and cotiee, and in fact all articles of food conducive 
to the production of fat. An abundance of out-of-door exercise should 
be taken. Great attention should be given to the general health. 

o o 

HYDATID TUI OK OF THE LIVER. 

This is a disease in which cysts are formed in the liver, being de- 
veloped from the echinococcus. The origin of these cysts is very curi¬ 
ous. Eggs from the tape-worm from the common dog find entrance 
to the stomach through the food or drink, being developed into minute 
embryos which find their way into the liver, there forming the cysts 
which are characteristic of this disease. The dropsical enlargement 
becomes so great as to cause inconvenience to the patient. Death 
sometimes occurs from rupture of the cyst and discharge of its contents 
into the abdominal cavity, chest, veins, or some other internal part. 
In Iceland the disease is so very common that it is said to be the cause 
of at least one-seventh of the whole number of deaths. 

Treatment.— The only measure of treatment of any value is re¬ 
moval of the fluid by means of the aspirator. It has been found that 
if one-half or two-thirds of the fluid be removed, the disease will dis¬ 
appear in a majority of cases. Electricity has also been used with 
success in the treatment of cases of this kind. 

CONTRACTION OF THE LITER. 

Diminution in the size of the liver is by no means so common an affec¬ 
tion as enlargement of this organ. The most com¬ 
mon cause is the use of alcoholic drinks, which 
occasion what is known as atrophy, or cirrhosis, of 
the liver. This form of liver is seen in Fig. 200. 

It is sometimes called “ hob-nail ” liver on account of 
the great abundance of small nodules seen upon the 
surface. The first symptoms of the disease are 
those of alcoholic poisoning, which are nausea, 
retching in the morning, accompanied by a sink¬ 
ing feeling, loss of appetite for solid food, bitter 
taste in the mouth, pain after eating, irregularity 
of the bowels, piles, turbid urine, and mental de- Fig ._ 2 90. Gin Liver, 
pression. After a time, the patient becomes sallow 

and emaciated, and reddish spots appear upon the face in consequence of 



964 


DISEASES AND THEIR TREATMENT. 


the enlargement of the veins; also in most cases there is a dull pain low 
down upon the right side, and pain in the right shoulder. Sometimes the 
roughness of the surface of the liver may be felt through the abdominal 
walls. If the disease has existed some time, abdominal dropsy occurs 
from obstruction to the portal circulation ; also enlargement of the exter¬ 
nal veins of the abdomen, due to the same cause. Piles is an almost 
constant accompaniment of the disease, being produced in the same way. 
Disease of the kidneys is also quite likely to be present. 

Treatment. —Total abstinence from all stimulants. The diet must 
be of the plainest and simplest character, all fats, sweets, spices, pastry, 
and all other foods difficult of digestion being carefully avoided. Abdom¬ 
inal dropsy should be treated as described elsewhere. The most that 
can be done in the majority of cases is to palliate the symptoms and 
improve the patient’s general health in every possible manner. 

DISPLACEMENT AND DISTORTION OF TRK LIVER. 

The morbid conditions of the liver considered under this head are 
wholly attributable to the abuse of the organ by tight lacing. Figs. 

291, 292, 293, and 294, are rep¬ 
resentations of livers found in 
patients in post-mortem exam¬ 
inations, which illustrate the ter¬ 
rible effects of following the 
custom of constricting the waist. 
The custom is not wholly con¬ 
fined to the female sex as might 
be supposed. Jn Fig. 291 the 
organ is so distorted as to be 
scarcely recognizable. The low- 
Liver Distorted by Tight Lacing. er portion has been crowded 

down into a conical form, and the whole organ has evidently been so 
compressed as to render the proper performance of its functions impossi¬ 
ble. In Fig. 292 the compression has been applied somewhat differently, 
and consequently a different effect has been produced, the organ having- 
been nearly cut in two by the continuous pressure brought to bear upon 
it. Fig. 293 represents a liver which has been divided into three parts 
or lobes, in the lower of which can be seen several enlarged veins, 
branches of the portal vein, which have become enormously distended 
by the long-continued pressure. Fig. 294 illustrates a case in which 





DISPLACEMENT AND DISTORTION OF THE LIVER. 


9Go 


the pressure applied about the waist was so great that the liver was 
compressed entirely out of its normal position, being crowded down 



wholly below the ribs, until its rounded surface, which should be pre¬ 
sented upward, is presented outward against the abdominal wall, giv¬ 
ing the deceptive appearance of enormous enlargement. 



When pursuing a special course of study in this class of diseases in 
Bellevue Hospital several years ago, we encountered the case of a 

















































966 


DISEASES AND THEIR TREATMENT. 


woman in whom the condition 
of the liver was as represented 
in Fior. 295. The constriction 

o 

of the waist had been so great 
that the liver was almost lit¬ 
erally divided in two. The 
case was in fact a typical one 
of “ tight-lace fissure of the 
liver.” 

It is stated on good author¬ 
ity that displacements and dis¬ 
tortions of the liver in conse¬ 
quence of tight lacing are ex¬ 
ceedingly common. Indeed, it 
is impossible to believe that 
any liver could be subjected 
to the abnormal conditions- 
necessitated by the modern 
fashionable dress without be¬ 
ing compressed out of its natu¬ 
ral shape and position. The 
only remedy, of course, for dis¬ 
placements and distortions is to discontinue the cause and to employ 
such means as will, so far as possible, restore the distorted parts to their 
normal condition. In the majority of 
cases this can be accomplished only to a 
slight degree, as the distortion becomes 
permanent after it has existed for a num¬ 
ber of years. 

As before remarked, women are not the 
only transgressors in this direction. The 
habit of sustaining the pantaloons by 
buttoning them tightly about the waist, 
or holding them by means of a tightly 
buckled belt, is a very bad one, and may 
produce as much distortion of the liver 
as tight-lacing in ladies. Some years ago, 
the injury resulting from the general 295. 

prevalence of the habit in the Russian army became .so apparent that 
a royal edict was issued prohibiting it. 




















ENLARGEMENT OF THE SPLEEN. 


967 


ESLARfiEilIEJT OF THE SPLEEN.-AGUE CAKE. 

SYMPTOMS.—Sallow countenance; paleness of the lips and gums; dyspepsia; 
emaciation ; liability to hemorrhage; sense of weight and uneasiness on the left side . 
When great, the liver may be felt below the border of the ribs on the left side. 

In cases in which enlargement of the spleen is slight, none of the above 
mentioned symptoms may be present. 

Cause, —Enlargement of the spleen is a frequent result of malarial 
poisoning. It generally occurs, to some extent at least, in all cases «>f 
malarial disease, and also in typhus and typhoid fevers, and various 
other acute diseases, especially those of an infectious character. Why 
this enlargement occurs is not understood, but the most recent view 
on the subject, as elucidated by Prof. Mosler in Ziemson’s Encyclopedia, 
is that the spleen acts somewhat as a strainer for the blood, and gathers 
to itself the disease germs and other morbid elements which are cir¬ 
culating in the vital fluid. Numerous experiments which have been made 
upon animals seem to confirm this view. It is thought by the dis¬ 
tinguished author mentioned, that mercury and various other drugs are 
productive sources of disease of the spleen. It has also been observed 
as the result of disease of the heart, lungs, and liver. 

Treatment.— Recent experiments made by Mosler, Fleury, and va¬ 
rious eminent German authorities, have shown very clearly that the cold 
douche is one of the most effective of all remedies in the treatment of en¬ 
largement of the spleen. In cases in which the enlargement is very 
marked, it is frequently possible to demonstrate an actual decrease in 
size of the organ immediately after the application of a cold douche. 
We usually employ in such cases the alternate hot and cold douche, using- 
temperatures as extreme as the patient can bear without great discomfort, 
and have obtained very excellent results. Various other means of apply¬ 
ing heat and cold alternately are also useful. Another remedy of value 
is the abdominal bandage or wet girdle. It should be worn constantly 
for several weeks. If irritation of the skin is produced, the bandage 
may be left off during the day. Vapor and Turkish baths, wet-sheet 
packs, and other powerful derivative measures, are also useful in the treat¬ 
ment of this affection. There is also some evidence that electricity is a. 
valuable remedy in these cases. 


5)68 


DISEASES AND THEIR TREATMENT. 


SYMPTOMS RELATING TO THE DIGESTIVE ORGANS. 

Under this head we shall notice briefly, for the convenience of the 
reader, the most important symptoms which require attention in the 
treatment of diseases of the digestive organs, and which have not previ¬ 
ously been noticed at all, or at least but briefly, giving also ready and 
simple methods of treatment for the same. 

Flatulence. —Gas in the stomach and bowels comes from the fer¬ 
mentation of imperfectly digested food. Restrict quantity of food. 
Avoid starch, sugar, butter, all sweets and fats. Also avoid tea, coffee, 
chocolate, and all other drinks at meals. Use soft boiled eggs, rare beef, 
and dry food. Relieve the bowels regularly. Wear wet bandages at 
night. Knead and percuss the bowels a great deal. Take a teaspoon¬ 
ful of powdered charcoal in a little water after each meal, or eat one or 
two charcoal crackers. 

Acidity .—Avoid sweet and starchy foods, soups, coarse vegetables, 
raw fruits, and drink at meals. Eat slowly a small quantity. Avoid 
mixing fruits and vegetables. In many cases milk must be discarded. 
Find some one or two articles of food which do not produce acidity, and 
use them exclusively until the stomach gets into a more normal condi¬ 
tion. Persons troubled with acidity should be especially careful to avoid 
drinking at meals or soon after. Water may be taken half an hour be¬ 
fore the meal with advantage, especially hot water. As a means of tem¬ 
porary relief, a lialf-teaspoonful of soda may be taken in a little water; 
but this remedy should not be often resorted to, as it will do more harm 
than good in the end. The same is ti-ue of magnesia, a very popular 
remedy for acidity. Charcoal may be used with advantage as recom¬ 
mended for flatulence. 

Heart-Burn. —This condition differs so little from the preceding 
that it is relieved by the same remedies. A very few sips of hot 
water will sometimes give prompt relief, and if taken a half-hour after 
the close of the meal, will usually prevent the occurrence of this 
troublesome condition. The patient must abstain from all sorts of 
fats and greasy foods most scrupulously, as well as from sweets. In 
many cases, it is well also to make use of but little flesh food, for a 
time, at least. 

Nausea. —When present soon after eating, give the patient fre¬ 
quent small sips of hot drink, either water alone, or water to which a 


DIGESTIVE ORGANS. 


9G9 


few drops of camphor, peppermint, winter-green, or some other aro¬ 
matic has been added. Also apply hot fomentations over the stomach 
constantly for an hour or twn. The hot-water bag may be used with 
advantage instead of moist heat. In some cases a few sips of strong 
lemonade, taken very hot, gives immediate relief. In obstinate cases, 
the patient may take three or four drops of dilute muriatic acid in a 
tablespoonful of water, drawing the acid liquid through a glass tube 
or a straw, to avoid injury to the teeth. If the stomach is empty, 
small sips of iced water or bits of ice may be swallowed at frequent 
intervals. Ice to the spine, opposite the stomach, and the local appli¬ 
cation of electricity—either faradization or galvanization,—are meas¬ 
ures to which we have often resorted with success when other means 
have failed. When the nausea evidently arises from the presence in 
the stomach of substances which ought to be expelled, as indigestible 
articles which have been eaten, or the irritating products of indiges¬ 
tion, vomiting should be induced by drinking copiously of warm 
water and tick lino: the throat with the finger or a feather. If neces- 
sary, a little salt may be added to the warm water. 

Yomiting. —Employ the same remedies recommended for nausea, 
applying them with greater energy and persistence. Sometimes ice 
to the stomach will give relief when other measures fail. If relief is 
not otherwise obtained, apply a mustard plaster over the stomach. 

Regurgitation of Food. —Many dyspeptics habitually spit up 
the food eaten very soon after each meal. Often the food is raised to 
the mouth by an involuntary effort which cannot be controlled by the 
will, the food spit out being in the same condition as when swallowed. 
In some of these cases the regurgitation is the result of habit; in 
others, it is due to a morbid irritability of the stomach. In both classes 
of cases it is important that the patient should remain very quiet for 
an hour or two after eating. The food should be dry in character, and 
restricted in quantity at first, the patient being gradually accustomed 
to larger quantities until able to take as much as necessary. When 
the food thrown up is very acid, the remedies recommended for acidity 
should be employed. 

Swallowing Air. —The curious habit of swallowing air, known as 
wind-sucking, or cribbing, in horses, is sometimes acquired by human 
beings. After a few acts of swallowing accomplished by much effort, 
the patient will sometimes belch very large quantities of air. We have 


970 


DISEASES AND THEIR TREATMENT. 


met with hut a few cases of this rare disease. The only cure is to 
watch the patient carefully for a few hours after each meal, compell¬ 
ing him to desist should he he observed in the act of repeating the 
practice. 

Heaviness at the stomach. —Persons suffering with various 
forms of stomach derangements often complain of a feeling of weight 
or heaviness at the stomach after eating, even though the quantity of 
food taken he very small. This is particularly common in cases of 
chronic catarrh of the stomach. Relief will usually be obtained by 
sipping hot water in very small quantities and applying hot fomenta¬ 
tions over the stomach for half an hour after a meal. We have cured 
several patients by having them wear a hot bag over the stomach for 
an hour or two after each meal. The alternate hot and cold douche 
daily applied to the spine, opposite the stomach, is an excellent meas¬ 
ure of treatment. The wearing of the warm moist abdominal bandage 
at night is also a good remedy, and may be used with advantage in 
many cases. 

Faintness. —An unpleasant sensation called “ faintness,” or an 
“all-gone feeling” occurring before or sometimes after meals is a fre¬ 
quent source of very great annoyance to many sufferers from stomach 
disorders. One of the best means of relief is taking a few sips of 
ice-cold water or of hot lemonade. The common practice of eating 
to relieve the unpleasant sensation, while it affords temporary relief, 
aggravates the evil in the end. Discontinue the use of condiments; 
restrict the use of animal food; when very faint, drink a little cold 
water or a glass of hot lemonade. 

Pain in the Stomach. —Apply hot fomentations over the seat of 
pain. In case this does not give relief, apply ice over the stomach and 
fomentations to the spine, giving the patient small bits of ice to 
swallow. A large drink of hot water will frequently stop the pain at 
once. Cramp in the stomach can usually be relieved in the same way. 

Pain in the Bowels, —Apply hot fomentations and administer a 
hot enema. Repeat applications at intervals of half an hour for two 
or three hours, if not relieved before. Cramp in the bowels will usu¬ 
ally yield to the same remedies. 

Pain in Small of Back. —Hot fomentations to the back and 
stomach afford most prompt relief, though sometimes they must be 
continued for some hours when the pain is severe, and the patient 
must be kept very quiet. Daily rubbing of the painful parts, and 


DIGESTIVE ORGANS. 


971 


the use of alternate hot and cold applications, together with the ab¬ 
dominal girdle worn nights, are also useful measures. 

Pain Beneath Shoulder-Blades. —Generally due to disorder of 
the stomach. Relieved by fomentations over stomach, with daily rub¬ 
bing, and the application of moist or dry heat to the seat of pain. 

Fullness, Weight, and Pain in Bight Side.— The various un¬ 
pleasant sensations felt under the lower ribs upon the right side are 
partly attributable to disease of the duodenum, and partly to conges¬ 
tion and inactivity of the liver. Fomentations applied daily, with 
rubbing and percussion of the side, together with the judicious use 
of electricity and the moist abdominal bandage worn at night, con¬ 
stitute the principal measures of treatment. 

Pain under Ribs on Left Side. —A dull pain is frequently felt 
in this region, due to enlargement or congestion of the spleen. The 
best remedy is the abdominal bandage worn night and day for a 
month, and the use of hot and cold applications used in the form of 
the douche or of compresses rapidly changed. Eminent German au¬ 
thorities pronounce this the best of all remedies for enlargement of 
the spleen. 

Painful Defecation .—In relieving the bowels, many persons suf¬ 
fer with pain, the most common cause of which is hemorrhoids, or piles, 
which also often occasion a considerable hemorrhage in addition to a 
dull, heavy pain. A sharp, acute pain is generally due to a fissure 
or fistula. In some cases the pain is greatest in the act of defeca¬ 
tion, in others it is most severe half an hour later. The latter is 
the case when the pain is the result of fissure. Of course the proper 
mode of treatment will include radical measures or surgical inter¬ 
ference ; nevertheless, much can be done to mitigate the sufferings of 
the patient without a surgical operation. One of the very best means 
we know of is evacuation of the bowels in steam or warm water. 
Instruct the patient to sit over a vessel nearly full of hot water, as 
hot as can be borne without burning. This will so relax the parts as 
to greatly diminish the pain; and if the contents of the bowels have 
been softened by an enema, as should always be done, the patient may 
get along with scarcely any pain at all. We have often relieved in 
this way persons who had suffered for twenty years without any 
mitigation of their suffering. 


972 


DISEASES AND THE III TREATMENT. 


Tenesmus, or Constant Desire to Relieve the Bowels.— This 

unpleasant symptom is best relieved by an injection into the rectum 
of cold or even iced water at frequent intervals. Cool or cold hip 
baths, quite shallow, are also useful in these cases. In some cases, hot 
enemas give most prompt relief. 

Weakness in Bowels. —Apply the cold douche daily, and follow 
with vigorous rubbing. An abdominal supporter is necessary and use¬ 
ful in many cases. 

Loss of Appetite. —Sun-baths, daily massage and inunction, and 
general tonic treatment, are indicated. Give patient simple food served 
attractively and not more than three times a day. Let the patient 
drink a glassful of hot water half an hour before each meal. Create 
a demand for food, and the appetite will soon come if there is power 
to digest „ it. The use of bitters and various tonics is not necessary 
to relieve these cases. We have frequently remarked a great increase 
in appetite and recovery from an actual aversion to food by a change 
from highly seasoned food to simply prepared food consisting chiefly 
of fruits and grains. 

Voracious Appetite. —Self-control is the only sure remedy; but 
the disuse of stimulating foods will aid very much in enabling a per¬ 
son to control his appetite. We have often recommended persons 
troubled in this way to eat a morsel of food half an hour before the 
time for the regular meal. This will often lessen the craving for food 
sufficiently to enable the patient to keep himself within reasonable 
bounds. 


THE RESPIRATORY ORGANS. 


073 


DISEASES OE THE RESPIRATORY ORGANS. 


PHYSICAL DIAGNOSIS, 

It is only within the last century that diseases of the lungs have 
been well understood. The greatest aid to their investigation has 
been rendered by the discovery by Laennic of the stethoscope, and 
the perfection of the several means of examination of the lungs em¬ 
ployed in “ physical diagnosis,” which comprise inspection, palpation, 



Fig - . 296. Using the Laryngoscope. 


mensuration , succussion, percussion, and auscultation. Of these, by 
far the most important are the last two. We have space here only 
for a very brief description of each. 

Inspection. —This consists in critically viewing the chest. By 
this means we discover whether there is proper motion of the walls of 
the chest, or whether there is unequal motion. We also may discover 
bulging of portions of the chest from - various causes. 

By means of an instrument known as the laryngoscope, shown in 
Fig. 296 it is possible to inspect the larynx and even the upper part of 



















DISEASES AND THEIR TREATMENT . 


974 


the trachea. By means of the same apparatus the nasal cavity may 
be examined. The instrument consists essentially of two mirrors, one 
of which, a small one, is attached to a handle, by means of which it is 
held at the back part of the mouth. A strong light is focused upon 



Fig. 297. 


the small mirror by a larger concave one, which is held in position 
upon the head by means of a band encircling it. By holding the two 
mirrors in proper positions, the light may be thrown into the larynx 
or nasal cavity, bringing all the parts into distinct view. When seen 

by means of the laryngoscope, the healthy 
vocal cords appear as seen in Fig. 297 in 
different stages of respiration. In Fig. 
298 the same organs are represented as 
seen in a case of ulceration of the 

Fig. 299 shows a very convenient 
form of tongue depressor which is very 
useful in inspecting the condition of the 
throat, and in connection with the use 
of the laryngoscope. In the absence of a better instrument for this 
purpose, the handle of a teaspoon may be used. 




Fig-. 299. 



Palpation is the term applied to examination of the chest with 
the hands. By the aid of the sense of touch, much may be learned of 
the condition of the hums. In health, the resonance of the voice gives 
to the chest a slight vibratory movement, known as vocal fremitus, 



THE RESPIRATORY ORGANS. 


975 


which can be felt by means of the hand. This movement is most 
marked upon the right side, and is increased in diseases which cause 
solidification of the lungs, as in pneumonia. 

Mensuration.— This consists in .measurements of the chest. By 
means of mensuration the degree of mobility of the chest walls and 
the breathing capacity may be ascertained, also any departure from 
the natural symmetry caused by the accumulation of fluid in one 
side, morbid growths, etc. 

Succussion is a shaking movement given to the chest for the pur¬ 
pose of detecting the presence of fluid. When air is also present in 
the pleural cavity, sounds will be produced by the splashing of the 
liquid serum or pus; if no air is present, no sounds will be heard, 
even though a considerable quantity of fluid may be contained in the 
chest. 

Percussion. —This is one of the most important of all means for 
examination of the chest. It consists in striking upon the chest-wall 
for the purpose of comparing the sounds produced by the percussion 
with sounds similarly produced in health. Percussion is best per¬ 
formed by placing the forefinger or middle finger of the left hand 
upon the chest, preferably in the space between the ribs, and striking 
it a quick elastic blow with the tips of the fingers of the other hand. 
The force of the blow should be sufficient to elicit a distinct sound. 
The sounds may be intensified by placing the patient so that his 
shoulders may rest against a door. Care should be taken to have 
both shoulders supported equally. The percussion should be performed 
upon the bare skin or with not more than a single thickness of muslin 
over the flesh. When performed outside the clothing, as we have 
often seen it done, nothing accurate can be learned of the state of the 
lungs. One side of the chest should be compared with the other. 
Sounds produced in this way differ chiefly in quality and pitch. The 
sound produced in health by striking the chest has a peculiar resonant 
quality called pulmonary resonance. It is never heard elsewhere. 
The pitch is low. When this sound is somewhat muffled, it is said to 
be dull. This condition naturally exists at the apex of the lung, 
above the clavicle, and below the fifth rib on the right side, over the 
liver. When the resonance is absent, the condition is known as flat¬ 
ness. This sound may be found in health over the kidneys and the 
lower part of the liver, near the seventh rib. Dullness is found in 


97 G 


DISEASES AND THEIR TREATMENT. 


pneumonia and consumption, being produced by consolidation of the 
lung. Flatness is sometimes found in the same diseases and also in 
dropsy of the chest. Tympanitic resonance is another modification of 
sound which may be found over the stomach and bowels in health. 
It is noticed in cases in which one side of the chest has been filled 
with air, the lung itself having collapsed, a condition known as 
pneumo-thorax. It is also sometimes observed when large cavities 

have formed in the lungs. In cases in which 
cavities exist in the lungs, two other peculiar 
modifications are sometimes produced; viz., 
amphoric resonance, which is produced by a 
cavity possessing rigid walls, and the cracked- 
pot resonance, produced when the walls are 
flaccid. The first sound is like that produced by 
tapping upon a bottle. The second is described 
by its name, the peculiarity being due to the 
coming together of the walls when percussion is 
performed. It is heard only when the patient’s 
mouth is open and placed near to the ear of the 
examiner. 

Percussion is sometimes practiced with an in¬ 
strument called a pleximeter, consisting of a ham¬ 
mer and a small disk, the latter being placed 
upon the chest-wall and struck with the hammer. 

The lingers are much more efficient and accurate 
© 

than any artificial means which has yet been 
devised. 

Auscultation. —Many of the most important 
indications respecting diseases of the chest are ob¬ 
tainable only by this means, which consists in 
listening at the chest wall by the ear alone, placed 
against the chest, or by the aid of an instrument 
known as the stethoscope, a cut of which is shown in Fig. 300. In aus¬ 
cultation, attention is given to both inspiration and expiration. Each 
has its particular characteristics in health and in disease. In health, the 
inspiratory sound is of a peculiar breezy character, and low in pitch; 
the expiratory sound, if present, very short, and still lower in pitch. 
The sounds heard over the large bronchial tubes at the upper part of 
the sternum differ from this quite materially, resembling that produced 



Fig-. 300. 







THE RESPIRATORY ORGANS. 


977 


by air drawn through a tube, being high in pitch, and the expiratory 
sound higher than the inspiratory, and continued longer. 

The Breathing in Disease. —1. The breathing may be exaggerated. 
This most often occurs in a portion of lung which is overworked on ac¬ 
count of the inactivity of some other portion. It is also heard in em¬ 
physema in some cases. It is common in children in health. 

2. Diminished breathing is noticed in consumption in the affected 
portions. It also occurs in some cases of emphysema. 

3. The breathing may seem to be suppressed altogether in pleurisy 
accompanied by a considerable quantity of fluid, in pneumonia, con¬ 
sumption, and obstruction of the bronchial tubes. 

4. Bronchial breathing ls heard in parts of the chest in which it ought 
not to occur, in diseases in which the lung becomes solidified, as in 
pneumonia and consumption. 

5. Peculiar sounds are produced by air passing through cavities in 
the lungs. They are sometimes musical in character, often resembling 
the sound produced by blowing into a bottle. 

6. In chronic bronchitis and emphysema, sibilant or whistling and 
sonorous sounds often accompany respiration. These sounds are pro¬ 
duced by contraction of the air-passages at some points. 

Bales .—Certain sounds known as rales are often heard in disease of 
the lungs, never in health. They are chiefly of four kinds, as follows : 
1. Crepitant rales, a fine, dry, crackling sound, heard just at the end of 
inspiration, not at all in expiration, most distinct just after the patient 
coughs; heard in consumption, pneumonia, and pleurisy. 2. Sub¬ 
crepitant rales, a fine bubbling sound, heard in both inspiration and ex¬ 
piration. It occurs in bronchitis, pleurisy, consumption, pneumonia, and 
in oedema of the lungs. 3. Mucous rales, similar to subcrepitant, but 
louder and coarser. Heard in pneumonia, acute and chronic bronchitis, 
and in consumption. 4. Gurgling rales are heard over small cavities. 
Sibilant and sonorous rales are mucous rales heard with sibilant and 
sonorous respiration. 

The Voice in Disease .—The natural sounds of the voice are much 
modified by disease. The following are a few of the most important 
modifications : 1. The voice, or vocal resonance, may be increased, as is 
usually the case in consumption and pneumonia, and sometimes in 
emphysema. 2. The vocal resonance is diminished when there is a 
slight accumulation of fluid in the chest. 3. The voice may be sup- 
62 


978 


DISEASES AND THEIR TREATMENT. 


pressed entirely, as is the case where there are large collections of fluid 
in the chest. 4. Bronchophony, egophony, pectoriloquy, the amphoric 



voice and metallic tinkling, are peculiar sounds sometimes heard in the 
chest, each of which has its particular significance, but requires the ear 
of a skilled examiner to detect. 

























EXPECTORATION. 


979 


A correct idea of the position of the lungs in the chest and their re¬ 
lation to other organs may be obtained by reference to Fig. 301, which 
shows the internal organs in outline. 

Expectoration. —Much can be learned of the condition of the lungs 
from an examination of the matters expectorated, or what is technically 
known as the sputum. The chief points of interest in relation to the 
sputum are its consistence, quantity, odor, color, and constituents. 

Consistence .—The density of expectorated matter varies greatly. 
It may be tough or tenacious or a limpid fluid. When very firm, it con¬ 
sists almost wholly of mucus, and is an indication of a high degree of 
irritability of the mucous membrane. This kind of expectoration gen¬ 
erally has the form of little round masses which are raised with great 
difficulty. When the sputum comes from enlarged bronchial tubes, or 
from cavities in a consumptive lung, it contains some pus and is less 
firm. The rounded masses are then somewhat flattened, but retain their 
form for some time after expectoration. Opaque fluid sputum is usu¬ 
ally pus. It occurs in bad forms of bronchitis of long standing, in ab¬ 
scesses of the lung, and in cases of empyema in which an opening into 
the air passages allows the pus in the pleural cavity to escape into the 
lung. It often occurs also in the advanced stages of consumption, at in¬ 
tervals. A clear, fluid expectoration indicates oedema of the lung from 
passive congestion. Frothy mucus, or that which contains much air, 
floats upon water, while that of greater consistence sinks. When the 
sputum sinks and retains its rounded form, it is generally supposed to 
indicate the presence of a cavity in the chest; but the evidence is by no 
means positive, as the same kind of sputum may occur in bronchial 
catarrh. 

Quantity .—The quantity of expectoration is not very significant, 
since it may be quite abundant in very mild cases, and scanty in the 
most severe ones. As a general rule, especially in whooping cough and 
acute bronchitis, the increase in the quantity of sputum and the disap¬ 
pearance of the difficulty in raising it, occur at the same time. When 
the sputum becomes scanty, the violence of the cough greatly increases. 
The sudden cessation of expectoration in a case in which it has been 
quite copious is a very bad symptom, especially if the patient shows 
sicms of weakness. This is one of the forerunners of death in consump- 

O # 

tion. A very copious expectoration, as of several tablespoonfuls at a sin¬ 
gle act of coughing, is indicative of a pulmonary abscess, or of empyema 


980 


DISEASES AND THEIR TREATMENT. 


if it occurs but once, and suddenly, If habitual, occurring perhaps every 
morning, it is evidence of dilatation of the bronchial tubes. 

Odor .—The odor of the sputum is not usually marked; but it becomes 
very fetid when it is long retained in the lung before expectoration, as 
in enlargement of the bronchial tubes in cases of chronic bronchitis, in 
abscess of the lungs, in the putrid form of bronchitis, and in consumptive 
cases with cavities. The odor is extremely bad in cases of gangrene, 
when the lung substance is undergoing rapid destruction. 

Color .—Red sputum of course indicates the presence of blood. When 
the blood is not expectorated at once, but becomes mixed with mucus, 
the sputum will be likely to be reddish brown or very slightly tinged 
with red. The rusty sputum seen in pneumonia owes its color to the 
presence of blood. In some cases, after blood has been retained for some 
time, it gives to the sputum a yellow or greenish color. These colors are 
generally due, however, to the presence of pus. The occurrence of jaun¬ 
dice in a person who is expectorating freely usually causes the sputum 
to assume a yellow or green color. The sputum is often colored by dust 
inhaled, as by coal dust in stokers, miners, and those who labor in coal. 

Constituents of the Sputum. —Some idea of the constituents of 
the sputum can be obtained by attention to the points already mentioned; 

but in cases in which there is any obscu¬ 
rity, a careful microscopical examination 
of the sputum is of the greatest importance, 
as by this means much positive informa¬ 
tion can be gained that will be sought in 
vain in any other way. The microscope 
always shows the presence of more or less 
epithelium in the sputum, which usually 
comes from the mouth, as shown by its character 
In Fig. 303 may be seen a representation of the 
peculiar ciliated epithelium which comes from the 
bonchial tubes. It is sometimes found, also, in mucus 
from the nasal cavity. In red or rusty sputum, red 
blood corpuscles, as shown in Fig. 304, are usually 
found. Pus cells are found in putrid bronchitis and 
in all cases in which there is a destruction of tissue 
in the throat or lungs, either from consumption or 
ordinary ulceration. They resemble the white cor¬ 
puscles of the blood; and, indeed, it is believed that they are, at least 



Fig. 303. Pavement Epithelium 
from the Mouth. 


See Fig. 302. 



Fig'. 


303. Cylindrical 
Epithelium. 







COLD IN THE HEAD. • 


981 


in part, identical with the white cells of the blood, which fin d their way 
out of the blood-vessels. \\ hen destruction of the lung is taking place, 
fragments of tissue may be recognized by the microscope in the sputum. 
The most characteristic of these is yellow elastic tissue, fibres of which 
0 shown m l-'i—,. ^04*. Xn cases of advanced consumption, these fibres 
are always found in the sputum, and constitute a sure means of dis¬ 
tinguishing the stage of the dis¬ 
ease, and of confirming a diagno- 
sis. This means may also be used 
as a means of determining the rate 
of progress of the disease. When 
the fragments of tissue are abun¬ 
dant, the lung is breaking down 
rapidly; when scanty, the destruction is less rapid; and when they 
disappear altogether, the destructive process is checked. 

In croupous bronchitis, the sputum 
frequently contains casts of larger or 
smaller portions of the bronchial tubes, 
which may be easily made out by ex¬ 
amination of the expectorated matters. 

A very large cast of this kind is shown 
in Fig. 305. 

The sputum often contains various 
foreign matters, and when putrid, 
always shows the presence of bacteria 
• and various other low organisms which 
accompany the putrefactive process 
elsewhere 

COLD IA TIIE HEAD.—CORYZA. 

SYMPTOMS. — Chilliness; sneezing; snuffing; lassitude; pain in the forehead; 
watery discharge from nose, becoming thick and yellow after two or three days; aching 
in the limbs and back; fever, as indicated by thirst, loss of appetite, and dryness of the 
skin ; eyelids swollen ; eyes congested, often suffused with tears. 

“ Cold in the head ” is a simple inflammation of the mucous membrane 
of the nasal cavity, and is one of the most common of all affections. It 
is generally thought to be the result of taking cold, as by getting the 
feet wet, etc., but it evidently has other causes as well. Sudden check¬ 
ing of the action of the skin by exposure to drafts while it is in a heated 




Fig - . 304. Yellow Elastic Tissue Fiber from 
the Lungs. 



982 


DISmSES AND THEIR TREATMENT. 


state is undoubtedly one of the chief causes. Irritating substances, such 
as ipecac and fluorine gas will produce this affection in certain individ¬ 
uals. There is also reason for believing it to be contagious, as it may be 
observed to go through a whole family without there being any other 
apparent cause than that of contagion. Drs. Salisbury of Cleveland, and 
E. Cutter of Boston, have recently stated that the disease is caused by 
certain microscopical germs, which may be communicated from one per¬ 
son to another. Some persons seem to be remarkably susceptible to tak¬ 
ing cold in the head, being affected by the slightest exposure. The dis¬ 
ease usually lasts from two to seven days and usually terminates in re¬ 
covery, although when it is frequently repeated in the acute form it 
may become chronic. In some cases the frontal sinus and the antrum 
of Highmore become affected, both of these cavities being continu¬ 
ous with the nasal cavity. When they are affected, the headache and 
pain are very much greater. Sometimes the disease extends into the 
Eustachian tubes and occasionally also to the ears, thus giving rise to 
deafness. Several acute diseases, particularly measles, influenza, and 
typhus fever are ushered in by symptoms of coryza. 

Treatment. —The most efficient measures of treatment are rest, 
diet, and, when the disease is the result of exposure to cold, vigorous 
measures for securing activity of the skin, as the wet-sheet pack, 
the vapor, or the Turkish, bath. The pain in the forehead when ex¬ 
treme may be relieved by fomentations over the affected part at the same 
time that the patient is taking a hot foot or sitz bath. The local 
symptoms may be relieved by the nasal douche administered with the 
syphon syringe. A solution of a teaspoonful of salt in a pint of warm 
water should be employed. The douche may be used two or three 
times a day with advantage. From one to three quarts may be in¬ 
jected each time. 

When there is a good deal of pain in the nose, a snuff composed of 
camphor and white sugar finely pulverized, in the proportion of two or 
three grains of camphor to an ounce of sugar, may be employed. 

The soreness of the upper lip which often occurs is due to the irritat¬ 
ing effects of acrid discharges from the nose. It may be prevented by 
keeping the lip smeared with oil, cream, vaseline, or some other unguent. 
The nose should be wiped with a linen handkerchief which should be 
frequently changed. Neither silk nor cotton should be used. The habit 
some patients have of snuffing cold water into the nose is a bad one. It 


CHRONIC NASAL CATARRH. 


983 


gives temporary relief, but generally protracts the inflammation. When 
the attack is drawing near its close, a long walk or lide in the open air 
is one of the most efficient means of cure. We have often known a 
long ride on a cold day to cure an acute catarrh at once. This is not, 
however, the proper remedy to apply at the beginning of the catarrh, 
but only after the severity of the first attack has subsided. 

The susceptibility to colds is best relieved by a course of treatment 
to harden the skin. The most efficient measure is the frequent use of 
cool baths, as the cool spray, etc. The liability to colds may be greatly 
diminished by the employment of oil inunctions. This measure is espe¬ 
cially useful after hot baths which cause vigorous action of the skin. 
A cold should receive prompt attention, as many chronic diseases of the 
respiratory organs originate in this way. The popular idea that a cold 
is a matter of small consequence and needs little attention as the patient 
will recover without treatment, is an erroneous one, since colds, when left 
to themselves, nearly always leave the affected part in a more or less dis¬ 
eased condition. 

In adult patients, a cold is not at all dangerous in itself, but very 
young children not infrequently suffer severely and even fatally from its 
effects. This is especially true of children who are nursing at the breast. 
The nasal passages being obstructed, it is very difficult for them to take 
their food in the usual way. In such cases, infants should be fed with a 
spoon. If this precaution is not taken, death will sometimes occur from 
want of sufficient nourishment. 

CHRONIC NASA!. CATARRH. 

SYMPTOMS.—Similar to those of Coryza, but less acute; discharge from the nose, 
either through the nostrils or throat; formation of greenish scales in the nose ; mucous 
membrane swollen, often obstructing breathing; in some cases, diminished secretion, 
constituting “ dry catarrh; ” often offensive breath. 

Chronic catarrh of the nose is so common a disease in most parts 
of the world that it scarcely needs description; at any rate, the above 
symptoms are sufficient to identify the disease. 

Cause. —Among the most important may be mentioned “ taking 
cold,” a common coryza becoming chronic catarrh, from neglect of 
treatment or by being frequently repeated; errors in diet, especially 
the use of fats and sugar in excess, and an inactive state of the liver, 
in part due to their effect upon digestion. An inactive state of the 
liver is nearly always present in chronic nasal catarrh, which is indi- 


984 


DISEASES AND THEIR TREATMENT. 


cated not only by general symptoms, but by the fact that the dis¬ 
charge from the nose, and especially the crusts which are formed, 
contain quite a large amount of the peculiar poison which is excreted 
by the liver, known as cholesterine. 

Nasal catarrh may continue for many years without greatly im¬ 
pairing the general health, but not infrequently patients subject to 
it suffer with evidences of a general decline which are properly traced 
to the long-continued drain upon the system resulting from this dis¬ 
ease. The local effects of the disease are at first slight, but after it 
has continued some time often become much more serious. The 
mucous membrane which was at first only swollen and congested, 
becomes ulcerated. In some cases the ulceration even extends to the 
bones of the nasal cavity. In these cases the discharge is exceedingly 
foul-smelling in character, and is often more or less bloody. We have 
known cases in which the whole interior of the nasal cavity seemed to 
be in a state bordering on putrescence. Not infrequently the disease 
of the bony tissues extends so far as to destroy the septum between 
the nose and the mouth. Still more serious results arise from the ex¬ 
tension of the disease to contiguous organs. The disease not infre¬ 
quently extends upward into the frontal sinus, a cavity in the skull 
just above and between the eye-brows. In these cases there is per¬ 
sistant dull aching in this part of the head. Sometimes it extends to 
the cavity known as the antrum of Highmore, and produces dull, ach¬ 
ing inpa in this part. Frequently the catarrhal disease extends into 
the Eustachian canals, which communicate with the ears, and by ex¬ 
tending upward reaches the ear-drum, or tympanum, which thus be¬ 
comes the seat of chronic catarrh, one of the most common of all 
causes of deafness. When the disease extends downward from the na¬ 
sal cavity, the patient suffers with chronic sore throat, or pharyngitis. 
As the disease progresses in a downward direction, catarrh of the 
larynx, or laryngitis, and finally bronchial catarrh, or bronchitis, and in 
some cases even consumption, are produced. We have met with many 
cases of consumption in which the history of the case clearly showed 
that it began with catarrh of the nasal cavity. 

Treatment. —Notwithstanding the trivial importance usually at¬ 
tached to this disease, we believe it to be one of much greater gravity 
than might be supposed from the immediate results. Many people 
suffer from the disease for years, failing to give the matter sufficient 


CHRONIC NASAL CATARRH. 


985 


attention to secure recovery. When of very long standing, the disease 
is somewhat obstinate to cure, and yet we have been able to demon¬ 
strate many times in the course of our experience that it is really 
curable. The measures to be employed are chiefly the following 

Careful regulation of the diet, all articles of food being avoided 
which have a tendency to diminish the activity of the liver. As in 
nearly all cases of catarrh there is chronic torpidity of the liver, it is im¬ 
portant that the patient should carefully follow all the directions given 
for the treatment of that disease with reference to diet as well as 
other particulars. Butter, sugar, fats, condiments, excess of animal 
food, and excess of food of any kind, should be particularly avoided. 
The patient should drink freely of pure water, and live in the open air 
and sunshine as much as possible, taking an abundance of out-of-door 
exercise every day. Especial attention should be given to the cloth¬ 
ing, which should be carefully adapted to changes in the weather from 
day to day. The body should always be clothed warmly. Care 
should be taken to prevent exposure to drafts or any other means 
which will produce liability to cold. Baths should be employed for 
the purpose of exciting activity of the skin. Packs, vapor baths, Turk¬ 
ish baths, wet-sheet rubs, and in fact almost every form of general 
bath may be employed for this purpose. The application of fomenta¬ 
tions over the liver and alternate hot and cold applications to the spine 
are indicated in connection with general treatment. 

These measures are essential when a radical cure is expected, and 
the employment of local measures alone will accomplish very little un¬ 
less the predisposing causes of the affection are removed by general 
treatment. Much good can be accomplished, however, by the use of 
local measures, among the most useful of which may be mentioned the 
following:— 

The employment of saline solutions in the form of the nasal 
douche or in some other way. A solution which answers as well as 
any for this purpose consists of a teaspoonful of salt to a pint of soft 
water. This solution, as well as others which are employed for the 
same purpose, may be applied to the affected membrane in any one of 
three different ways : by injecting it into the nasal cavity through the 
nostrils by means of the syphon syringe; by washing out the nasal 
cavity in a similar manner, only injecting the fluid into the back part 
of the cavity allowing it to pass out through the nostrils. These meth¬ 
ods of treatment have been already fully described elsewhere. The 


98C 


DISEASES AND THEIR TREATMENT. 


solution may also be applied to the mucous membrane by snuffing it 
up into the cavity. A little of the solution is taken up in the hollow 
of the hand, which is placed to the nostrils, and by forced inhala¬ 
tions a portion can be drawn up in contact with the affected parts. 

When there is an offensive odor to the breath arising from the de¬ 
composition of catarrhal discharges in the nose or from injury to the 
bones, a little carbolic acid in the proportion of 20 to 80 drops to a 
pint of water may be added with advantage. In very bad cases in 
which there is a large amount of secretion, which hardens, forming 
large scabs in various parts of the nasal cavity, it is often necessary to 
employ, at least at the beginning of treatment, by means of the post¬ 
nasal douche, a large amount of an alkaline solution, the object of 
which is to dissolve or wash away the hardened secretion. It is gen¬ 
erally necessary to use from one to three gallons of the alkaline solu¬ 
tion, according to the severity of the case. Ordinary soda or saleratus, 
in the proportion of a teaspoonful to a quart of water, answers as well 
for this purpose as anything which can be employed. After the nasal 
cavity has been thoroughly treated with alkaline washes by means of 
the syphon syringe, applications should be made of a small quantity of 
fluid, from half a pint to a pint, containing salt and carbolic acid, or a 
very small proportion of sulphate of zinc. The proportion of the lat¬ 
ter should be about five grains to the pint. Chlorine water, a dram 
to a pint, permanganate of potash in the proportion of ten grains to a 
pint of soft water, and other mild disinfectant lotions, may also be em¬ 
ployed with benefit. When the catarrh has begun to invade the 
throat, the inhalation of hot steam by means of the steam inhaler 
(Figs. 273, 274) will do much to check the progress of the disease. 

The extension of the disease to the ear and other parts must of 
course be treated as may be demanded by the particular case in hand. 
In some cases no method of treatment seems to work successfully, and 
the patient apparently derives no benefit from anything except change 
of climate ; but we have never yet met with a case so bad that it could 
not be benefited by a strict compliance with the rules laid down and a 
thorough employment of the measures mentioned. 


OZENA. 


987 


OZENA. 

SYMPTOMS.—Stuffiness of the nose; swelling of the membrane; headache; general 
symptoms of acute or chrome catarrh; ill-smelling discharges, sometimes tinged with 
blood; formation of scabs m the nose, having a disgusting odor; ulceration of the septum 
or other parts of the nose. 

Cause. —Ozena is generally the result of chronic nasal catarrh or 
repeated attacks of acute catarrh. It is most likely to occur in gouty 
or scrofulous subjects. It is very frequently the result of polypus of 
long standing. 

o o 

Treatment. —The same measures of treatment as directed for 
chronic catarrh should be employed for this disease. It will be neces¬ 
sary, however, to give great attention to thorough cleansing of the 
nostrils, for which the solutions of permanganate of potash and carbolic 
acid will be found useful. A snuff composed of half a dram of chlorate 
of potash to an ounce of sugar, used two or three times a day, is very 
serviceable. The disease is often very obstinate, and requires long.and 
thorough treatment to effect a cure. 

« 

NOSEBEEED-EPISTAXIS. 

SYMPTOMS.—Stoppage of the nose ; sensation of pressure in the lower part of the 
forehead just above the nose; blood flowing from one or both nostrils; sometimes the 
blood is conveyed into the throat and expectorated instead of proceeding from the nostrils. 

Cause. —Hemorrhage from the mucous membrane of the nose is a 
very frequent result of chronic catarrh in which there is sometimes 
more or less congestion of the mucous membrane. It also frequently 
accompanies polypus, especially when ulcers are present. These hem¬ 
orrhages are of trivial importance, however, and usually stop in a 
short time of themselves. The most serious cases are those in which 
there is a morbid tendency to hemorrhage, particularly in persons suf¬ 
fering with hemorrhagic diathesis. The hemorrhage may be excited 
by some violence, as a blow upon the nose, picking the nose, or thrust¬ 
ing something into it. In persons who have a predisposition to hem¬ 
orrhage, it may result from eating a hearty meal, drinking tea and 
coffee or other hot drinks, making violent efforts of any kind, as in 
running, laughing, or holding the breath. In some persons, hemor¬ 
rhage from the nose is so easily excited that it is of very frequent 
occurrence, and is a source of great detriment to the health, and may 
even shorten life. As a general rule, hemorrhage from the nose be- 


988 


DISEASES AND THEIR TREATMENT. 


comes more obstinate as it is more prolonged, and although the bleed¬ 
ing is not profuse, the patient may suffer great injury on account of 
the long-continued drain upon the system. 

Treatment. —Set the patient upright. Do not allow him to bend 
forward over a basin of water or anything of the sort. Place to the 
nose a dry linen handkerchief, pressing the corner of it as far as pos¬ 
sible into the nostril from which the blood flows, holding it in place 
so as to allow a clot to form and close up the bleeding vessels. In 
the meantime, the patient’s arms may be raised above his head, a pro¬ 
cedure which will of itself often produce an immediate cessation of 
bleeding. If the bleeding still continues, throw into the nose with a 
syringe a strong solution of alum. Tannin and vinegar may be used 
in the same way. Application of ice to the neck is a very good meas¬ 
ure, but bathing the face and snuffing cold water into the nose are 
measures which rarely accomplish any good. A great amount of good 



Fig:. 306. Plugging the Nose. 


may be done by sponging the face with very hot water and snuffing into 
the nostrils a solution of chlorate of potash, ten grains to the ounce, as 
hot as can be borne. Hot water itself has a powerful effect to stop hem¬ 
orrhage, especially when it comes in contact with the fine blood-vessels 
in the mucous membrane. In extreme cases, the extremities may be 
ligated so as to withdraw a considerable quantity of blood from the cir¬ 
culation. Care should be taken to warm the extremities, so as to re¬ 
lieve the pressure of blood in the head as much as possible. Some 
good may be derived from plugging the nostrils with cotton-wool or 
soft, dry muslin. In the worst cases, however, it becomes necessary to 
plug the posterior passages from the nose, known as the posterior 
nares. The best way to do this is quite well shown in Fig. 306. A 



CATARRH OF THE LARYNX. 


989 


strong cord is passed through the nose by means of a gum elastic cathe¬ 
ter or something of the kind, and the end is drawn out of the mouth. 
A plug of muslin or cotton-wmol is attached to the cord, and the other 
end protruding from the nose is pulled upon with sufficient force 
to bring the plug snugly into place behind the soft palate. This 
measure rarely fails to accomplish the object for which it is em¬ 
ployed. The plug should not be left in place more than forty-eight 
hours, and a string should be attached to it before it is drawn into po¬ 
sition in order to withdraw it, as it must be removed in the same way 
in which it is applied. 

CATARKII OF TIIF LARAAX. 

SYMPTOMS. —ACUTE : Tickling, burning, or soreness in the throat, aggravated by 
speaking or talking; painful swelling; voice deeper than natural, hoarse, cracked, per¬ 
haps lost altogether; violent cough, easily excited, of a peculiar character, being usually 
harsh and hoarse ; sputum at first scanty and glary or dear; later in the disease the ex¬ 
pectoration becomes thicker; in severe cases, interference with respiration, and filling up 
of the larynx; the latter symptom most likely to occur in children, often mistaken for croup. 

CHRONIC : Voice permanently impaired, being deepened, coarse, and cracked ; occa¬ 
sionally, temporary loss of voice; periodical spasmodic cough; expectoration of yellow, 
lumpy mucus. 

This disease rarely proves fatal of itself, at least in adults. It is oc¬ 
casionally fatal in children, producing death by suffocation. It is im¬ 
portant to distinguish disease of the larynx from pharyngeal disease, 
as in that affection there is also alteration of the voice, but only in 
quality, the pitch not being affected. Patients with nasal and pharyngeal 
catarrh frequently have a nasal or gutteral quality of voice, owing to 
the contraction of the nasal cavities; but the voice is not deep, hoarse, 
or cracked. It is also important to distinguish the disease from croup, 
with which it is very often confounded. The hoarse voice and diffi¬ 
cult respiration frequently occur in children suffering from pharyngeal 
catarrh, but it is by no means so serious an affection as croup. Cases 
of so-called croup so readily cured by domestic remedies, are really 
cases of pharyngeal catarrh. 

The chronic form of the disease is very obstinate, being subject to 
frequent exacerbations. Even if the patient recovers, he is very sus¬ 
ceptible to new attacks, which occur with such frequency that he can 
hardly be said to be free from the affection, although the symptoms 
can usually be made to subside after some little time. 

Causes.— The causes of catarrh of the larynx are similar to those 


990 


DISEASES AND THEIR TREATMENT. 


which produce nasal and pharyngeal catarrh. The predisposing causes 
are general weakness, a stimulating, unwholesome diet, and a disposi¬ 
tion to sweat readily, resulting in frequent chilling. The disease may 
be excited by any one of numerous causes, among which may be men¬ 
tioned the following: 1. Those which cause local irritation, as breath¬ 
ing cold air, inhalation of dust or irritating vapors, prolonged and 
loud talking or screaming, and severe coughing. 2. Improper cloth¬ 
ing, especially neglect to keep the limbs warmly clad, exposure of the 
neck, etc. It should be mentioned, however, that more harm is often 
done by clothing the neck too warmly than by exposing it. Great in¬ 
jury is often done by wearing a woolen comforter about the neck, as 
it produces perspiration and a relaxed condition of the skin, which 
renders it unnaturally susceptible to the influence of changes of tem¬ 
perature. 3. Improper diet, particularly the use of condiments and 
alcoholic liquors, is a frequent cause of laryngeal catarrh. 4. The dis¬ 
ease may extend to the larynx from some other part, as from the 
nasal cavity or pharynx. 5. It may occur in connection with some 
constitutional disease, as measles Or typhus fever. 6. It may be the 
result of the epidemic form of any fever, when it generally assumes 
an epidemic form. 7. Catarrh of the larynx is an accompaniment of 
ulcers and tumors of the larynx, as well as of tuberculous disease of 
this part. 

Treatment. —The most important measures of treatment are those 
which will prevent the occurrence of the disease. Among these may 
be mentioned particularly, bathing of the neck and throat with cold 
water two or three times a day, especially in the months of the year 
in which the disease is most likely to occur. Careful attention 
should also be given to the clothing; particularly for the limbs. If 
the feet become wet by exposure they should be quickly dried and 
warmed. It is also important that the diet should be carefully regu¬ 
lated. Condiments and spirituous liquors, as well as fats, sugar, pas¬ 
try, sweetmeats, preserves, etc., should be carefully avoided, as they 
have a marked tendency to produce a predisposition to this disease by 
clogging the liver and deranging the digestive organs. It is also im¬ 
portant to call attention to the mistake often made by patients who 
fear this disease, of protecting themselves too carefully. Over pro¬ 
tection is as serious an error as deficient protection. The persons 
most liable to the disease are those who shut themselves up in-doors 
most carefully. Wearing thick furs or other clothing about the neck 


CATARRH OF THE LARYNX. 


091 


in cold weather is a very injurious practice, as it causes perspiration and 
relaxation of the skin of that part, which makes it in the highest de¬ 
gree susceptible to changes of temperature. The neck should he 
gradually accustomed to cold temperatures, just as are the hands and 
face, and should be protected only when absolutely necessary. In 
acute cases, loud or long continued talking or laughing should be for¬ 
bidden. In some cases, absolute silence must be enforced. The patient 
should be urged to resist the tendency to cough as much as possible. 
In the majority of cases it will be found that coughing can be con¬ 
trolled by an effort of the will if the patient has sufficient force of 
character. Coughing increases the irritation without doing any par¬ 
ticular good. The throat can generally be cleared by a slight effort 
without the prolonged hacking cough in which many patients indulge. 
No matter if the patient declares that he cannot help coughing, it 
must be insisted upon that he shall abstain from doing so. 

Where the disease is the result of taking cold, the patient should be 
subjected to such measures of treatment as will secure thorough 
sweating. The patient may be given a sweating pack, vapor bath, 
hot-air bath, Turkish or Russian bath. To encourage perspiration, 
teas of various sorts may be given. Tea made of elder-blossoms 
is in considerable repute for this purpose; but it is probably not su¬ 
perior to warm water. Fomentations should be applied to the throat, 
and the patient may also inhale the vapor of water as hot as it can be 
borne. The most convenient apparatus for this purpose is the form of 
inhaler we have devised for such cases and used quite extensively in 
diseases of the larynx, shown in Figs. 273, 27-k Alternate hot and cold 
applications to the throat are also beneficial. Mustard plasters and 
stimulating poultices are sometimes used, but we have never found 
them necessary. The diet of the patient should be carefully regulated. 
He should avoid butter, pastry, fat meats, etc. He should also abstain 
from the use of sugar and sweetmeats of any kind. The more closely 
he restricts himself to a diet of grains and fruits, preferably those of 
an acid character, the more favorable opportunity he has for making 
a good recovery. 

In a chronic case of laryngitis, it is necessary for the patient to 
give the most scrupulous attention to his diet for a long time. In the 
majority of cases it will also be necessary to treat the patient for 
functional diseases of the liver and stomach, which almost always ac¬ 
company diseases of the larynx. Sometimes change of climate is 


992 


DISEASES AND THEIR TREATMENT. 


necessary, but we believe that the majority of cases can be cured by 
a careful regulation of the regimen. Tonic measures should be adopted 
for the improvement of the general health, such as the application of 
electricity, massage, and inunctions, together with such baths as will 
secure activity of the skin, applied not so frequently as to produce any 
degree of prostration. Local treatment by means of the inhaling ap¬ 
paratus is invaluable in catarrh of the larynx as well as pharyngeal 
catarrh. For vapor inhalation, nothing is better than tincture of gum 
benzoin, in the proportion of ten drops to the ounce of water, using 
the inhaler shown in Fig. 274. We have used this remedy a great deal 
in cases of this kind, and have found that good results were obtained 
from its. use, though we have never been able to ascertain with cer¬ 
tainty that any better effects were obtained when the drug was used 
than when the patient was treated with pure steam. Atomized fluids 
are of real value in these cases, the best solutions for inhalations be¬ 
ing common salt in the proportion of ten to twenty grains to the 
ounce of water, and alum in the proportion of five to ten grains to 
the ounce. 

To allay the paroxysms of coughing and difficulty of breathing 
which not infrequently occur in both the acute and chronic form of 
the disease, the best of all remedies is the application of a sponge 
dipped in hot water to the throat, repeated until the skin is considera¬ 
bly reddened. The patient should be allowed to drink freely of hot 
water or hot lemonade at the same time. In cases of children suf¬ 
fering from the disease, the drinking of an abundance of liquid is 
particularly important. The child should be prevented from sleeping 
soundly, and should be frequently awakened and made to drink freely 
of warm or hot water. The use of hot drinks or hot water applied 
by a sponge is very strongly recommended by Niemeyer for this class 
of cases. 

It is very important that the treatment of this disease should be 
prompt and energetic, and it should be unremitting until a cure is 
effected, since when neglected it very often leads to consumption of the 
throat or tubercular laryngitis. 

CROUP. 

SYMPTOMS.—At first, those of a slight cold, or catarrh,—slight fever, hoarseness f 
cough, running at the nose; after a few hours, fits of coughing, increased hoarseness, and 
harassed respiration, spasm of the muscles of the throat; characteristic symptoms now 
appear, — brassy, ringing, or barking cough, accompanied with a crowing sound, increased 


CROUP. 


093 


fever, embarrassment of the respiration, irregularity of the pulse, features expressive of 
distress, patient worse at night and better toward morning; in fatal cases, drowsiness 
increases, breathing becomes more embarrassed, lungs congested, skin covered with cold 
sweat; finally, coma, asphyxia, and death. 

Causes. —The causes of croup are not thoroughly understood. They 
are probably similar to those which produce acute catarrh of the larynx. 
Indeed, it is held by some that croup is identical with acute catarrh 
of the larynx in adults, the difference in severity being due to the 
age of the patients. It occurs most frequently in children from two 
to six years of age, more often in boys than in girls. The disease is 
characterized by the formation of a false membrane in the larynx 
and trachea. It sometimes also affects the pharynx. The danger to 
life is from suffocation through accumulation of the false membrane. 

Treatment. —The old treatment, by applying antimony, mercury, 
and blisters, was in the highest degree unsuccessful. According to 
Tanner, one-half the persons treated by this plan died. The disease 
is a very severe one and sometimes difficult to manage, but with 
proper treatment from the first, few cases will prove fatal. 

Apply hot water to the throat by means of sponges or flannels 
wrung out in hot water as directed for acute catarrh of the larynx. 
If relief is not quickly secured, exchange the hot applications for cold 
ones, and if some relief is obtained, keep the cold constantly applied. 
If necessary, employ ice compresses. This measure must be employed 
thoroughly to be of any value whatever. Used early in the disease, 
it will prevent the formation of the false membrane. If it is not em¬ 
ployed early enough or with sufficient thoroughness to accomplish 
this, measures must be employed to secure an early separation of 
the false membrane from the mucous membrane of the larynx. For 
this purpose hot and cold applications should be applied to the throat, 
and the patient should be made to inhale the vapor of hot water, as 
hot as it can be borne and as large a portion at a time as possible. 
The vapor may be inhaled through the apparatus for the purpose, 
represented in Fig. 27-t, or from a tea-kettle or tea-pot. A paper cone 
may be arranged in such a way as to conduct the steam to the patient’s 
mouth. A very excellent method of generating steam for this pur¬ 
pose is to slake lime in a tea-pot, and have the patient inhale the va¬ 
por through the nozzle. We have used this method on several occa¬ 
sions with complete success. The vapor of warm vinegar is also some¬ 
times useful. Among the most serviceable remedies for causing sep- 

G3 


994 


DISEASES AND THEIR TREATMENT. 


Oration of the false membrane may be mentioned lime-water, vinegar, 
and a strong solution of chlorate of potash taken by means of an at¬ 
omizer. The chlorate of potash solution should be hot when taken, 
and the patient should inhale it a large part of the time. 

It is of the greatest importance that the temperature of the room 
in which the patient is placed should be carefully regulated. The air 
should also be kept thoroughly saturated with moisture by boiling 
water or by means of slaking lime. The latter method has been fre¬ 
quently employed with success, the lime being placed in a tub near 
the center of the room or near the patient, and water applied to it. 
Sponging of the hands, feet, arms, and limbs is also recommended for 
this disease. 

If the patient becomes so greatly exhausted that he loses the 
ability to cough, although the membrane may be separated suffi¬ 
ciently to allow expectoration, means should be adopted to restore the 
patient as much as possible. Dr. Niemeyer recommends placing the 
patient in a warm bath and pouring cold water on his head, the back 
of the neck, or spine, for the purpose of exciting increased nervous 
activity, particularly to excite cough, thus enabling the patient to 
throw out the loosened membrane. In case all other measures fail, 
and suffocation seems impending, as shown by increased difficulty in 
breathing, blueness of the skin, etc., the surgical operation of laryn- 
gotomy or tracheotomy should be performed. This consists in mak¬ 
ing an opening into the larynx or trachea and passing in a silver tube 
through which the patient can breathe. Life has sometimes been 
saved in this manner. 

(EDEMA OF T2IE GLOTTIS. 

SYMPTOMS. — Hoarseness, rapidly increasing until the voice is lost; harsh, barking 
cough ; inspiration laborious, long-drawn, and whistling ; expiration short, easy, and gen¬ 
erally inaudible, though sometimes noisy; patient complains of “ something in the throat; " 
other symptoms similar to those of croup. 

This is a condition in which the tissues about the epiglottis and 
upper part of the larynx become the seat of a watery swelling similar 
to that which often affects the feet, ankles, and lower eyelids. If the 
finger is passed into the throat, two hard swellings, sometimes as large 
as a pigeon’s egg, may be felt at the root of the tongue; and when the 
patient attempts to fill the lungs, these swellings are drawn together, 
and close the opening at the top of the larynx so that inspiration be- 


SPASM OF TEE GLOTTIS. 


995 


comes extremely difficult. They may sometimes be seen by making 
the patient open the mouth widely and pressing the tongue. The 
disease occurs most commonly in adults, in which respect it differs 
from croup, which is most frequent in children. The principal excit¬ 
ing causes are acute catarrh, laryngitis, erysipelas of the face, and oc¬ 
casionally small-pox, consumption of the throat, and Bright’s disease. 

Treatment. —The old prescription for this disease reads about like 
this: “ blood-letting, leeches in large numbers to the throat, emetics, 
cathartics, etc.;” but we believe with Niemeyer that such treatment 
is worse than useless in this disease, as well as in croup. According 
to the learned authority quoted, the local application of ice is of far 
more value than any of the remedies mentioned. Indeed, we believe 
this to be by far the best remedy for this disease. The patient should 
be instructed to hold small pieces of ice in the back part of the mouth, 
frequently swallowing a small piece. Ice may also be applied ex¬ 
ternally. We prefer for external application, however, alternate hot 
and cold applications made with a sponge and a piece of ice. The 
sponge should be dipped in hot water, slightly pressed, and applied to 
the throat as hot as the patient can bear, and held in position for a 
few minutes. It should be followed by rubbing the throat with ice 
for two or three minutes. This treatment should be used in conjunc¬ 
tion with ice internally. 

If there is rattling in the throat, and evidence of the presence of 
•considerable mucus, the patient should drink freely of warm water. 
If possible, enough should be taken to produce nausea and vomiting, 
as the effort will frequently relieve the embarrassment of breathing. 
In case other measures fail, a surgeon should be called in to puncture 
the swollen parts, which will give very speedy relief. 

SPASM OF THE GLOTTIS-LARYNGISMUS STRIDIJXUS. 

SYMPTOMS.—Interruption of breathing; fingers and toes rigidly contracted; patient 
struggles for breath ; becomes black in the face ; suffocation threatens, spasm generally 
ceases after a few seconds, patient drawing a long breath with a whistling or crowing sound. 

This affection consists in a sudden contraction of the muscles which 
oontrol the vocal cords, by means of which the narrow opening be¬ 
tween the cords, called the glottis, is closed, preventing the entrance 
of air into the lungs. The disease occurs most frequently in children, 
particularly in infants nursed with a bottle and most frequently dur- 


99G 


DISEASES AND TIIEIR TREATMENT. 


ing teething. Spasms may occur at intervals of a few hours, days, or 
weeks. The disease also occurs frequently in adults, especially hys¬ 
terical females 

Treatment. —To relieve the spasm, apply cold water to the head, 
face, and chest. Slap rharply the chest and back. Open the mouth of 
the patient and draw the tongue forward, having the thumb and finger 
protected by a handkerchief or thin towel. Putting the patient into a 
hot bath will sometimes give immediate relief. If these measures fail, 
apply artificial respiration as elsewhere directed. As patients suffering 
from this disease are likely to become more.and more susceptible to it, 
it is important that such measures should be taken as will remove the 
liability to this alarming and not infrequently fatal affection. The prin¬ 
cipal measures for this purpose are proper attention to the diet, which 
should be very simple, abundance of exercise in the open air and sun¬ 
shine, frequent bathing, etc. In teething children, it is often necessary 
to lance the gums. It should always be done when the gums are found 
tender and swollen. 

THROAT COS81JMPTIOM-LAR1SGEAL TITRERCITTOSIS. 

SYMPTOMS.—Chiefly those of acute and chronic laryngitis; in addition, shortness of 
breath; hectic fever ; emaciation and general debility ; pulmonary consumption. 

This disease most often occurs in the latter stages of pulmonary 
tuberculosis, or consumption. It occasionally occurs as an independent 
disease. Its causes are essentially the same as those which are elsewhere 
described as productive of tubercular disease of the lungs. The disease 
cannot be readily distinguished from other affections of the larynx un¬ 
less the patient is also suffering from lung disease of some character. 

Treatment. —The treatment is essentially the same as that recom¬ 
mended for chronic catarrh of the larynx. Little can be hoped for, as 
the disease is almost always fatal. However, much can be done to pal¬ 
liate the sufferings of the patient. Drinking a glass of hot milk early 
in the morning will frequently relieve the harassing morning cough to 
a considerable degree. The patient must be required to abstain as much 
as possible from “ hawking ” and coughing, which are exceedingly annoy¬ 
ing in this disease. The employment of hot vapor inhalations and chlo¬ 
rate of potash spray are found the most useful internal remedies. Local 
applications to the throat are also of some service. It is important that 
the patient should be kept in a warm, moist atmosphere as much as pos¬ 
sible. Attention should be given to the general health, as directed for 
pulmonary consumption. 


PARALYSIS OF THE GLOTTIS. 


997 


PARALYSIS OF THE GLOTTIS-LOSS OF VOICE—APHONIA. 

SYMPTOMS. — Complete or partial loss of voice; in slight cases, only hoarseness or 
deep monotone voice. 

This affection appears in two forms, as the result of functional dis¬ 
ease or of some organic affection. The first form is more frequent in 
women, with whom it is a symptom which frequently accompanies 
uterine disease. The patient frequently speaks only in a whisper for 
a long time, then entirely recovers the voice again. When long contin¬ 
ued, it becomes nearly as serious as the graver form of the disease, in 
which there is some structural derangement. This form is most fre¬ 
quently caused by disease of the larynx, as acute or chronic laryngitis, 
ulceration of the larynx, pressure upon the nerves which control the 
part by tumors of some sort, and disease of the brain. 

The diagnosis of this affection is made conclusive by occular exam¬ 
ination of the larynx by means of a laryngoscope, the use of which is 
illustrated in Fig. 296. By means of this instrument the skilled opera¬ 
tor can inspect the vocal cords, and thus discover whether or not there 
is a lack of proper motion in the act of breathing or attempting to 
speak. 

Treatment. —For the functional form of the disease, electricity is a 
valuable local means of treatment. In applying this agent, one pole 
should be applied over the upper part of the sternum, and the other 
upon that part of the larynx familiarly known as “Adam’s Apple.” 
In some cases a cure has been effected by a single application of elec¬ 
tricity, and the patient generally experiences some benefit from the 
treatment almost immediately. 

Alternate hot and cold applications, together with rubbing of the 
throat with cold water, are also useful. Great attention should be 
given to the general health and the removal of the local disease, of 
which this affection is in these cases generally a symptom. In the 
treatment of the more severe form of the disease, special attention 
must be given to the particular cause of the disease, by the removal 
of which the patient will show a marked improvement, although some 
cases of this affection are of course incurable, it being in these cases 
the result of causes which cannot be removed. 


998 


DISEASES AND THEIR TREATMENT. 


ACUTE BRONCHITIS. 

SYMPTOMS. — Shivering, sometimes distinct chill; slight fever; tightness about the 
chest; cough, at first dry and hard, with expectoration of glary, frothy mucus; after¬ 
ward, copious yellow sputum; headache; lassitude; coated tongue; little appetite; fre¬ 
quently humming or rattling sounds in the chest. 

This disease frequently accompanies catarrh of the larynx. It is 
not infrequently that we have nasal catarrh, catarrh of the larynx, 
and bronchial catarrh combined. A severe attack of this sort is fre¬ 
quently termed catarrhal fever. When there is severe frontal head¬ 
ache, soreness of the limbs, and pain in the joints with tenderness, the 
patient is frequently said to have catarrhal rheumatic fever. At the 
beginning of the disease, the patient feels as though his “chest is 
stopped up,” coughs hard and expectorates but little, as the secretion 
is scanty. After a few hours or days, the secretion becomes much 
more abundant and is expectorated easily, and the cough is said to be 
“ loose.” The causes of this affection are precisely the same as those 
which cause catarrh of the larynx, hence, we need not recapitulate 
them here. 

Treatment. —The treatment for this disease should be precisely 
the same as that recommended for acute catarrh of the larynx, with 
the exception that the local treatment should be administered to the 
whole chest and not to the throat alone. Great advantage will be de¬ 
rived from the frequent or continuous inhalation of warm vapor and 
the constant wearing of warm, moist compresses on the chest during 
the intervals of treatment. 

No measures of general treatment will at all compare with those 
which excite vigorous action of the skin, as the warm blanket pack, 
the wet sheet pack, and the Turkish, Russian, or vapor, baths. 

The diet should be restricted to very simple, unstimulating food, 
such as fruits and grains, and should also be limited in quantity. 
Decided benefit may be derived in the majority of cases by drinking 
very freely of warm mucilaginous drinks. A number of glasses, six to 
ten, should be taken during the day. 

A dry, cold, atmosphere should be avoided in the winter time. 
The patient should remain in-doors most of the time, so as to secure a 
uniform, warm, moist atmosphere. This measure must not be carried 
to an excess, however ; and while the patient is confined, care should be 
taken to secure for him proper exercise by means of calisthenics, med- 


CAPILLARY BRONCHITIS. 


999 


icjil gymnastics, etc., together with massage and an abundance of fresh 
pure air. The employment of expectorants and the hundreds of famil¬ 
iar remedies which are recommended as “ sure cures ” for a “ cold,” in 
the majority of cases do no good, but positive harm. In case expecto¬ 
ration is exceedingly profuse, it may often be diminished somewhat 
by inhalation, by means of the inhaler previously described (see Fig. 
274), of vapor of tar, in the proportion of a dram to an ounce of water. 

In young children suffering from the disease, the lungs are likely 
to be choked with the expectoration, on account of the inability to re¬ 
move it by coughing. If the evidence of accumulation is very great, 
it may be necessary to employ a mild emetic to induce vomiting, by 
which means the accumulated mucus may be dislodged. This may 
frequently be done also by causing the child to cry violently by plac¬ 
ing it in a cold bath, rubbing the feet with a brush, or some similar 
means. 


CAPILLARY BRONCHITIS. 

SYMPTOMS.—Those of acute bronchitis, to which are added great frequency and 
difficulty of breathing; if the patient can talk, speech is short and jerking; nostrils dilated 
at each breath; face swollen and congested; countenance indicating great distress; great 
restlessness; more frequent pulse, cough ineffectual; rattling in the chest. 

This form of bronchitis most frequently occurs in children. It af¬ 
fects the smaller bronchial tubes, not the smallest, and is much more 
dangerous than the preceding on this account. In very young chil¬ 
dren it is a fatal disease, as the bronchial tubes are so small in infants 
that they become easily obstructed, which occasions collapse. 

Treatment. —The ordinary methods of treating this disease are by 
no means successful. The most useful recommendation found in the 
text-books is to avoid any weakening measures, and to endeavor to 
maintain the patient until nature can have time to effect a cure. In 
the treatment of a number of cases of this disease, we have become 
satisfied that much can be done to facilitate recovery if thorough and 
prompt measures are taken at the outset. As soon as the nature of 
the difficulty is discovered, the patient should be given a blanket pack 
so as to induce free perspiration. This will almost invariably bring 
marked relief to the most urgent symptoms, and it should be repeated 
as often as necessary—as frequently as two or three times a day if de¬ 
manded by the urgency of the symptoms. This measure, together 
with the inhalation of steam, will often effect almost marvelous re- 


1000 


DISEASES AND THEIR TREATMENT. 


suits. If the patient is too young to use the inhaler, the atmosphere 
of the room should be kept warm, not less than 75°, and the atmos¬ 
phere should be kept moist by boiling water in a large iron kettle on 
the stove, or by slaking lime. Care should also be taken to secure 
an abundance of fresh air. 

CnKOXIC BROSCniTIS. 

SYMPTOMS.—Habitual cough; shortness of breath; copious expectoration; symp¬ 
toms of acute bronchitis, with less intensity. 

The causes of chronic bronchitis are essentially the same as those 
of the acute variety. In fact, it is most commonly produced by the 
frequent occurrence of acute bronchial catarrh. It is always associated 
with an inactive condition of the liver and with more or less impair¬ 
ment of the digestion. When it continues a long time there is usually 
more or less debility. In consequence of the obstruction, the small 
bronchial tubes become greatly dilated. This affection is known as 
emphysema. When it is present, the patient suffers much from la¬ 
bored breathing, the chest is generally enlarged, and the space between 
the ribs is abnormally depressed. 

Chronic bronchitis is seldom a direct cause of death, but may lead 
to a fatal result by producing other diseases. It is often mistaken by 
unskillful persons for consumption, a much more grave disease; but 
a careful examination will show the absence of the symptoms charac¬ 
teristic of the latter disease. 

Treatment. —The first attention should be given to the diet, which 
should be wholly unstimulating in character, consisting chiefly of far¬ 
inaceous articles of food. Eggs and milk may also be allowed, and 
when the digestive organs are somewhat enfeebled, especially if the 
patient is troubled with acid or flatulent dyspepsia, fish and meat in 
moderate quantities need not be interdicted. Many patients suffering 
with emphysema are given great inconvenience by gas in the stomach 
and bowels. Such persons should avoid the use of vegetables, sweets of 
all kinds, tea and coffee, and all kinds of alcoholic drinks. Silk or wool¬ 
en should be worn next to the skin. The patient should be careful to 
protect himself against changes of temperature, and should dress 
sufficiently warm to keep the skin active. The measures of treatment 
indicated are such as will increase the activity of the skin, as the pack, 
inunction, rubbing wet-sheet, hot-air bath, and Turkish bath. After 


CHRONIC BRONCHITIS. 


1001 


each bath, especially in the cold season of the year, an inunction of 
purified cocoa-nut oil, vaseline, or some other unguent, should be em¬ 
ployed to prevent taking cold. The patient should spend as much of 
his time in the open air as possible, engaging in gentle exercise. 

For local treatment, no measure is of more value than the inhala¬ 
tion of hot vapor and the spray of hot water. When expectoration 
is excessively copious, inhalation of vapor of tar may be employed, as 
already directed, page 806, or the patient may inhale the spray pro¬ 
duced by the atomizer from weak solutions of lime or tannin. When 
the patient is troubled with a dry, harassing cough, relief will almost 
certainly be afforded by the inhalation of hot vapor. Daily fomen¬ 
tations should also be applied over the chest. These applications should 
be followed by sponging the chest with cold water to tone up the 
relaxed skin. 

As an inactive condition of the liver is very common in this dis¬ 
ease, it should receive such attention as has been already directed 
for that condition. 

In some cases, it will be necessary to make a change of climate, 
although the benefits derived from this measure are not always as 
great as are supposed. Probably one of the greatest advances made 
in the treatment of emphysema, which is one of the most serious re¬ 
sults of this affection, is what is known as the “ Pneumatic ” treatment. 
This mode of treatment has been elsewhere described. (See page 681.) 
We have recently adopted this treatment for this class of cases, em¬ 
ploying Waldenberg’s apparatus, constructed for us by Reynders, of 
New York, and have observed good results. We have under treat¬ 
ment at present a number of patients suffering with the disease in 
different stages, for whom we hope to obtain a marked degree of 
benefit in due time by this mode of treatment. 

The “ grape cure ” has been very strongly recommended for chronic 
bronchial catarrh, and has been employed very successfully, especially 
in cases in which there is a scanty and tenacious secretion expectorated 
by violent coughing. It is probable that in cases of this kind the 
cure is not due to any specific principle in the grape, but from the 
simple diet and the taking of large quantities of fluid. 

Patients suffering with emphysema should exercise great care to 
avoid severe coughing, and should always restrict the tendency to 
cough as much as possible, as violent efforts increase the irritation and 
aggravate the difficulty. The employment of narcotics in allaying 

Of? * 


1002 


DISEASES AND TIIEIR TREATMENT. 


cough in the different forms of bronchitis is often productive of bad 
results. In the chronic form of the disease the patient soon becomes 
so dependent on the narcotic, the dose of which must be very rapidly 
increased, that before he is aware of it he finds himself in the un- 
happy position of an habitual opium-taker. The best authorities also 
deprecate the employment of expectorants. 

WINTER COUGH. 

This is a mild form of chronic bronchitis which affects the patient 
only in winter. It is, in fact, the precursor of the more formidable dis¬ 
ease. The patient takes a cold at the beginning of winter, and does not 
get entirely rid of it until the commencement of warm weather. Tie is 
then free from the cough until the following winter, when another cold 
is contracted which hangs on a little longer than before, perhaps lasting 
a good part of the summer. The next fall a cold is contracted earlier 
than before, and the following summer the cough does not disappear 
entirely. Now the patient is really suffering with chronic bronchitis; 
and this is the way in which the majority of cases begin. 

Treatment. —The treatment for winter cough is the same as 
recommended for chronic bronchitis. For tightness in the chest, noth¬ 
ing will give so prompt relief as a hot fomentation at night followed 
by inhalation of the vapor of hot water, and a moist compress to be 
worn upon the chest during the night. 

BRoxeniAL croup, ok croupous broaciiitis. 

SYMPTOMS.—Expectoration of casts of bronchial tubes; dry cough; bleeding from 
lungs; some difficulty in breathing; often begins with chill, followed by fever and pain 
in side; may be acute, or chronic. 

This is a rare disease. Bronchial croup may occur from extension of 
the disease from the larynx into the large bronchi, or from the air-cells 
into the small bronchial tubes; but in this affection the croupous process 
is confined to the bronchial tubes, usually those of moderate size. The 
disease is sometimes acute, but is more often chronic, existing for years, 
in many cases the patient coughing up daily, or at longer intervals, 
casts of some portions of the air-passages. 

Treatment. —This disease must be treated upon the same general 
plan recommended for croup of the larynx. Careful attention to the 


ASTHMA. 


1003 


general health, and the daily employment of hot and cold applications 
to the chest, and inhalations of hot vapor, will accomplish more than 
any other remedies. 

ASTimi. 

SYMPTOMS.—Patient suddenly attacked, or after premonitions of headache, sleep¬ 
iness, etc., or an attack of indigestion; great difficulty of breathing; chest becomes dis¬ 
tended, since the air cannot be easily forced out of the lungs after inhalation; loud wheez- 
ings or whistlings heard with each breath ; sense of constriction about chest; pulse feeble ; 
lips purple; eyes staring; attacks most likely to occur in the night, often being periodical. 

This disease is often confounded with others in which there is diffi¬ 
culty in breathing, as in disease of the heart, other affections of the lungs, 
etc. Asthma proper is a purely nervous disease. It consists in a mus¬ 
cular contraction of the smallest bronchial tubes, those next the air-cells, 
by which the air is prevented from passing out of the cells after it has 
been breathed in. The patient complains of inability to “ get his breath 
out,” notwithstanding efforts so vigorous that he is bathed with perspira¬ 
tion. In fact, the more severe the effort, the less effectual, in the major¬ 
ity of cases, as the difficulty is aggravated by the attempt to overcome 
it. Asthmatic attacks sometimes occur periodically, without any ap¬ 
parent exciting cause; but in most cases there is some cause to which 
each particular attack is attributed by the patient. The most common 
causes are excessive muscular exertion, taking cold, inhalation of sul¬ 
phurous fumes, or of some other irritating substance, as dust from the 
sweeping of carpets, etc. The emanations from feathers is not infre¬ 
quently the cause of asthmatic seizures. Many persons have suffered 
for years in consequence of sleeping on feather beds or pillows, being 
wholly ignorant of the real cause. This disease is often tolerated for 
years, rarely causing death, but ultimately undermines the patient’s 
health. Chronic sufferers from asthma are usually thin, sallow, and 
hollow-cheeked. In the great majority of cases, asthma is connected 
with some other serious disease; as chronic bronchitis, emphysema, dys¬ 
pepsia, disease of the liver, and, in females, disease of the uterus. Males 
are affected much more frequently than females. 

Treatment. —When the attack is occasioned by indigestion, and 
there is undigested food in the stomach, give the patient an emetic of 
warm water at once. Small bits of ice swallowed, 01 a cup of stiong 
coffee, will often give relief. Give the patient plenty of fresh air, but be 
careful to avoid chilling. A remedy very successful in many cases is 


1004 - 


DISEASES AND THEIR TREATMENT. 


the hot sitz bath accompanied by fomentations to the chest and cold ap¬ 
plications to the spine. Electricity is also a very useful agent. In some 
cases, we have obtained relief by the use of this agent when all others 
failed. A remedy very strongly recommended by a physician who is 
himself a sufferer from asthma is the following : Breathe out slowly and 
wait after the lungs are emptied as long as possible; then fill the lungs 
and hold the breath as long as possible. Repeat the process several 
times. Nitre paper, made by soaking blotting-paper in a solution of 
saltpeter and drying, when burned, gives off fumes, the inhalation of 
which gives almost magical relief. The most effective of all measures of 
treatment, however, is the inhalation of compressed air and exhalation 
into rarefied air by means of a pneumatic apparatus. The most of these 
measures are simply palliative. In order to cure the disease, the real 
cause must be ascertained and removed. Every attention must be given 
to the general health and to the special morbid conditions which may be 
suspected of being a cause of the difficulty. The patient must avoid all 
the known exciting causes. A pure, dry atmosphere should be sought; 
but the same climate is not best for all patients. Wind, dampness, dust, 
and smoke must be sedulously avoided. Fomentations over the liver two 
or three times a week, the moist abdominal bandage, worn nights, and 
sufficient eliminative treatment to secure activity of the skin, such as 
packs, Turkish, or hot-air, baths, etc., are measures which we have found 
of real value in the treatment of a good many cases of this disease. 

SPASM OF THE DIAPHRAGM. 

SYMPTOMS.—Breathing very difficult and slow, expiration twice as long as inspira¬ 
tion; abdominal muscles hard; face blue; no wheezing or whistling. 

This is a peculiar form of asthma in which there is a rigid contrac¬ 
tion of the diaphragm. The patient is troubled greatly to expel the air 
from his lungs. 

Treatment. —The same remedies recommended for ordinary asthma 
should be applied. The hot bath, fomentations to the chest, and ice 
compresses to the spine will be found particularly serviceable. In severe 
cases, opium or chloroform are required to relieve the spasm. 


HAY ASTHMA, OR HAY FEVER. 


1005 


HAY ASTHMA, OR H1Y FEVER. 

SYMPTOMS. —Usually begins with weakness, coated tongue, diarrhea, alternating 
with constipation, general debility, and sleeplessness; sometimes begins suddenly; tick¬ 
ling in the nose; coryza; prolonged and violent sneezing; swelling and redness of the 
eyes, with evidences of acute mucous inflammation; tickling in the throat, with dryness 
or slight burning; sometimes slight deafness; bronchial catarrh; great difficulty in 
breathing, with tightness about the chest and croupy symptoms; attacks most frequent in 
daytime, instead of night as in nervous asthma; sometimes frequent chills followed by 
considerable fever. 

This curious disease has been very closely studied for a number of 
years, and yet its cause is, at the present date, still undetermined. It 
has been believed by many eminent physicians that the disease is caused 
by the pollen of plants or grasses, and experiments conducted by an emi¬ 
nent German physician seem to confirm this view ; but it has not been 
determined what particular plants furnish the noxious pollen. Atten¬ 
tion has been specially called to the rag-weed, a very common plant al¬ 
most everywhere, as it has been observed that the occurrence of the dis¬ 
ease in a large number of persons is simultaneous with the flowering of 
this plant. We have frequently been told by patients that they be¬ 
lieved this to be the cause of the disease in their particular cases at least. 
On the other hand, there are those who hold the disease to be chiefly a 
nervous disorder. Our friend, Dr. Geo. M. Beard of New York, has 
collated a large number of facts upon this subject which seem to show 
beyond any room for doubt that one of the essential causes of the dis¬ 
ease is individual idiosyncrasy. The] exciting cause is probably different 
in individual cases, which accounts for the fact that different persons are 
affected at different seasons of the year. The disease usually lasts four 
to six weeks, and leaves the patient almost as suddenly as it appears, in 
some instances observing in its departure the very same regularity, even 
to the hour, as is observed in some cases in its commencement. The 
disease is rarely or never fatal, but usually leaves the patient weak and 
debilitated. 

Treatment. —The author of the article on hay fever in Ziemssen’s 
Cyclopedia of Medicine says, “ Treatment is still powerless against hay 
fever.” It has long been considered as settled that drugs are of no value 
in the treatment of this affection. We have found, however, that by 
the employment of Turkish, vapor, Russian, and similar baths, the pa¬ 
tient’s sufferings may be very greatly mitigated, more than by any 
other means. For several years we have annually had a number of 


1006 


DISEASES AND THEIR TREATMENT. 


these cases under treatment, and have found that in nearly every case 
the disease can be controlled by the treatment named. In most cases 
the patient is very greatly relieved while in the bath, and the relief 
continues for some tune after. If care is taken in the interval of treat¬ 
ment to avoid exposure to the cause of the malady, in nearly all cases 
the attack can be greatly lessened in severity, much shortened, and, in 
some cases, broken up altogether. The employment of the hot-vapor 
inhalation is another remedy of great value in cases in which the asth¬ 
matic symptoms are prominent. Hot and cold applications to the spine 
are also useful in some cases. In many persons the real disease is ag¬ 
gravated by taking cold. It is superfluous to say that the greatest care 
must be exercised to avoid any aggravation of this sort. 



Fig-. 307. A magnified portion of Lung affected by Emphysema. 
a. Greatly dilated air-cells; b. Cells of natural size (Bennett). 


EMPHYSEMA. 

SYMPTOMS.—Weak cough; frothy or heavy yellow expectoration; shortness of 
breath on making any exertion; voice weak; complexion dusky or bluish; asthmatic 
attacks; weak pulse; digestion slow; bowels constipated; chest barrel-shaped; slight 
chest movement in breathing; symptoms of bronchitis. 

Pulmonary emphysema consists in an enlargement of the air-cells. 
In consequence of the abnormal thinning of the walls of the cells, 
many capillary vessels become atrophied, so that the blood is not suf- 





EMPHYSEMA. 


1007 


ficiently aerated, and the system receives an insufficient supply of oxy¬ 
gen. This difficulty is greatly increased by the inability of the lungs 
to empty themselves, a portion of the impure air charged with car¬ 
bonic acid gas remaining in the dilated cells, thus preventing the 
proper purification of the blood. It is the accumulation of this poison 
in the blood that occasions the blueness of the skin of the face and 
other parts. The obstruction to the circulation of blood through the 
lungs occasions* congestion of the stomach, liver, and other abdominal 
organs. Hemorrhoids result in some cases. Out of these remote ef¬ 
fects of the affection grow many of the most serious results which ac¬ 
company its long continuance. The condition of the lungs in this dis¬ 
ease is shown in Fig. 307. 

The causes of emphysema are pleurisy, producing adhesions; 
chronic bronchial catarrh, or bronchitis ; violent coughing, as in whoop¬ 
ing-cough and dry bronchial catarrh; lifting heavy weights; playing 
upon wind instruments in an injudicious manner, and similar causes. 

Treatment. —If the disease is the result of, or is accompanied by, 
bronchial catarrh, this must receive such treatment as has been already 



Fig - . 308. Dobell's Residual Air-Pump, for use in Emphysema. 


prescribed for that disease. The patient must avoid exposure to cold. 
A uniform temperature is very necessary, as emphysematous patients 
take cold very easily. Flannel should be worn constantly. Warm 
packs, water and vapor baths are of great utility. Massage and in¬ 
unction are also very useful remedies. To relieve the asthma which 
accompanies this disease, the use of the pneumatic apparatus is of 
greatest service. (See Fig. 217.) This is also the most serviceable of all 
means of treatment for effecting a radical cure in the few cases in 
which this can be accomplished. By causing the patient to breathe 
into rarefied air, the distended air-cells can be emptied of their con¬ 
tents, and somewhat contracted. By a continued daily use of this 
remedy, more has been accomplished than by any other means. This 





1008 


DISEASES AND THEIR TREATMENT. 


treatment is employed very extensively in France and Germany, and 
has lately been introduced into this country. Some months ago we 
had an apparatus constructed for the purpose of administering the 
pneumatic treatment, and the results obtained have been thus far very 

satisfactory. In Fig. 308 is shown a 
form of respirator so constructed that 
the same effect obtained by exhalation 
into rarefied air with the pneumatic ap¬ 
paratus can be obtained in very small 
degree. Patients suffering with emphy¬ 
sema should avoid coughing as much as 
possible, as it aggravates the disease. 
They should also wear some form of 
respirator whenever exposed to cool air. 
See Fig. 309. The diet is of great im¬ 
portance. All kinds of food which have 
a tendency to form gas (See flatulent 
dyspepsia pp. 933, 939) must be care¬ 
fully avoided. Fats, sugar, and every¬ 
thing clogging to the liver must be carefully avoided also. Most 
patients will be decidedly benefited by restriction to two meals a day. 

COLLAPSE OF LUNGS. 

SYMPTOMS.—Shallow breathing; shortness of breath ; blueness of the countenance, 
due to deficient aeration of the blood; in chronic cases the pulse becomes small, com¬ 
plexion pale, urine scanty. 

Most frequent in newly .born children. In adults is most often 
the result of capillary bronchitis, measles, disease of the heart, dropsy 
of the chest or abdomen, air in the chest or pneumo-thorax, and nar¬ 
rowing of the chest by deformities of the spine. Compression of the 
lungs, causing collapse, is the cause of shortness of breath in hunch¬ 
backs and the usual early death of such persons. 

Treatment. —With the exception of cases of very young children, 
this affection can be intelligently managed only by treating the dis¬ 
ease of which it is the result. The treatment required in most cases 
is the same as that recommended for capillary bronchitis. In cases of 
compression from dropsy, tapping, or removal of the fluid by aspira¬ 
tion, is generally required. The treatment of collapse of the lungs in 
infants is described in the section on diseases of children. 



Fig. 309 . Kespirator. 


CONGESTION OF THE LUNGS. 


100 !) 


CONGESTION OP THE ECNGS. 

SYMPTOMS.—Fullness or constriction of the chest; shortness of breath ; dry, hack¬ 
ing cough, sometimes accompanied with frothy expectoration, occasionally streaked with 
blood; in severe cases, great difficulty in breathing; very rapid respiratory efforts, 
choking sensation, cough, with copious expectoration of bloody, frothy sputum ; face red 
at first, grows paler as patient becomes exhausted, drowsy, and finally dies, if not relieved. 
In passive congestion, greater shortness of breath, especially on exercising. 

This is a very common affection, though not often recognized as a 
distinct disease. Mild cases are considered—and correctly in many 
cases—to be incipient consumption, and severe ones are called pul¬ 
monary apoplexy. There are two forms of the disease: 1. Active 
congestion, in which too much blood circulates through the lungs, and 
2. Passive congestion, in which there is too much blood retained in the 
lungs from some obstruction to the pulmonary circulation. The symp¬ 
toms of the two diseases are very similar, it being sometimes impossi¬ 
ble to distinguish between them in an individual case, except by ob¬ 
serving the causes and inducing circumstances. 

Causes. —The causes of active congestion are as follows: 1. In¬ 
creased action of the heart, most often noticed in young persons, par¬ 
ticularly about the age of puberty, and in narrow chested young per¬ 
sons troubled with palpitation of the heart. This may be induced by 
excessive exercise, the use of tea, coffee, alcoholic drinks, smoking, and 
great mental excitement of any sort, as from rage, delirium, etc. There 
is good reason for believing that this condition in young persons leads 
to pulmonary consumption when not corrected. It may often be con¬ 
sidered, indeed, as the incipient stage of that disease. 2. Exposure of 
the lungs to cold air. 3. Rarefying of the air in the lungs, as in croup, 
•k Disease which disables some part of the lungs, as pneumonia or 
pneumo-thorax. The chief causes of passive congestion are, 1. Or¬ 
ganic disease of the heart, particularly disease affecting the valves of 
the left side. 2. Feebleness of the heart from general debility, fever, 
fatty degeneration, or any other cause. This form is very likely to 
occur in cases of protracted fever when the patient lies long upon the 
back, from settling of the blood in the lower part of the lungs. 

Treatment. —Forbid all kinds of foods and drinks of a stimulating- 
character, especially in that form of active congestion seen in narrow- 
chested young persons, and which is very likely to result in consumption. 
Tea, coffee and hot drinks of all kinds, as well as all kinds of alcoholic 
drinks, stimulating condiments, flesh diet, and indeed, everything of an 

G4 


1010 


DISEASES AND THEIR TREATMENT. 


exciting nature must be strictly avoided. The diet should consist chiefly 
of fruits and grains. Milk may be used freely in place of meat and 
eggs. The “ grape cure ” practiced at Meran on Lake Geneva in Swit¬ 
zerland, is wonderfully successful. The patient lives on grapes, eating 
several pounds a day. The milk and whey cure are also practiced suc¬ 
cessfully in these cases. In the cases of violent congestion usually 
termed pulmonary apoplexy, the usual remedy is bleeding. We have 
treated a number of cases of this disease without this measure, however, 
and with such excellent results as warrant the assertion that it is not 
required. In one case in w T hich the patient expected to die any moment, 
and was expectorating large quantities of bloody, frothy sputum, the 
heart beating very violently, almost instantaneous relief was obtained by 
the use of faradization, the positive pole being applied at the base of the 
brain and the negative over the lungs. The same patient was relieved 
in a similar manner in several subsequent attacks. In other cases, the 
warm full bath has been equally effective, relieving the lungs by attract¬ 
ing the blood to the surface. To prevent congestion arising from long 
illness with confinement in bed, change the position of the patient often, 
and thus prevent settling of the blood in dependent parts of the lungs. 
In congestion arising from pneumonia or other disease of the opposite 
lung, relief will be obtained only by cure of the primary disea.se. For¬ 
tunately, the same remedies that relieve the one, also affect favorably 
the other. Bleeding, especially in such cases as these, is an almost fatal 
mistake, since it will only temporarily relieve the urgent symptoms, 
and will certainly aggravate the main disease. The same remark applies 
with still greater force to congestion arising from disease of the heart. 
In these cases, great care should be taken to warm the extremities and in 
every possible way promote the circulation in the surface. Fomenta¬ 
tions to the chest, applied as hot as can be borne for a short time, and 
ice-compresses between the shoulders, is an excellent measure which al¬ 
most always gives relief. If amelioration of the symptoms is not other¬ 
wise obtained, we may relieve the lungs by the use of Junod’s boot; or, 
in the absence of this, by tying a ligature around one or both limbs near 
the body with sufficient tightness to obstruct the venous circulation and 
cause an accumulation of blood in the limbs. This measure is really 
equivalent to the abstraction of a considerable quantity of blood, with¬ 
out the dangers of the latter measure. The ligatures should not be kept 
in place so long as to injure the ligated parts, and should be gradually 
loosened as soon as the lun^s are relieved. 

O 


HEMORRHAGE FROM THE LUNGS. 


1011 


HEMORRHAGE OF THE LITGS.-IITMOPTYSIS. 

SYMPTOMS.—Blood frothy and coughed up in mouthfuls; blood mingled with phlegm 
or mucus ;• blood bright red and fluid, no clots. 

The following comparative table of symptoms shows very clearly 
the difference between hemorrhage from the lungs and bleeding from 

o O o 

the stomach, conditions which are often confounded:— 


BLEEDING FROM THE LUNGS. 

Difficult breathing. 

Pain or heat in the chest. 

Blood frothy. 

Blood of bright red color. 

Blood mingled with phlegm. 

No clots. 

Blood coughed up in mouthfuls. 
Symptoms relating to the chest. 


BLEEDING FROM THE STOMACH. 
Nausea. 

Tenderness at pit of stomach. 

Blood not frothy. 

Blood of dark color. 

Blood mixed with food. 

Clots always present. 

Blood vomited freely. 

Symptoms relating to the stomach. 


The chief causes of hemorrhage from the lungs are congestion of the 
lungs, or disease which weakens the walls of the small blood-vessels. 
Undoubtedly the latter cause is the most common one. Pulmonary hem¬ 
orrhage occurs most frequently in persons suffering with consumption, 
■either in its incipient or its advanced stages. Bleeding at the lungs must 
not, however, be taken as positive evidence of the existence of tubercular 
disease, since many cases are observed in which even a severe hemorrhage 
from the lungs is not followed by any other symptoms of disease of the 
lungs, the patient enjoying perfect health for many years. There is 
good evidence for believing that hemorrhage from the lungs is a cause 
of consumption, the retained blood giving rise to inflammation, which is 
followed by breaking down of the lung. Hemorrhage of the lungs oc¬ 
curs with considerable frequency in person.^ of a scrofulous or tubercu¬ 
lous tendency who seem to be in perfect health ; in these cases it is justly 
regarded as a very ominous indication, and one which demands prompt 
and vigorous attention. 

The bleeding generally occurs from the rupture of a capillary vessel 
in the mucous membrane of the bronchial tubes, but occasionally in the 
deeper tissues of the lungs. Death from hemorrhage occurs much more 
rarely than is generally supposed, even in cases of severe tubercular dis¬ 
ease. In fact, some eminent physicians maintain that consumptive pa¬ 
tients who have occasional hemorrhages succumb to the disease less rap- 



1012 


DISEASES AND THEIR TREATMENT 


idly than those who do not suffer with hemorrhage at all. Many con¬ 
sumptives express themselves as feeling relieved after a slight hemor¬ 
rhage, probably owing to the temporary relief of congestion. In cases 
in which there is very profuse hemorrhage which cannot be controlled 
by treatment, the bleeding is usually caused by the rupture of a vessel 
of large size. The expectoration of small quantities of blood, in the form 
of small streaks or specks in mucus or phlegm, is a symptom of little or 
no importance. In these cases the source of the slight bleeding is gen¬ 
erally in the throat. In some cases, clots of blood collect in the throat 
at night from slight hemorrhage from the nose. 

Treatment. —Rest in 
bed with the head and 
shoulders elevated. Men¬ 
tal and physical quiet. 
Restrain cough as much 
as possible, as it greatly 
aggravates the hemor- 
rhage. Give patient iced- 
water to drink and small 
bits of ice to swallow. 
Apply ice compresses over 
chest, and every fifteen 
minutes make hot ap¬ 
plications between the 
shoulders by means of hot 
bricks, fomentations, or hot bags. Take care to keep the trunk and 
limbs dry, and apply heat to the extremities. Frozen compresses may 
be applied thus: Mix, in an ordinary large milk-pan, equal parts of 
pounded ice and salt at least two inches deep. Mix quickly and cover. 
Place the pan upon a compress of cotton or linen of four or five thick¬ 
nesses wrung out of iced-water as dry as possible. In a few seconds the 
compress will be frozen. Apply at once, and cover with a dry flannel 
A good means of applying continuous cold is by means of the syphon 
syringe, as shown in Fig. 310. The upper vessel is filled with water 
containing two or three pounds of salt to the gallon, and a quantity of 
ice. The current of the ice-cold mixture is started by means of the tabs 
upon the sides of the bag, the stop-cock on the lower tube being closed. 
When the bag is sufficiently full, the stop-cock is opened sufficient¬ 
ly to allow the fluid in the bag to pass out at the same rate that it 



Fig. 310. Applying cold to chest for hemorrhage of lungs. 








































PULMONARY APOPLEXY. 


1013 


runs in When the water has nearly run out of the upper vessel, that 
which has run into the lower vessel should be put into the upper one 
and a new supply of ice, or ice and salt, added. By this means an in¬ 
tense degree of cold may be kept up for hours without wetting the pa¬ 
tient or giving him any inconvenience whatever. Good results are also 
obtained by employing cold enemas. The temperature should be as low 
as the patient will bear. It is customary to add a little vinegar to the 
rectal injections, though we think the addition is unnecessary. Com¬ 
mon salt is a remedy popularly reputed to be of value in these cases. 
The usual dose is a teaspoonful of finely-powdered salt taken dry. The 
most useful internal remedy, however, is the inhalation of a solution of 
alum or tannin. The proportion should be 5-10 grs. to the ounce of 
water, and the solution should be inhaled by means of an atomizer. 
Junod’s boot (Fig. 219) and ligation of the limbs are remedies of value 
in hemorrhage from the lungs as well as in congestion. The diet should 
be the same as directed for congestion, meat, stimulants, hot drinks, and 
stimulating condiments being carefully avoided. Little food should be 
taken during the attack, and for a day or two after. The patient’s mind 
should be quieted by the assurance that, in all probability, he will re¬ 
cover, and it may even be suggested to him that the effect of the hem¬ 
orrhage may be beneficial. We have never failed to relieve cases of 
hemorrhage by the employment of this plan of treatment. 

PUIMOJIiRY APOPLEXY. 

SYMPTOMS.—Violent hemorrhage from the lungs; or suffocation, due to filling of the 
lungs with blood; or sudden death from internal hemorrhage. In less severe cases the 
chief symptoms are sudden difficulty in breathing; cough with expectoration tinged with 
blood; symptoms of pneumonia or pleurisy; in cases of heart disease, sudden irregular¬ 
ity of the pulse. 

This serious affection is the result of the obstruction of a blood¬ 
vessel in the lungs, which may arise in consequence of disease of the 
heart or some other affection which gives rise to clots or small portions 
of tissue in the circulation. The disease is somewhat obscure, and is 
sometimes difficult of detection. It is easily mistaken for pneumonia, 
of which it is sometimes the cause. 

Treatment. —Elevate the head and shoulders of the patient. Ap¬ 
ply warmth to the extremities. If there is much bleeding, employ the 
remedies recommended for hemorrhage from the lungs. If the case is 
a severe one, so that the blood flows faster than it can be expectorated, 
it will of course prove speedily fatal. 


1014 


DISEASES AXD THEIR TREATMENT. 


INFLAMMATION OF THE LUNGS.—PNEUMONIA. 

There are three forms of pneumonia, croupous, catarrhal, and 
chronic. We will first call attention to 

CROUPOUS PNEUMONIA. 

SYMPTOMS.—Marked chill, followed by fever which rises often very high, even on 
first day; headache; shortness of breath, patient breathing thirty to fifty times a minute 
instead of sixteen to twenty times ; pain in chest, at the seat of the disease, of a piercing 
or stabbing character; short, ringing cough; expectoration of rust-colored mucus, which 
is very tough and tenacious; careful examination of sputa shows casts of small tubes; 
pulse rapid, ninety to one hundred and fifty; sometimes jaundice; redness of cheek upon 
the affected side; eruption upon the lips; crackling sound heard upon placing ear to af¬ 
fected side. 

The above-named symptoms generally follow one another in suc¬ 
cession, with exception of the high pulse, which is present all through 
the disease. They are sometimes separated into three groups, known 
as the three stages of the disease. 1. Engorgement. In this stage 
the affected part of the lung is intensely congested with blood, and 
the air-passages contain a viscid mucus which glues together the walls 
of the small bronchial tubes, producing a crackling sound when the 
patient takes a deep breath, which can be easily heard by listening at 
the point of pain. The latter symptom is always present in this stage, 
except in very old persons, in whom it is sometimes absent. It is sim¬ 
ilar to the pain of pleurisy, which is also present at this stage, the cov¬ 
ering of the affected portion of the lung participating in the inflam¬ 
mation. 2. Hepatization. In this stage the air-cells are filled with a 
tenacious exudation, which causes the chest to lose its natural resonance. 
When percussed, the sound obtained is flat or dull. 3. Resolution or 
purulent infiltration. At this stage, the matter in the air-cells is 
usually liquefied and absorbed—not expectorated as many suppose. 
In case absorption does not occur, suppuration sometimes takes place, 
often extending to the lung, even forming cavities of greater or lesser 
size. In other cases, the lung remains solidified, and the patient suf¬ 
fers with chronic pneumonia, or consumption. 

Pneumonia sometimes occurs as a complication of typhoid fever 
and other acute diseases. It is also sometimes attended by acute 
catarrh of the stomach and bowels. It is not a very fatal disease in 
young and healthy subjects, but in weak children, in old persons, and 
in habitual drinkers, it is a very fatal malady. 


CROUPOUS PNEUMONIA. 


1015 


Causes. —The exciting causes of the disease are not well under¬ 
stood. It is generally attributed to “ taking coldbut there is some 
doubt whether this is an important cause of the disease. From an 
extended study of the subject, Dr. H. B. Baker, Secretary of the State 
Board of Health of Michigan, has ascertained that pneumonia is most 
frequent when the temperature and amount of moisture in the air is 
low, and the amount and force of wind and the proportion of ozone is 
high. This conclusion he has reached by a comparison of the weekly 
reports of diseases made to the Board of Health, by its numerous cor¬ 
respondents, with the daily records of the various meteorological ob¬ 
servers in various parts of the State. While this kind of investiga¬ 
tion is still in its infancy, the results which have already been ob¬ 
tained are exceedingly interesting, and may probably be considered as 
reliable. Pneumonia occurs at all periods of life, but is most frequent 
in males and in aged and feeble persons. 

Treatment. —The old-fashioned routine treatment of blood-letting, 
is now, fortunately, pretty much out of date. The study of the nat¬ 
ural history of the disease has recently shown that the great majority 
of cases of this disease recover with no active treatment, or no treat¬ 
ment other than simple nursing. It has also been observed, and is 
acknowledged, that patients who are bled are, as a general rule, much 
less likely to live than those who are not bled, where bleeding is gen¬ 
erally practiced. The greatest immediate danger in this disease is the 
depressing influence of the excessive heat upon the heart; hence in this, 
as in most other acute diseases characterized by high fever, the most 
important measures of treatment are those which will reduce the fever. 
Of these, the cool bath, the graduated bath, the sponge bath, the wet- 
sheet pack, and the cold enema are the most effective. Cool com¬ 
presses alternated at intervals of two or three hours by hot fomenta¬ 
tions for five or ten minutes should be applied to the chest, particu¬ 
larly to the affected side, the seat of pain. The hot fomentations re¬ 
lieve the pain, and the cold compresses check the diseased process. 
The compresses should be wrung out of cold water and changed every 
five to eight minutes, or as often as they become warm. Although 
the cool compresses are not usually liked by the patient, they will 
soon give relief if their use is continued, and they do much toward 
shortening the course of the disease. Care should be taken to keep 
the patient’s body from being wet except where the treatment is ap¬ 
plied. The cold compress is much used in the large hospitals of Ger- 


1016 


DISEASES AND THEIR TREATMENT. 


many. In the great hospital at Prague, it is considered the main reli¬ 
ance in the treatment of this grave malady. We have used it in con¬ 
junction with other measures of treatment in many cases with marked 
success. When the pulse becomes as rapid as ninety-five to one hun¬ 
dred and ten, or more, cool sponging, the wet-sheet pack, the cool full 
bath, or the cool enema should be employed. In ordinary cases an}’ 
one of the first three measures mentioned is usually sufficient, if re¬ 
peated with proper frequency. When much chilliness is produced by 
the contact of water with the skin, the cold enema is a most admir¬ 
ably useful measure. It will control the high temperature when other 
measures fail to accomplish the desired result in many cases. The 
amount of water required is half a pint to a pint. The temperature 
may be forty to sixty degrees. The colder the water, and the larger 
the quantity employed, the greater and more prolonged will be the 
effect. We consider this one of the most important of all. the recent 
advances in the use of water. Next in importance to the use of water 
in this disease, is the employment of fresh air. The apartment should 
be kept as cool as possible without discomfort, and an abundance of 
fresh air should be continually supplied. Drafts should be avoided; 
but it is better to have fresh air with drafts, than to sacrifice the pure 
air for fear of drafts. In case water cannot be applied, the patient may 
be exposed with the surface unprotected to the cooling effects of the 
air. It is even admissible to expose the wet surface of the body to 
the air, allowing the patient to be cooled by evaporation. The danger 
of taking cold in this disease is by no means so great as supposed. It 
is wholly unnecessary and is exceedingly harmful to cover the patient 
with many blankets under the mistaken notion that he must be kept 
at a sweltering heat to prevent him from having a relapse or an ex¬ 
tension of the disease. 

The diet of the patient should consist of milk, oatmeal gruel, ripe 
fruit, and similar easily digested food. No meat, eggs, or other stim¬ 
ulating food should be allowed. 

The most active symptoms do not usually continue more than 
three or four days. Improvement then usually begins. This process 
may be greatly encouraged by the use of alternate hot and cold com¬ 
presses applied three or four times a day. It is also well to have the 
patient wear a warm wet compress over the chest at night for the pur¬ 
pose of stimulating absorption. 


CATARRHAL PNEUMONIA. 


1017 


CATARRIIAL OR LOBULAR P^'EUMOA'IA. 

SYMPTOMS — High fever; short, harsh, painful, hacking cough ; other symptoms of 
croupous pneumonia; occurs most often in children as a complication of measles or 
whooping-cough. 

This affection seldom occurs as a primary disease. It is most fre¬ 
quent subsequent to capillary bronchitis, the bronchitis of measles, and 
whooping-cough. When the peculiar cough of the latter disease is sud¬ 
denly displaced by a short, hacking, painful cough, there is ground for 
suspecting this disease. The dullness present is found usually at the 
back, forming a narrow strip on each side of the spine, instead of being 
confined to the lung as in ordinary pneumonia. 

Treatment. —The treatment of this affection is essentially the same 
as that already described for croupous pneumonia. Cool compresses to 
the chest are especially to be recommended as among the most useful 
measures. According to Bartels and Ziemssen, both very eminent Ger¬ 
man authorities, cool compresses are “ by far the most efficient mode of 
treatment.” In children, in whom the disease is by far most frequent, 
the wet-sheet pack and the blanket pack are very useful. 

CHROMC P^EUjJIOSIA. 

SYMPTOMS. — Cough ; evidences of bronchial irritation ; sinking in of the chest wall 
upon the affected side. 

This is a rare disease. It occurs most often after pneumonia, and 
accompanies many cases of consumption, causing the well-known and 
very characteristic sinking in of .the upper part of the chest wall, par¬ 
ticularly just below the clavicle. 

Treatment. —Nothing can be done to cure the disease itself, as it 
consists in a hardening and contraction of the tissues of the lung, which 
cannot be overcome by any known method of treatment. The best of 
all remedies is the inhalation of hot vapor of water by means of a steam 
inhaler. Either pure water may be used, or water to which ten drops 
of tincture of Benzoin to the ounce has been added. 

CONSUMPTION. 

SYMPTOMS— Loss of appetite; emaciation; debility; malaise; frequent breathing; 
shortness of breath on slight exercise ; pain m chest and shoulders ; prickling, heat, and 
pain beneath the sternum; cough; hoarseness; expectoration of frothy mucus, rusty 
sputum, or mucus streaked with yellow ; fever, highest in afternoon ; chill or chilliness 
in morning or forenoon; night sweats; pointed nose, from emaciation, with motion of 


1018 


DISEASES AND THEIR TREATMENT. 


nostrils at each breath; incurved nails; narrow chest, sunken beneath the collar bones ; 
usually dullness of affected portion of lung when percussed; irregular or jerky respira¬ 
tion ; rales and other abnormal sounds heard by examination with the ear; hemorrhage. 

This is one of the most formidable of all the maladies from which 
the human family suffers, being the direct cause of more than one 
fifth of the deaths from all diseases combined. Notwithstanding the 
great interest which has always been taken in the study of this disease, 
it has not until recently been well understood, and even now presents 
many difficult problems. The symptoms above mentioned do not all oc¬ 
cur in the same patient, as individual cases are seldom quite alike, but 
all belong to the disease, and any of them may occur in any case dur¬ 
ing the course of the disease. The disease usually begins insidiously, 
and progresses steadily to its termination, though not infrequently the 
patient will, at times, seem to improve very much, the disease seeming 
to be held in check. The rapidity of the progress of the disease depends 
much upon the temperament of the individual, his hereditary or ac¬ 
quired tendencies, and the particular conditions under which he is placed. 
The two sexes suffer with about equal frequency. The periods of life 
most subject to the disease are infancy to seven years, and twenty to 
thirty years of age. 

Owing to the extreme frequency of the disease, we ought, perhaps, 
to sketch the progress of the malady with somewhat greater definiteness. 
Its cause, as remarked, is different in different individuals ; but there are 
three principal types of the disease which may be definitely described. 
One patient has an attack of pneumonia ; it may be of the ordinary 
croupous form, or it may be of the catarrhal variety. Instead of recov¬ 
ering in a few days as is usually the case, he does not regain his usual 
strength, and continues to suffer with a slight cough and some shortness 
of breath. By degrees the cough increases, all the other symptoms be¬ 
come more aggravated, and the affected lung begins to break down, as 
shown by the character of the expectoration, which becomes yellowish, or 
streaked with yellow, and when cavities have formed, is coughed up in 
round, grayish masses which preserve their form. After the cough be¬ 
comes severe, hemorrhages are also likely to occur, which, if very fre¬ 
quent, rapidly exhaust the patient’s strength, although death seldom re¬ 
sults directly from the loss of blood. 

Another patient takes a severe cold in the fall, from which he does 
not entirely recover before spring. The next fall he takes a more severe 
cold, which lasts well into the summer. The following winter he con- 


CONSUMPTION. 


1019 


tracts a still more obstinate catarrh of the bronchial tubes, from which 
he does not become entirely rid during the summer, and which is aug¬ 
mented by a fresh cold the following whiter. Thus the disease which 
was at first a simple acute catarrh, becomes chronic catarrh, and soon, 
by extension into the small bronchial tubes and air-cells, real consump¬ 
tion is occasioned. The cough continues, the fever rises, the expectora¬ 
tion becomes more abundant and purulent, the appetite fails, emaciation 
comes on, hemorrhage occurs, and the patient rapidly declines. 

Still another patient has neither cough nor expectoration at the start, 
simply feeling weak and “ good for nothing,” gradually losing strength 
and flesh. Perhaps he is first startled about his condition by a hemor¬ 
rhage from the lungs. Soon cough and frothy expectoration begin, and 
the patient fails rapidly. This is a case of primary tuberculosis. Less 
than an hour ago we examined two cases of pulmonary disease, one that 
of a man in the prime of life, the other that of a young lady, both of 
which gave essentially the above history. 

The disease is sometimes divided into stages ; but as it is impossible to 
discriminate closely between the three stages described, the classification 
is of no practical value. The disease begins with a consolidation of the 
lung tissue, a catarrh of the smallest bronchial tubes, or deposit of tu¬ 
bercles. After a time, there is a breaking down of the lung tissue from 
the destructive changes which occur in consequence of the morbid pro¬ 
cess, and cavities are formed. The matter expectorated, if examined un¬ 
der a microscope, shows the presence of portions of lung tissue. It is pos¬ 
sible, by physical examination, to determine whether or not a cavity is 
present. The course and progress of these destructive changes are ex¬ 
actly indicated by the intensity of the fever. When it rises high, the 
disease progresses rapidly, and when it is checked the disease is controlled. 
In some cases the destructive process is prolonged through years. In 
others, it is completed in a few weeks or months. 

Causes. —The following may be mentioned as the most clearly 
traceable causes of consumption :— 

1. Impure A ir .—The health of the lungs depends more upon pu¬ 
rity of the atmosphere than upon any other cause. There are numerous 
impurities to which the air is subject, but the most potent of them all in 
the production of consumption is what is known as the organic matter 
of the breath. This is always present in air which has been contam¬ 
inated by the products of respiration, hence is found in abundance in the 
air of churches, lecture halls, school rooms, and other places where large 


1020 


DISEASES AND THEIR TREATMENT. 


numbers of people congregate, as well as in most dwelling houses during 
the cold season of the year, when dwellings and other buildings are 
very seldom sufficiently ventilated. Some of our most eminent sanitary 
authorities assert that this organic matter is the most important of all 
the causes of consumption. The inhalation of dust is another active 
cause, the effect being to produce local irritation which gradually in¬ 
creases and extends more and more deeply into the air-tubes until the 
air-cells become involved. This cause is particularly active upon those 
engaged in the trades of stone-cutting, file-grinding, wool-carding, cigar¬ 
making, and other dusty occupations. 

2. Improper Diet .—Errors in diet, particularly the use of food of an 
innutritious character or deficient in the elements of nutrition, and an in¬ 
sufficient supply of food, are very productive of conditions of the system 
which in the highest degree favor the occurrence of consumption. 
Young ladies who attempt to live on bread and butter and pickles, and 
older ones who make white bread and strong tea their staple articles of 
diet, are the favorite victims of this disease. The idea has been ad¬ 
vanced that the use of an exclusively vegetable diet is productive of con¬ 
sumption, but no substantial evidence has been presented in favor of this 
view, and it can be clearly shown by irrefragable evidence that this is 
not the case. Indeed we have seen persons recover from the disease in 
its third stage when subsisting upon an almost exclusively vegetable diet. 
Vegetable food will sustain life well under all conditions, in health as 
well as disease, provided it is well digested and thus made into pure and 
healthy blood. 

3. “Taking Cold !’—A large number of those who suffer with this 
disease date the beginning of their disease from “ taking cold ” at some 
time. This cause is seldom looked upon with that degree of seriousness 
which it really deserves. A cold is thought to be so trivial that it hardly 
requires medical attention at all, and thus many acute catarrhs which are 
in themselves trivial, lay the foundation for this more formidable malady. 
A cold should never be neglected. Drinking large draughts of cold 
water when the body is overheated by exercise has been pointed out by 
some as a cause of consumption, and there are reasons for believing that 
this may be the case. The practice is certainly a very pernicious one, 
often occasioning a great shock to the system, fully as much as is pro¬ 
duced by exposure of the surface of the body to cold air. 

4. Tight Lacing .—This absurd and not yet obsolete custom has 
contributed a large proportion of the victims to this disease. By 


CONSUMPTION. 


1021 


constriction of the chest, some portions of the lungs are rendered inactive, 
and these inactive parts are thus rendered unnaturally liable to this 
disease. 

5. Contagium .—Another most important cause of this terrible mal¬ 
ady is contagium. Within a few years it has been shown beyond chance 
for reasonable doubt that consumption is a communicable disease. It 
has been proven that the disease may be communicated through eating 
the flesh of tuberculous animals, and also by the use of the milk of con¬ 
sumptive cows. Furthermore, there is strong evidence that the disease 
may be communicated through respiration by breathing infectious parti¬ 
cles exhaled by a consumptive person or animal. The danger is of 
course the more imminent the more closely confined the healthy person 
may be with the individual suffering with the disease, and the less at¬ 
tention is paid to ventilation. Numerous cases might be cited in which 
a kind relative or an attentive nurse has very closely followed a friend 
to a consumptive’s grave. The probability is very strong that conta¬ 
gion, especially through the medium of consumptive animals, is really 
one of the most widely acting and active causes of this terrible malady. 

The English medical journals are devoting considerable attention 
to the subject of consumption in cows and other animals. The Brit¬ 
ish Medical Journal calls attention to the late report of Mr. Law, of 
Cornell University, to the National Board of Health, quoting from 
the report as follows:— 

“ Phthisical cows are often eaten without causing obvious disease 
in the consumers. I have known large dairies of tuberculous cows 
in the hands of vigorous and healthy looking owners, who consumed 
the milk freely. It may be freely concluded that a large number of 
individuals, while in the enjoyment of robust health will withstand 
the influence of tubercle taken in by the stomach ; but it must be 
otherwise with the weak and young, those with poor feeding and 
worse air, those living in damp, sunless localities, and subjected to 
much exposure. In a case that recently came under my notice in 
Brooklyn, N. Y., a family cow was found in an advanced state of 
tuberculosis, and the owner and his wife were evidently rapidly sink¬ 
ing under the same malady. In another case reported to me, a fam¬ 
ily cow, supposed to be suffering from lung-plague, was found to be 
afflicted with tuberculosis instead, and the owner’s wife (a consump¬ 
tive), who had been making free use of the milk, warm from the cow, 
was persuaded to give it up, and underwent an immediate and decided 


1022 


DISEASES AND THEIR TREATMENT. 


improvement. It is for infants and adults who are somewhat infirm 
or out of health, or whose surroundings are not of the most salubrious 
kind, that the danger is greatest; but this embraces such an extended 
class that the moral interests involved are almost illimitable. The 
destruction of infancy and wasting of manhood from this cause is un¬ 
questionably far greater than has hitherto been realized.” 

Notwithstanding the opinion of Prof. Law that the milk and flesh 
of consumptive cows may be eaten by robust persons without injury, 
it is evident that there is at least a possibility that even the well may 
be affected, and where there is a hereditary tendency to consumption, 
the possibility will undoubtedly become a probability. Again, while 
a person might successfully resist the infection when in health, a sud¬ 
den temporary indisposition, even that from a simple cold, might be 
sufficient to make him susceptible to, and entail upon him, a fatal 
malady. We agree with Mr. Law in thinking that- this danger is far 
greater than is generally realized, and the present prospect is that the 
danger will increase rather than diminish. 

6. Sexual Excesses. —Self-abuse and excessive venery are undoubt¬ 
edly most powerful acting causes of pulmonary consumption. The en¬ 
ervating effects of these vices are felt by every organ in the body and 
not more by any other organ than by the lungs. We have seen many 
cases of consumption among young persons in which the disease could 
be directly traced to secret vice; and in a number of instances we 
have met cases in which the evidence was too strong to be mistaken 
that excessive sexual indulgence with the opposite sex was the real 
foundation of the disease. This should be borne in mind by persons 
suffering with this affection, as in many cases the sexual desires are 
not abated even though the disease may have reached an advanced 
stage, although their gratification is in the highest degree detrimental 
to the prospects of recovery. 

7. Foreign Bodies .—Certain trades, such as stone-cutting, file¬ 
grinding, wool-carding, cigar-making, manufacturing of hats, and 
other occupations productive of much dust, which the workmen are 
obliged to inhale, are exceedingly productive of disease of the lungs. 
The fine particles which are received into the lungs produce, first, 
simply a slight irritation which results in congestion, and finally set¬ 
tled catarrh, which, gradually working down into the fine air-tubes of 
the lungs, at last involves the air-cells and gives rise to morbid pro¬ 
cesses the final result of which is consumption. We have met a num- 


CONSUMPTION. 


1023 


// 

ber of cases in which the disease originated in this way. Fig. 311 
illustrates the microscopical appearance of a small portion of the lung 
of a person who died of consumption which resulted from the inhala¬ 
tion of charcoal dust. 



Tig. 311. 


It will be observed that the lung tissues are so completely filled 
with the fine particles of charcoal that the lung has become almost as 
black as the charcoal itself. In cases in which persons have become 
consumptive by the inhalation of fine particles of stone while work¬ 
ing at the trade of stone-cutting, the lung frequently contains so large 
a quantity of stony particles as to have a gritty feeling, and resist the 
edge of a knife. The deposits of blood in the lungs are the result of 
hemorrhage, another cause which should be mentioned. It is gener¬ 
ally supposed that hemorrhage from the lungs is positive proof of the 
existence of consumption. This is a mistake, however, as it not infre¬ 
quently happens that the hemorrhage is itself the cause of the disease 
rather than the result; * portions of blood left in the lungs undergo a 
kind of degeneration, which soon results in the formation of tuber¬ 
cles, and finally in the breaking down of the lungs and the formation 
of cavities. 

8. Various Diseases .—From the examination and study of several 
hundred cases of lung disease within the last ten years, we have be¬ 
come satisfied that consumption is a primary disease in but a small 
proportion of cases. In a majority of consumptive persons whom we 
have met, history has showed very clearly that the system was first 



1024 


DISEASES AND THEIR TREATMENT. 


weakened and debilitated by some other affection before the pulmon¬ 
ary difficulty manifested itself. We have become fully convinced that 
dyspepsia is a very common cause of consumption. Through impair¬ 
ment of the digestion, the blood becomes of poor quality, the patient 
loses flesh and strength, and his power to resist the causes of disease 
becomes so susceptible that slight things which in health would not 
have affected him at all are sufficient to lay the foundation for a fatal 
malady. A great majority of persons who suffer from chronic diabetes 
finally die of consumption. This is also a very common termination 
for the wretched and misspent lives of syphilitic patients. Typhoid 
fever, measles, whooping-cough, chlorosis, intermittent and other ma¬ 
larial fevers, and other affections which merely debilitate the system, 
frequently terminate in consumption. 

9. Alcoholic Drinks. —Dr. Richardson has recently shown that the 
use of alcohol not only predisposes an individual to consumption but 
that it entails upon him liability to a peculiar form of the disease 
which is the direct result of alcoholic poisoning. This is particularly 
true of persons who use liquors to an immoderate degree, but it is also 
true of moderate drinkers as well. The facts demonstrated by Dr. 
Richardson furnish an unanswerable objection to the employment of 
alcoholic drinks as a preventive of consumption, for which it has been 
so highly recommended by many physicians. It also clearly interdicts 
its use as a curative remedy. 

« 

10. Tobacco .—It is well known that the use of tobacco is exceed¬ 
ingly productive of catarrh of the nose and throat, which fact alone 
is sufficient to condemn its use, if it were impossible to show that its 
deleterious effects upon the respiratory organs extended no farther 
than the organs mentioned, since it is well known that catarrh of the • 
throat very frequently extends by slow degrees into the larger and 
then to the smaller bronchial tubes, finally setting in operation the 
degenerating changes and processes which result in the destruction of 
the lungs. 

11. Depressing Mental Influences. —Long-continued grief, fear 
anxiety, disappointment, together with other depressing mental in¬ 
fluences, often result in the production of conditions of the system 
which render the individual thus suffering open to the inroads of pul¬ 
monary disease. The recognition of this fact ought to lead every in¬ 
dividual who is from any cause so situated as to be subject to depress- 


CONSUMPTION. 


1025 - 


ing influence to contend strongly against such influence rather than 
to give way to their emotions and allow themselves to become the 
prey of circumstances. Causes of this kind can be contended against 
as successfully as those of any other sort. The depression arising 
from too close confinement to mental labor, especially when it is of a 
very taxing or onerous character, operates in the same way as de¬ 
pressing influences of any other sort. 

12. Heredity .—It is very rare that the disease itself is inherited. 
The unfortunate inheritance is simply a tendency to the disease, or a 
susceptibility of constitution which increases an individual’s liability 
to the affection. There is no doubt that it is entirely possible for 
the individual whose family is consumptive in a marked degree, 
and whose inherited tendency is unmistakable, to so regulate his course 
of life as to overcome the tendency, at least in a very large degree, and 
to so fortify his constitution against this malady as to prolong his 
life to the natural limit of human longevity. 

13. Prolonged Nursing is another cause of pulmonary disease to 
which attention should be called. Many mothers have survived the 
risks and sufferings of child-birth only to die victim to the long-con¬ 
tinued drain upon their system arising from prolonging the period of 
lactation beyond its natural limit. Healthy mothers with robust con¬ 
stitutions may do this with impunity ; but a weakly woman who has 
given birth to several children in rapid succession, and whose consti¬ 
tution has been materially weakened by the excessive demands upon 
her sexual and nutritive forces, even perils her own life by the main¬ 
tenance of that of her child. We do not wish to give any counte¬ 
nance to the evil practice becoming so common, especially in large cit¬ 
ies, of employing wet nurses for the simple purpose of relieving moth¬ 
ers of the inconvenience of nursing and caring for their ow r n off-spring, 
when they are well able and qualified by nature to do so; but it often 
becomes the duty of the observing physician to urge upon a weakly 
mother the discontinuance of nursing as the only means of safety to her 
own life and possibly also of her child, to whom the insidious pulmon¬ 
ary disease might be imparted through the medium of mother’s milk. 

14. Climate .—Much has been said about the influence of climate 
as a cause of consumption; but we think that much more has been 
charged to climate than is really just. The opinion prevails that the 
inhabitants of cold climates are particularly subject to diseases of the 

G5 


1026 


DISEASES AND THE IB TREATMENT. 


lungs, especially to tuberculosis; but it has within a few years been 
clearly shown by careful observation that dwellers in cold climates are 
no more subject to the disease than the inhabitants of the tropical re¬ 
gions. In fact, some nations living at the extreme north are almost 
wholly exempt from the malady which is the greatest bane of the race 
in temperate climates. The truth in regard to this matter seems to be 
that consumption is most prevalent in countries in which the climate 
is changeable, being subject to sudden and rapid alternations of heat and 
cold. Either steady cold or moderate, continuous heat are much more 
favorable to health of the lungs than alternations of temperature. 

Treatment. —The first and most important measures of treatment 
are those which contemplate the prevention of the malady. These 
consist first, of a careful avoidance of all the known causes of the dis¬ 
ease ; and second, of the most strenuous efforts to counteract any known 
tendency to it through heredity. The infants of consumptive mothers 
should not be allowed to nurse unless a healthy wet nurse is employed. 
Children with a scrofulous or consumptive tendency should be kept in 
school but little, and should be given every opportunity for physical, 
development. When grown to adult age such persons should not en¬ 
gage in any occupation which is known to favor lung disease, but 
should make all their habits and conditions, so far as possible, tend 
toward the one object of contending against their hereditary tendency. 
In the treatment of the disease when it has developed sufficiently to be 
recognized, it is important that prompt and vigorous measures should 
be employed at once. The greater portion of the sufferers from this 
disease sacrifice their only hope for life by delay and procrastination. 
If the disease has obtained even the slightest foot-hold, there is no 
time to be lost. The principal indications to be met are ; 1. To check 
the fever; 2. To improve the patient’s nutrition; 3. To arrest the night 
sweats; 4. To alleviate the cough; 5. To develop the lungs; 6. To 
sustain and invigorate the patient in every way possible. The best 
means to be employed for the above purposes, according to the results 
which we have obtained in the treatment of hundreds of cases of this 
disease, are the following :— 

1. To Check the Fever .—If possible, prevent the chill which al¬ 
most always precedes the fever, by keeping the patient in bed until an 
hour or two after the usual time for chilling is past, placing warm jugs 
or bricks at his feet, so as to keep him warm, but taking care not to 
induce perspiration if it can be avoided. When the patient suffers 


CONSUMPTION. 


1027 


with no well-defined chill, but has wandering and irregular sensations 
of chilliness, this plan cannot be adopted; but the patient should 
remain quiet in bed during the early part of the day, and if the fever 
runs very high, it will be better for him to remain quiet in bed for 
several days in succession, provided, of course, that he can have other 
proper treatment at the same time. By this means the patient’s vital¬ 
ity and strength will be economized; but he must not be confined in 
bed for a long period, as he needs the advantages of out-of-door air 
and exercise. As soon as the fever is materially lessened, let him re¬ 
sume his daily walks and rides in the open air. Copious water drink¬ 
ing, at least to the amount of three to six glasses of water a day, is 
another means by which the fever may be successfully lowered. The 
employment of sponge baths at the time when the fever is highest, is 
a means of great comfort to the patient. Either pure water or water 
containing one-third its measure of alcohol may be employed in spong¬ 
ing the patient. Inunction on the dry, parched skin, after moistening 
it by a wet-hand rub, is another measure not to be forgotten. When 
the patient is strong and does not sutler with night sweats, a wet com¬ 
press worn about the chest often affords very great relief from the 
parching fever. 

2. To Improve tlce Patient's Nutrition .—As defective nutrition is 
one of the principal causes of consumption, the improvement of the pa¬ 
tient’s nutrition is one of the most essential features of the treatment of 
this disease. In order to accomplish this, attention must first be given 
to improvement of the digestion. If the patient is suffering with any 
of the various forms of dyspepsia, he must receive such treatment for 
the same as has been already described in the section on “ Diseases of 
the Digestive Organs.” This is a matter of very great importance, 
though it is often overlooked, the supposition being that the stomach 
disorder depends upon the disease of the lungs rather than the con¬ 
trary, which is really the case. The diet of the patient should first 
consist of such food as he can best digest. In many cases, milk and eggs 
with well-cooked grains and a small allowance of fruit, constitute the 
dietary best adapted to the condition of both the lungs and the stomach. 
Dr. Salisbury, of Cleveland, who has a peculiar theory regarding 
consumption, believing that it originates from the products of fermen¬ 
tation hi the stomach, requires his patients to abstain from the use of 
fruit and sweet and starchy foods altogether, and to depend almost 
exclusively upon lean meat with a very small allowance of bread. He 


1028 


DISEASES AND THEIR TREATMENT. 


requires his patients to take several pounds of beef steak or other lean 
meat daily. He claims very extraordinary results from his plan of 
treatment. His plan differs from that which we have followed for a 
number of years in but the one particular of diet. We have never 
thought it necessary to confine patients to an exclusively nitrogenous 
diet, and believe there are several evils which may arise from this 
course, which are perhaps as great as those growing out of the disease 
itself. We have also obtained by our plan results as remarkable as 
any claimed by Dr. Salisbury. We shall have to receive considerable 
more evidence than has yet been produced to convince us of the neces¬ 
sity of depriving consumptive patients of fruits and grains, and confin¬ 
ing them wholly to flesh diet. The daily employment of massage, and 
inunction at least two or three times a week, together with daily 
sponging with salt water, are excellent means for stimulating nutri¬ 
tion. To these measures should be added, when possible, a sun bath 
daily from half an hour to two hours in length, according to the pa¬ 
tient’s strength and the frequent use of electricity in the form of gen¬ 
eral faradization. 

3. To Arrest Night Sweats .—The exhausting sweats from which 
many patient’s suffer, particularly at night, or at any time when 
asleep, should be checked as speedily as possible. The best means of 
accomplishing this are the use of the salt sponge bath at night; spong¬ 
ing the body with a mixture of alcohol and water in proportion to 
one part of the former to two of the later; and sponging with hot 
water at bedtime. The last remedy we have employed very frequently 
of late, and are much pleased with the results afforded by it in the pre¬ 
vention of these exhausting sweats. It is important that patients 
suffering in this way should know that the sweats are greatly aggra¬ 
vated by opium in any form, and hence are increased by cough mix¬ 
tures of any sort which contain this drug. 

4. To Alleviate the Cough .—This troublesome symptom is often 
one of the chief sources of weakness and increasing debility, since it de¬ 
prives the patient of his necessary rest at night and excites him with 
continued and harassing efforts to relieve the unpleasant sensations by 
which it is provoked. Not infrequently the cough is produced, not by 
the condition of the lungs themselves, but by some form of irritation in 
the throat. This chronic irritation of the larynx is not infrequently 
itself produced by elongation of the palate. The cause of the cough 
should always be sought for, as it not infrequently happens that much 


CONSUMPTION. 


1029 


annoyance and waste of strength will thus oe saved. If the difficulty 
is chiefly in the throat, it will be readily relieved by soothing gargles 
and other treatment, such as has been described for inflammation or 
chronic catarrh in this location. Very simple remedies are often effect¬ 
ive to relieve the most distressing cough, such as gargling of water in 
the throat, holding pieces of ice in the mouth, taking occasional sips of 
strong lemonade, and similar remedies. The best of all means of allaying 
the irritation of the throat we have ever found is the inhaler which has 
already been described. (See Fig. 274.) Another measure for the relief 
of cough is the application of fomentations to the chest and between the 
shoulders. These applications should not be given more than once or twice 
a day. The time of each application should not extend over fifteen or 
twenty minutes. If the patient perspires easily, great care will be neces¬ 
sary to prevent weakening him by exciting perspiration by fomentations. 
In this case the application to the chest of dry heat by means of the hot- 
water bag is better than the use of fomentations. A tepid compress ap¬ 
plied to the chest at night will frequently relieve the harassing night 
cough. The application should be made with a soft woolen cloth of two 
thicknesses, which should be wrung as dry as possible and should be cov¬ 
ered with several thicknesses of dry flannel to retain the warmth and 
moisture. The chest should be rubbed in the morning with the hand 
dipped in cool or tepid water, and covered with a dry flannel or chest 
protector through the day. The use of various cough mixtures for the 
relief of cough is generally attended by more harm than good, as a 
majority of them contain opium, to which their effectiveness in relieving 
cough is chiefly due, but which encourages the exhausting night sweats, 
and hence really occasions much harm, though temporarily contributing 
to the patient’s comfort. As a general rule, patients run down, and the 
disease progresses much more rapidly after beginning the use of opium 
in any form. 

It should be borne in mind that cough is merely a symptom, the 
significance arid importance of which varies greatly in different cases. 
Sometimes it is best that it should be encouraged instead of being re¬ 
pressed. When the patient expectorates very freely, the cough is a nec¬ 
essary means of relieving the chest of matters which would seriously in¬ 
terfere with the functions of the lungs if retained, by filling up the 
bronchial tubes and air-cells. Cough is important in such cases as these, 
as the suppression of expectoration would be the surest means of hasten¬ 
ing the death of the patient rather than encouraging the recovery. The 


1030 


DISEASES AND THEIR TREATMENT. 


kind of cough which it is important to relieve is an irritable, ineffective 
cough, unaccompanied by any considerable degree of expectoration. This 
cough is sometimes excited by the irritation occasioned by an elongated 
uvula, for which the proper remedy is snipping off the end of the offend¬ 
ing organ. Loaf sugar, honey, or a mixture of honey and lemon juice 
and other simple remedies familiar in every household, are often effective 
in relieving a cough which is accompanied by little expectoration. In 
cases in which cough cannot be relieved in any other way, and is very 
distressing and painful, the use of an opiate mixture is sometimes ad¬ 
visable, but should be administered only under the advice of an intelli¬ 
gent physician. 




Fig. 313. Spirometer. 


5. To Develop the Lungs .—As one of the causes of lung disease is 
deficient exercise of the lungs, it naturally follows that suitable exercise 
of these organs constitutes one of the most important measures of treat¬ 
ment. The general means which may be employed for developing the 
lungs has already been described under the head of “ Lung Gymnastics,” 
page 720. Too much emphasis cannot be laid upon the importance of giv¬ 
ing attention to these measures of treatment. The patient should make 
it a large part of his business each day to attend to his respiration. At 
frequent intervals he should expand his lungs to their full capacity 














































































CONSUMPTION. 


1031 


(avoiding violent efforts, especially when there is danger of hemorrhage), 
repeating the exercise at frequent intervals through the day. One of 
the most observable features of this disease is progressively increasing 
rigidity of the chest walls and decrease of motion in the affected portions 
of the lungs. The loss of respiratory power is very readily shown by 
means of the pneumatometer, Fig. 312. A healthy adult will easily 
raise the column of mercury of the instrument to GO or 100 degrees. 
But we have frequently found patients who could not produce an indi¬ 
cation of more than two or three degrees, showing an almost entire loss 
of respiratory power. The diminished lung capacity is admirably shown 
by the spirometer, one form of which is shown in Fig. 313. Too little 
attention has been given in the treatment of consumption to regular 
and systematic efforts to develop the lung power and capacity, notwith¬ 
standing the full recognition of the fact, that their loss is one of the 
most marked features of the disease. Another means of increas¬ 
ing the lung capacity and power is special exercise, both passive and 
active, applied in such a way as to increase the strength of the respira¬ 
tory muscles. Of active exercises some of the best are edven under the 

%j o 

head of “ Swedish Movements.” Figs. 332-234. Passive Movements con¬ 
sist chiefly in the rubbing and percussion of the muscles of the chest and 
back, and in the application to the patient, by an attendant for at least 
a half-hour daily, of some one of the most approved forms of artificial 
respiration. That described elsewhere as Sylvester’s method is very con¬ 
venient for this purpose. Another measure which we would strongly 
recommend is the application of electricity to the muscles of the chest. 
The application should be made sufficiently strong to cause contraction 
of the muscles. The best mode of application is to place the positive 
pole between the shoulders, applying the negative along the spaces be¬ 
tween the ribs so as to cause contraction of the intercostal muscles. 
The application should also be made to the pectoral muscles which form 
the fleshy part of the breast. In addition to the other measures de¬ 
scribed, probably the best of all means of expanding the chest and in¬ 
creasing lung power ’is the pneumatic apparatus devised by Walden- 

burm the construction and use of which has been described elsewhere. 

0 1 

(See Fig. 218). We have now used this apparatus in quite a number 
of cases and have obtained decidedly beneficial results. We regard it as 
one of the most important remedial appliances for use in such cases. It 
is, of course, too cumbersome and expensive to be adapted to the home 
treatment of this disease; but a simple form of the apparatus may be 


1032 


DISEASES AND THEIIi TREATMENT. 


readily constructed by almost any tinsmith, which will enable the pa¬ 
tient to derive nearly all the advantages of the pneumatic method of 
treatment. 

G. To Sustain and Invigorate the Patient in every Possible Way. 
—As this disease is characterized in a remarkable degree by progress¬ 
ively increasing debility, no means should be neglected which will 
contribute in any degree to sustain the patient’s strength and reinforce 
his waning vitality. A nourishing diet, abundance of sleep, cheerful 
surroundings, a plentiful supply of pure, fresh air, abundant daily ex¬ 
ercise in the open air, particularly in horseback riding, exposure to 
the action of the sun’s rays by exercise in the sunlight as well as by 
sun-bathing, and total abstinence from all depressing influences of 
every sort, are among the essentials of the hygienic management of 
this disease. Tonic applications of electricity and the judicious use of 
bathing, together with the daily employment of massage, frequent in¬ 
unctions, and all other means of improving nutrition, are necessary 
parts of the successful plan of treating serious cases of pulmonary dis¬ 
ease. Patients should be cautioned in regard to exercise, against ex¬ 
erting themselves to a degree to induce extreme fatigue, and to avoid 
violent exercises of all sorts, such as running, leaping, walking, going 
rapidly up stairs, speaking in a loud tone, or singing for a long time, 
or in any other way overtaxing the respiratory organs. Care should 
also be taken to avoid exposure to sudden changes of temperature. 
Patients accustomed to a warm atmosphere most of the time should 
in cold weather wear a respirator. When out of doors, they should 
take especial care to breathe wholly through the nose so as to avoid 
briiminf; cold air in contact with the mucous membrane of the lun^s, 
on account of its irritating character. An excellent form of respirator 
is shown in Fig. 309. By breathing through the respirator the air is 
warmed before it reaches the lungs, and thus injury is prevented. In 
the absence of a respirator, an ordinary cotton handkerchief may be 
used for the purpose with advantage, being tied over the mouth and 
nostrils in such a way that the air drawn into the lungs must pass 
through it. 

Much undue stress has been laid upon the influence of climate in 
the cure of consumption. The idea has prevailed that certain climates 
have a special curative effect upon this disease; but there has been a 
controversy as to which is the exact climate which possesses curative 
virtues, since it has been observed that patients get well under the 


CONSUMPTION. 


1033 


most diverse climatic influences. The diversity of opinion among phy¬ 
sicians on this subject has caused some to advise patients to visit Flor¬ 
ida, the West Indies, Mexico, and other tropical and semi-tropical 
regions, especially during the cold season of the year; while others 
have sent their patients to Minnesota and the Upper Lake regions, and 
even to more northern parts. A thorough discussion of the subject at 
a late meeting of the British Medical Association, in which Dr. Ben¬ 
nett and many other eminent physicians took part, led to the conclu¬ 
sion that the chief advantages derived from climates supposed to be 
favorable to recovery from this disease are uniformity of temperature 
and opportunity for abundant out-of-door exercise. Climates which 
are subject to rapid alternations of temperature, or in which the cold 
season of the year is so severe as to confine the patient within doors, 
or which in any other way interferes with daily and regular exercise 
in the open air, are unfavorable to this disease. We think, however, 
that many of the advantages of a change of climate may be obtained 
by careful management at home. In the summer season, in this lati¬ 
tude, a consumptive patient may enjoy nearly all of the advantages 
that can be obtained anywhere, especially if he is able to make a visit 
of six or eight weeks to the Upper Lake region during the latter part 
of July and August. In winter, by means of the respirator and proper- 
attention to clothing, abundant exercise can be taken out of doors; 
and with sufficient care in regulating the temperature and moisture 
within doors and securing good ventilation, almost as good conditions 
can be enjoyed as in any climate to which the patient could go. We 
speak from practical experience after having carried through several 
winters patients who have previously found it necessary to spend the 
winter season in a warm climate. 

In conclusion, a word must be said with reference to some popular 
errors concerning the disease. One of the most prominent of these is 
the idea that the use of alcohol is one of the most successful means of 
checking the progress of the malady. Many physicians have encour¬ 
aged this error, and not a few drunkards have been made such by a 
physician’s prescription, the intent of which was to cure the patient 
of a "rave malady, but the effect of which was to make him the vie- 
tim of a terrible vice. Evidence is yet wanting to show that alcohol 
has any curative value whatever in consumption, and there is plenty 
of evidence to show that the habitual use of liquor is one of the surest 
means of producing this disease. Within the last few years cod-liver 


1034 


DISEASES AND THEIR TREATMENT. 


oil has become a fashionable remedy for disease of the lungs. It is 
now generally admitted, however, by the most intelligent and experi¬ 
enced members of the profession that the advantages claimed for this 
remedy are by no means substantiated by experience, and that its chief 
utility, if it has any, is simply due to its nutritive value as oleaginous 
food. As such, however, it is much inferior to good sweet milk or 
cream, or any other easily digested animal fat. This has been clearly 
shown by the experience of many physicians, and the time cannot be 
far distant when this nauseating and indigestible drug will occupy a 
much less prominent place than it has heretofore held. Preparations 
of malt and maltine have lately been introduced. We have used them 
to a considerable extent, and, we think, with advantage. Many practi¬ 
tioners do not hesitate to pronounce them vastly superior to cod-liver 
oil. They are certainly much more palatable, and disturb the digest¬ 
ive organs much less. 

It is perhaps needless to say that the numerous quack remedies for 
consumption advertised in the newspapei's are wholly without merit. 
There is no known drug which will cure this disease, or in any certain 
degree influence its progress. Numerous remedies have been recom¬ 
mended at various times as curative, but not one has thus far stood 
the test of experience. The reputation acquired by certain popular 
remedies are chiefly built upon fictitious cases and cases of individuals 
who may have recovered from some disease which was supposed by 
the individuals themselves to be of a consumptive character, but which 
was really of a much less serious nature. What has been said of quack 
medicines is also true of the numerous domestic remedies for this 
disease. 

MILIARY TUBERCULOSIS. 

SYMPTOMS.—Frequent chills; fever; very frequent and small pulse; exhausting 
sweats; dry tongue; often delirium or stupor; great prostration; cough; shortness of 
breath; at last, oedema of the lungs. 

This disease must not be mistaken for what is known as acute or gal- 
loping consumption. It is the general manifestation of the same disease 
which in consumption is chiefly confined to the lungs, and in its course 
so closely resembles typhoid or intermittent fever that a correct diag¬ 
nosis is frequently not made. An examination of the lungs shows al¬ 
most an entire absence of the particular symptoms of local disease in 
these organs, about the only symptom which can be discovered being 


f 


PLEURISY . 1035 

great shortness of breath. The absence of symptoms in the lungs is clue 
to the fact that all parts of them are equally affected, while in ordinary 
consumption some particular part of the lungs is diseased, other portions 
often remaining in a nearly healthy condition. An examination after 
death shows the mesenteric glands, spleen, liver, and in fact all parts of 
the body, to be affected with tubercles. The disease usually runs a 
rapid course, the patient dying, in most cases, in from forty to sixty 
days. The disease is generally a primary one, and is probably due to 
infection of the system with tuberculous matter. It seems to us proba¬ 
ble, though the fact has not yet been proven, that infection most often 
occui's by the use of the flesh or milk of consumptive animals. It also 
sometimes occurs in the latter stages of consumption, the whole system 
becoming affected by the local disease. 

Treatment. —Little can be done but to render the patient as com¬ 
fortable as possible, since there is almost no hope of recovery; but as there 
is always a possibility as to a mistake of the nature of the disease, efforts 
for the relief of the patient should be unabated, even to the last. The 
most important measure of treatment is to control the raging fever as 
much as possible by sponge baths, compresses, etc. The same general 
rules of treatment should be followed which have been recommended for 
consumption. Cold applied to the chest is one of the best remedies for 
the shortness of breath. Ice should be applied to the head freely if the 
patient suffers much with headache, as is frequently the case. 

PLEIBISY. 

SYMPTOMS. —ACUTE : Chilliness; fever; sharp pain or “stitch" in the affected 
side, generally located below the nipple ; pain increased by coughing, pressure, or lying on 
affected side ; hot, dry skin ; flushed cheeks ; hard, quick pulse; frequent, short breath¬ 
ing; great nervousness; usually at first a grating sound heard over affected part; urine 
scanty and high-colored. 

CHRONIC: Increasing debility and shortness of breath ; slight pain; hacking cough ; 
small, rapid pulse; slight fever; dear mucous expectoration; accumulation of fluid in 
the cavity of the chest. 

This is a very common disease, though not as common as is generally 
supposed, since many people are in the habit of calling every pain or 
“stitch in the side” a pleurisy pain. Transient pains of this character 
are much more frequently clue to intercostal neuralgia than to pleurisy. 
The disease consists in the inflammation of the pleura, a membrane 
which lines the chest-walls and covers the lungs. I he acute type of the 
disease occurs in two forms, one of which is termed dry pleurisy, because 


1036 


DISEASES AND THEIR TREATMENT. 


there is no exudation or effusion. This disease presents scarcely any 
symptoms at all. It consists in the thickening of the pleura and adhe¬ 
sion of the lung to the chest-wall, and as it usually produces no serious 
results, it demands but little attention. In the several varieties of the 
form of the disease in which exudation or effusion occurs, more or less 
of the symptoms are found. Acute pleurisy usually runs a rapid 
course and ends in recovery. The exudation is generally very slight. 
The chronic form of the disease generally begins very insidiously, though 
it occasionally follows the acute form. It is accompanied by the accu¬ 
mulation of a large amount of fluid in the chest upon the affected side, 
which causes compression of the lungs and displacement of the heart, 
the latter organ being crowded over to one side or the other, according 
as the accumulation of fluid is hi the right or left cavity of the chest. 
As the disease occurs most often upon the left side, the heart is generally 
found nearer the middle of the chest than it should be. In a patient 
whom we had under treatment a few months ago, we found the left cav¬ 
ity almost completely filled with fluid, the lung entirely collapsed, and 
the heart crowded entirely over upon the right side. The fluid in 
chronic pleurisy may be simply serum, or it may contain a larger or 
smaller proportion of pus. Cases in which the cavity is filled with pus 
are termed empyema. Adhesion of the lung to the chest-wall almost 
invariably takes place in all cases of pleurisy when recovery occurs. 
No particular harm results from this condition, however. In chronic 
pleurisy, the chest upon the affected side generally becomes contracted, 
and the lung rarely becomes fully expanded to its natural size. 

Causes. —The causes of pleurisy are, 1. Injury to the pleura, as from 
fracture of the ribs ; 2. Other diseases of the lungs, as pneumonia, con¬ 
sumption, or cancer; 3. General disease, as rheumatism, blood poisoning, 
scarlet fever, etc.; 4. General causes of an obscure nature not well un¬ 
derstood, but probably similar to those which give rise to pneumonia, 
among which may be reckoned exposure to cold. 

Treatment. —The principal treatment required by the acute form of 
this disease is confinement in bed; a restricted diet, consisting of oat¬ 
meal gruel, fruits and grains, and other light vegetable food; avoidance 
of animal food of all kinds excepting milk, of stimulating condi¬ 
ments and intoxicating beverages of all sorts; and for the relief of pain ; 
hot fomentations applied continuously for several hours if necessary. 
The hot-water bag is a very useful means of applying fomentations in 
these cases. By wrapping the bag in a flannel cloth wrung out of hot 


DROPSY OF THE CHEST. 


1037 


water the heat will be retained very much longer than when a fomenta¬ 
tion is applied in the usual way. In cases in which the fever is high 
and the acute symptoms have passed away, a wet-sheet pack may be ad¬ 
ministered, or the patient may be sponged frequently with tepid water. 
In some cases the application of cold to the chest, by means of cloths 
wrung out of cold water, or even ice compresses, gives more relief than 
hot applications. In still other cases, the local symptoms are best con¬ 
trolled by means of cold compresses alternated at intervals of an hour or 
two with short fomentations. Recovery almost always takes place in 
the acute form of the disease. 

Chronic pleurisy is a much more obstinate malady. It is generally 
not recognized until after its effects have become fully developed. If 
the accumulation of fluid in the chest has existed for several months, the 
collapsed lung becomes so permanently injured that its full use can sel¬ 
dom be recovered. The first object in treatment should be to induce, if 
possible, absorption of the fluid. This may best be done by the use of 
all measures which will improve the patient’s strength and vitality. 
The same general course should be followed for this purpose as is recom¬ 
mended in the treatment of consumption. In addition to these general 
measures, alternate hot and cold applications should be daily made to 
the chest. Electricity may also be used with benefit. If the patient is 
strong, the vapor or hot-air bath may be employed with advantage two 
or three times a week. If, after the faithful employment of these meas¬ 
ures for a reasonable length of time, there are no evident symptoms of 
improvement as indicated by a decrease in the shortness of breath, the 
cough, and the amount of fluid in the chest as shown by percussion, the 
fluid should be removed from the chest by tapping or aspiration. 

IIYDROTIIOR.IX—DROPSY OF TIIE CHEST. 

SYMPTOMS .— Great difficulty in breathing, or shortness of breath, especially on 
slight exertion; dullness on percussion of the lower part of the chest. 

Dropsy of the chest, or, as the disease is generally termed in pop¬ 
ular phraseology, “ water on the chest, ’ is rarely a primary disease, 
generally occurring in connection with general dropsy, resulting from 
disease of the heart or kidneys. 

Treatment. —Measures of treatment should be directed toward the 
primary disease of which this affection is simply a result. These meas¬ 
ures, which are more fully described elsewhere, consist chiefly in such 


1038 


DISEASES AND THEIR TREATMENT. 


Fig. 314 . Aspirator. 



remedies as will excite great activity of the skin, as vapor and hot-air 
baths. In case general measures are not sufficient to cause absorption 
of the fluid, tapping or aspiration of the chest may become necessary. 
Fig. 314 represents one of the best forms of apparatus for performing 

aspiration, which is much to 
be preferred to the old opera¬ 
tion of tapping. In using 
this instrument, the chest is 
punctured with a fine needle 
which is hollow and is con¬ 
nected with a flexible tube, 
which is, in turn, connected 
with the cylinder of an air- 
pump. By the creation of 
a vacuum, a strong suction 
force is exerted, which pro¬ 
duces a steady flow of fluid 
through the needle into the 
instrument, from which, by 
reverse action, it is expelled 
into a convenient vessel. 
Several simple forms of this 
apparatus have been devised. 
The simplest of all is the 
ordinary Davison’s syringe. 
On one occasion, when our 
aspirator was accidentally 
broken by an assistant just 
as we were about beginning 


an operation upon a patient 
whose left lung cavity was almost completely filled with pus, we per¬ 
formed the operation by means of the Davison’s syringe, as suggested 
by our old teacher, Prof. Austin Flint, Sen., of Bellevue Hospital, by 
whom this ingenious method was first employed. In the case re¬ 
ferred to, we removed several quarts of green pus which had been con¬ 
fined within the chest for more than a year. The relief afforded the 
patient by removal of the fluid is generally very great, though at first 
severe coughing is produced by expansion of the partially collapsed lung. 
Unfortunately, complete recovery rarely takes place, owing to the ob¬ 
stinate character of the disease upon which this affection depends. 
































PNEUMOTHORAX. 


1039 


PNEUMOTHORAX. 

SYMPTOMS.—Patient feels as though “something had burst " in his chest; very diffi¬ 
cult breathing; patient lies upon the affected side, or sits up; severe pain in the region 
of the lower ribs ; intercostal spaces obliterated on the affected side; when on left side, 
displacement of the heart to the right side; if on right side, displacement of the liver 
downward; unnatural resonance of the chest; usually, also, fluid, which changes posi¬ 
tion with change in position of patient; absence of natural breathing sounds; splashing 
sounds heard by placing the ear to the chest and shaking the patient quickly. 

In this disease, one of the cavities of the chest is filled with air, the 
lung being in a state of collapse. The cause of the disease is perfora¬ 
tion of the lung, which may result either from accident, as from a 
wound by a bullet, knife, or bayonet, or it may be the result of break¬ 
ing down of portions of the lung, as in emphysema ard consumption. 
With each active inspiration the air passes through the opening in the 
lung into the pleural cavity, and, as the opening is generally ragged, so 
that the air cannot escape during expiration, the quantity of air in¬ 
creases with each breath, until the pressure within the cavity becomes 
so great as to equal the force of an inspiration. Sometimes, in case of 
wounds, the lung cavity is connected with the connective tissue spaces, 
and the air penetrates the tissues of the chest and trunk, causing, in 
some instances, enormous bloating. The lung on the affected side is, of 
course, completely compressed, so that no air can enter it. Much pres¬ 
sure is also exerted on the lung on the strong side, caused by the expan¬ 
sion of the affected cavity. When the perforation occurs on the left 
side, the heart is crowded over to the right. We have met instances in 
which the apex beat of the heart, which is usually felt just beneath the 
nipple, was displaced, by the pressure of air in the left cavity, to the ex¬ 
treme right side of the breast-bone. Within a day or two after perfor¬ 
ation occurs, pleurisy is usually set up, which occasions the exudation by 
which the cavity is gradually filled, in some instances, completely. We 
recently had under treatment a case of this character, which, owing to 
the complete filling of the chest with liquid, had been pronounced by a 
prominent professor in a medical college to be a case of fibrous growth 
in the chest. We pronounced the case one of empyema, and proved 
the diagnosis by performing the operation of aspiration and removing 
several quarts of pus. 


1040 


DISEASES AND THEIR TREATMENT. 


SYMPTOMS RELATING TO TIIE RESPIRATORY ORGANS. 

Cough. —Coughing is a convulsive expiratory effort, usually re¬ 
peated several times in rapid succession. It is symptomatic of several 
varieties of conditions, but by no means always indicates disease of the 
respiratory organs. It is present in consumption, pneumonia, pleurisy, 
chronic bronchitis, emphysema, pharyngitis, laryngitis, and, in fact, may 
appeal 1 as a symptom in nearly all diseases of the respiratory organs. It 
may also appear as a symptom of disease of the spine and spinal cord, 
of the oesophagus, the heart, the liver, and the stomach. In occasional 
instances, it may arise from the irritation of worms in the intestines, 
from the pressure of tumors in the chest, as well as from gout, rheuma¬ 
tism, and uterine and ovarian derangements. Occasionally it is seen in 
very young children who are teething, being due to sympathetic irrita¬ 
tion. Attention has very lately been called to what is known as ear 
cough, arising from disease of the ear. 

Chin Cough is a term frequently applied to a light, hacking cough 
in small children, arising from slight irritation of the throat or air- 
passages. It was formerly applied to whooping-cough. 

Stomach Cough is generally due to pharyngeal catarrh, which re¬ 
sults from derangement of the digestion. 

Nervous Cough is often occasioned by disease of the spinal cord. 
Under this head may also be included cough which is dependent more 
upon habit than upon any local disease. 

Painful Cough usually arises from some serious disease of the re¬ 
spiratory organs. 

Hacking or Tickling Cough is quite frequent in the first stage of 
consumption when it results from sympathetic irritation. It may be 
due to an elongation of the palate. 

Heavy or Hollow Cough is one of the symptoms -of chronic bron¬ 
chitis and advanced consumption, and is usually -attended by copious 
expectoration. 

Dry or Tight Cough is the accompaniment of the first stages of 
cold in the chest. It is due to congestion, with slight secretion. 

A Short, Sharp Cough generally accompanies the first stage of 
pneumonia. 

The Hoarse, Barking Cough of croup is readily recognized by its 
peculiar character. In true or membranous croup, the hoarse, barking- 
character gives way to a whistling cough. A loose cough, attended by 
a slight rattle, is an indication of improvement in the last-named disease. 


PAIN IN THE CHEST. 


1041 


The Whooping Cough, characteristic of the disease of that name, is 
so called from its violent spasmodic character, and from the fact that the 
spasmodic, expiratory efforts attending the cough in this disease are 
terminated by a very greatly prolonged inspiration, attended by the 
peculiar sound very aptly termed a whoop. 

Treatment .—The remedies for a cough vary according to its cause. 
An irritable, hacking cough can often be relieved by means of a little 
lemon juice; dissolving a small piece of white sugar upon the tongue; 
or chewing slippery elm. Simply gargling a little hot or cold water 
will produce relief, as well as the use of a steam inhaler. Painful cough 
is best treated by hot applications for the relief of the pain. Liver, 
stomach, and ear cough are cured by treatment of the organs primarily 
affected. Nervous cough can often be cured by a simple effort of will¬ 
power. The patient, having formed the habit of coughing from a slight 
temporary irritation of the throat, continues to cough when the original 
cause is removed. By a simple exertion of the will, this cough can usu¬ 
ally be controlled. Equal parts of lemon juice and honey will fre¬ 
quently relieve a harrassing cough. The chest compress is also useful. 

Pain ill the Chest. —Pain in the chest may be stinging, burning, 
or lancinating in character ; it may be dull and continuous, or sharp 
and only occurring at intervals. Patients also frequently complain of 
weight, oppression, constriction and tightness in the chest. Sharp 
pain is most often due either to neuralgia or pleurisy. Dull pain in 
the right or left side, beneath or between the shoulders, may be due to 
affections of the liver, spleen or stomach, as well as to pulmonary dis¬ 
ease. A stinging or burning pain beneath the breast-bone is one of 
the symptoms of chronic bronchitis. 

Treatment .—The best remedy for pain in the chest is the applica¬ 
tion of hot fomentations once or twice a day; and if the pain is chronic, 
the application of a warm compress to be worn through the night. 
Extensive pain in the chest may require a chest pack. A stitch in the 
side and the acute pain of pleurisy are often very greatly mitigated by 
the application of a soft woolen bandage, drawn tightly about the 
chest, in such a way as to restrain the movement of the affected part 
in respiration. The same end may be reached by applying a large 
pitch plaster or several adhesive strips over the affected part. 

Shortness of Breath. —This symptom may arise from restriction 
of respiration caused by pain, as in pleurisy and often in intercostal 

G6 


1042 


DISEASES AND TIIEIR TREATMENT. 


neuralgia, or it may arise from the disablement of a larger or smaller 
portion of the lungs, as in pneumonia, dropsy of the chest, chronic 
pleurisy and pneumothorax. Shortness of breath is also present as a 
marked symptom in consumption, and in congestion of the lungs aris¬ 
ing from any cause, particularly from disease of the heart. Simple 
weakness, as in case of nervous debility, may give rise to shortness of 
breath. 

Treatment .—The proper remedy is the removal of the cause. 
When this can be accomplished, the difficulty will speedily disappear; - 
but, as in many cases the cause is one which cannot be remedied, the 
symptom, of course, remains, notwithstanding the application of the 
most varied remedies; and the most that can be done, is to mitigate 
the inconvenience occasioned by this often very distressing symptom. 
The aggravation of this symptom by exercise suggests that, when it is 
very urgent, the patient should be kept as quiet as possible. When it 
is due to the accumulation of gas in the stomach and bowels, as some¬ 
times happens, speedy relief may be obtained by the evacuation of the 
bowels by a copious hot enema. Shortness of breath due to pain or 
congestion is generally relieved by hot fomentations. When due to 
disease of the heart, galvanic electricity applied to the sides of the 
neck sometimes gives very great relief. In dropsy of the chest, tap¬ 
ping or aspiration is sometimes a means of affording great comfort, at 
least, temporarily. 

In cases of emphysema, chronic bronchitis, and heart disease, in 
which the lungs are unable to perform a sufficient amount of work to 
purify the blood, as indicated by lividness of the face and lips, together 
with other symptoms of insufficient respiration, great relief may often 
be afforded by the employment of artificial respiration. What is 
known as Sylvester’s method, elsewhere described, may be employed, 
or better, the following method suggested by Dobell, an eminent Eng¬ 
lish physician: Place the patient in a chair, let a strong attendant 
stand behind him upon a stool, elevated just sufficiently to give him 
command over the shoulders of the patient without stooping forward 
too much. Let the attendant place his hands in front of the patient’s 
shoulders, taking hold in the axilla beneath them. Now let him lift 
the patient steadily upward sufficiently to raise his weight off the 
chair upon which he is sitting. After retaining this position for a few 
seconds, he should be let down slowly. After resting a few seconds, 
the operation should be repeated. The patient should be instructed to 


SXEEZIXG. —EICCO UGH. 


1043 


respire with the motions of the attendant. By the repetition of this 
exercise for half an hour, the patient’s condition will, in many cases, 
be very much improved, the livid appearance of the face and lips dis¬ 
appearing, and not infrequently, the fatal moment may be long post¬ 
poned. By a continuance of these measures at frequent intervals, for 
a few days, it may be deferred for weeks and often for months and 
years. It is quite probable that many pat ients die from carbonic acid 
poisoning who might be saved by the adoption of these measures, if 
they were thoroughly applied. 

Sneezing. —This symptom consists in an explosive expiratory ef¬ 
fort, the air being expelled through both the mouth and nose, but 
chiefly through the former. It is oftenest occasioned by irritation of 
the nasal and mucous membrane. It may arise from titillation, inha¬ 
lation of dust, congestion incident' to taking cold, or congestion pres¬ 
ent in influenza and hay fever. It is, in some cases, a purely nervous 
symptom. With many persons, sneezing is excited by looking at the 

sun or at a bright light. 

© © 

Treatment .—This symptom rarely becomes so troublesome as to 
require special attention by way of treatment, and yet, it is often at 
least convenient to be possessed of a remedy to check or relieve it. 
The disposition to sneeze can ordinarily be relieved by rubbing the 
nose between the thumb and finger. It may also be checked by press¬ 
ing the finger against the upper lip, just below the nose. In some 
cases, the nasal douche, administered with a fountain syringe, is essen¬ 
tial. The best solution employed is a teaspoonful of common salt, dis¬ 
solved in a pint of tepid water, or fifteen to twenty drops of carbolic 
acid, well dissolved. 

Hiccough. —This symptom is produced by a sudden spasm of the 
diaphragm. It may be excited by eating too much, thus causing indi¬ 
gestion and irritation of the stomach; drinking a large quantity of 
cold water, or by long-continued and immoderate laughter. It also 
occurs, sometimes, in the last stages of wasting diseases, when it is re¬ 
garded as a very grave symptom, indicating approaching dissolution. 

Treatment .—Hiccough can generally be stopped by taking a very 
small sip of very cold water or swallowing a small piece of ice. It 
may also generally be checked by holding the breath a long time, so as 
to interrupt the paroxysm, which occurs at regular intervals. When 
it is very obstinate, and is evidently the result of indigestion, a copi- 


1044 


DISEASES AND THEIR TREATMENT. 


ous warm water emetic should be administered for the purpose of 
emptying the stomach. In ordinary cases, the symptom will disap¬ 
pear of itself, after a short time. 

Foul Breath.—Although this symptom does not necessarily per¬ 
tain to the respiratory organs, it may be considered here, perhaps more 
properly than in any other connection. Foulness of breath may arise 
from decaying teeth, ozena, ulceration of the tonsils, foul emanations 
from the stomach, and from the fetid expectorations of consumption in 
its advanced stages, or cases of chronic bronchitis in which there is 
great dilatation of the bronchii, allowing accumulation and decomposi¬ 
tion of purulent secretions of mucus. 

Treatment. —Decaying teeth should be cleansed and carefully 
filled. Catarrh, attended by fetid secretions and ulceration of the ton¬ 
sils, should receive the necessary treatment. Foul emanations from 
the stomach may be best corrected by the adoption of such measures 
as will improve the digestion. The use of charcoal either in capsules 
or in the form of charcoal crackers, is an excellent measure for tempo¬ 
rary relief. The fetid odors arising from decomposing secretions in 
catarrh, bronchitis, consumption, and in gangrene of the lungs, may be 
in a great degree corrected by the inhalation of carbolic acid vapor. 
A few drops of pure carbolic acid or creosote, say four to six drops of 
either, should be placed in the inner cup of the steam inhaler, shown 
in Fig. 274, and inhaled three or four times a day. 


DISEASES OF THE CIRCULATORY ORGANS. 


The Pulse in Health. —The pulse is about 120 to 140 at birth. It 
gradually diminishes until it reaches about 90 at the age of seven or 
eight years. In adult life it is 65 to 75, and in old age not much over 
60. Females have a somewhat more frequent pulse than males, the dif¬ 
ference being five or six beats a minute. A difference of five to ten 
beats is made by changing from a lying position to sitting, and from 
sitting to standing. By violent running the pulse may be increased to 
140 or more. 




DISEASES OF THE CIRCULATORY ORGANS. 


1045 


The pulse is felt by placing the first two fingers upon the artery at 
the outside of the arm, with the second finger toward the heart. The 
force of the heart is determined by pressing with the second finger and 
noticing how much force is required to compress the artery so that the 
pulse cannot be felt by the first finger. The pulse may also be felt at 
the temple, the neck, and in various other situations. 

The Pulse iu Disease. —The following are the principal varieties 
of the pulse :— 

Frequent Pulse. A pulse diminished in force, increased in fre¬ 
quency. A characteristic of debility. 



Fig:. 315. Pulse of a Healthy Persou. 


Febrile Pulse. In fever, the rate of pulsation and usually also the 
force is increased. 

Feeble Pulse. A pulse that is readily extinguished by pressure 
with the finger. Indicative of great debility or exhaustion. 



Fig:. 316. Pulse of a Tobacco-User. 

Thready Pulse. A pulse which gives the sensation beneath the fin¬ 
ger of a vibrating thread. Present in cases of very great debility. 

Slow Pulse. An unnaturally slow pulse occurs in cases of brain 
poisoning or apoplexy; it is present in compression of the brain from 
fracture, and in unconsciousness from opium or liquor. 

Quick Pulse. An abrupt, jerking pulse, either frequent or moder¬ 
ate in rate of pulsation. 

Hard Pulse. A pulse which seems to indent the finger. Indicates 
great excitement of the circulation. 






1046 


DISEASES AND THEIR TREATMENT. 


Intermittent Pulse. A pulse which now and then loses a beat. 
Indicative of either functional or organic disease of the heart. 

Irregular Pulse. A pulse which is irregular in frequency and 
force. The irregularity may be only slight, or may be extreme. Is 
generally found in heart disease. Is very often the result of the use of 
tobacco and of strong tea and coffee. Figs. 315 and 316 show the con¬ 
trast between a healthy pulse and the irregular pulse of a tobacco-user, 
as indicated by the sphygmograph. 

Irritable Pulse. A pulse which is both frequent and hard. 

Wiry Pulse. A pulse which gives the impression of a vibrating 
wire. 

Palpitation of tlie Heart, as will be further explained elsewhere, 
is an excessive action of the heart. Throbbing at pit of stomach is 
usually due to palpitation of the aorta. 

Hemorrhage as a Symptom. —Hemorrhage, not from a wound, 
is generally caused by a diseased condition or morbid state of the blood¬ 
vessels. Spitting of blood may indicate hemorrhage from the stomach, 
or lungs, or simply from the nose or mouth. Nose-bleed is most often 
indicative of congestion of the head. It is a bad symptom when occur¬ 
ring in a person who is very feeble from a wasting disease. Hemorrhage 
from the bowels is a very grave indication when it occurs in connection 
with dysentery or typhoid fever ; but it is generally indicative of noth¬ 
ing more than the rupture of a dilated vein in the rectum, due to piles or 
hemorrhoids. Bleeding from the bladder may indicate disease of either 
the bladder or the kidneys. Hemorrhages into the skin occur in scurvy 
and purpura. 

\ 

HYPERTROPHY, OR OVERGROWTH OF THE HEART. 

SYMPTOMS.—Heavy beating of the heart; visible pulsation of the arteries; ringing 
in the ears; spots before the eyes; dizziness; in severe cases, apoplexy. 

This is a disease which may exist for many years without its pres¬ 
ence being manifest by symptoms sufficiently severe to attract attention. 

Causes. —The most common cause is disease of the valves of the 
heart, which interferes with the passage of the blood through its cavities 
into the arteries. It also occurs very frequently in persons addicted to 
the use of stimulants. The use of alcoholic liquors and tobacco are par¬ 
ticularly productive of this affection. 


DILATATION OF THE IIEALT. 


1047 


Treatment, —The treatment of the disease consists in an abstemious 
diet, excluding all alcoholic drinks, condiments, excess of animal food, 
tea, coffee, tobacco, and stimulants of all kinds ; overeating, and the use 
of hot drinks, or excessive drinks of any kind must also be avoided. In 
Germany, where it is frequently the result of high living and the use of 
beer, the “whey cure ” and “grape cure” are particularly noted as ef¬ 
fective means of treating this affection. 

In the first of these methods, the patient is made to subsist almost 
wholly upon the use of the whey of milk. The grape cure consists in 
confining the patient to the use of grapes almost exclusively. He is al¬ 
lowed to take from three to six or eight pounds of grapes each day. 
The water cure, even as practiced in the old-fashioned water-cures of 
Germany, is also advantageous. The essentials of treatment, in addition 
to careful dietetic measures, are the wet-sheet pack and warm full bath, 
repeated as often as the patient will bear, without much reduction of 
flesh or strength. If there is a great degree of plethora, the patient 
being full-blooded, with excessive redness of cheeks and lips, such meas¬ 
ures as the pack, full bath, and wet-hand rub, may be repeated daily for 
several weeks without detriment. Another excellent measure, suggested 
by Prof. Niemyer, is wearing constantly over the region of the heart a 
small bag filled with iced water. Frequent changes of the water would 
of course be required in order to continue the efficiency of the remedy. 
In cases in which enlargement is due to disease of the valves of the 
heart, the evils above described do not occur, and treatment for the af¬ 
fection is not required, as the enlargement is rendered necessary by the 
unusual obstacles which the heart has to overcome in its action. 


RIEATATIOA OF TIIE HEART. 

SYMPTOMS. — Small, feeble pulse, frequency increased on slight exertion; enlarge¬ 
ment and pulsation of the veins of the neck; congestion of the lungs, liver, kidneys, and 
stomach; dropsy; distress in the region'of the heart; shortness of breath continually, 
preventing the patient from lying down; angina pectoris; impulse of the heart diffused 
over a large space. 

Causes. —Dilatation of the heart is most often the result of dis¬ 
ease of the valves of this organ. It usually follows enlargement of 
the heart; the walls after becoming thickened to a certain extent, be¬ 
ing stretched until they become thin and feeble. Enlargement of the 
heart from any other cause than valvular disease, may also be followed 
by dilatation. 


1048 


DISEASES AND THEIR TREATMENT. 


Treatment. —The treatment of this disease consists chiefly in im¬ 
proving the patient’s condition as far as possible, by the avoidance of 
stimulating foods and drinks, especially by total abstinence from tea, 
coffee, tobacco, and alcoholic drinks. All depressing influences, espe¬ 
cially sexual excesses, and violent exertion of all sorts, should be care¬ 
fully avoided. The disregard of this caution has frequently occa¬ 
sioned rupture of the heart, and sudden death. The application of 
electricity to the spine, to the neck, and over the region of the heart, 
is an excellent measure of treatment, and will, perhaps, accomplish as 
much as any other one remedy. We have frequently seen almost mar¬ 
velous results from the use of electricity in this disease, in cases in 
which it was the result of long standing valvular disease of the heart. 

FATTY DEGENERATION OF THE HEART. 

SYMPTOMS.—Slow and feeble or irregular and frequent pulse; shortness of breath 
on exertion; occasional pain in the region of the heart; attacks of faintness or uncon¬ 
sciousness, somewhat resembling apoplexy; sometimes presence of arcus seni/us, or 
white ring around the edge of the cornea. 

There are two kinds of fatty degeneration of the heart, one in 
which the heart is overloaded with fat, and the other in which the 
muscular fibres of the heart are replaced by fat. 

Causes. —The principal causes of both varieties of fatty degenera¬ 
tion are, gluttony, the use of alcoholic drinks, and excessive use of fat 
foods. It is also sometimes the result of Bright’s disease of the kid¬ 
neys and poisoning with phosphorus. 

Treatment. —The great danger to be apprehended in this disease 
is sudden rupture of the heart, upon a slight exertion, on account of 
the weakening of its walls. If the disease has not existed too long a 
time, a cure may take place through careful attention to diet and hy¬ 
gienic rules together with an avoidance of the special causes which 
may have produced the affection. The patient must also avoid all 
violent exercise of all sorts. He should not allow himself to become 
excited or angry under any circumstances, as a fit of anger is as dan¬ 
gerous for him as a dose of poison. Violent exercise of all sorts, as in 
lifting heavy weights, running to catch a train, hurrying up stairs, or 
straining to relieve the bowels in constipation, must be carefully 
avoided. Sugar, fat, all condiments, must be thoroughly discarded. 


INFLAMMATION OF THE HEART-CASE. 


1049 


PEBICARDITIS-OFLAMMATIO^ OF TIIF HEART-CASE. 

SYMPTOMS.—May be slight; if severe, high fever, pain over the heart extending to 
the shoulder-blade, collar-bone, shoulder, and down the arm ; palpitation; irregular pulse; 
shortness of breath; patient cannot lie on left side; noises in the ears; nosebleed; 
cough; debility; faintness; suffocative paroxysm ; general dropsy; restlessness; great 
anxiety; delirium; weakness of heart-beat; rubbing sounds heard on listening over the 
heart. 

This disease is an inflammation of the sac which contains the heart. 
It is a very serious disease, and not infrequently ends fatally, although 
the symptoms are sometimes difficult to distinguish from those of 
other diseases with which it may be associated. 

Causes. —This disease very rarely occurs by itself. It is almost 
always a part, or result of some other affection, as of pleurisy, rheu¬ 
matism, disease of the kidneys, pneumonia, peritonitis, scurvy, spotted 
fever, scarlet fever, measles, etc. Rheumatism and pleurisy are the 
most frequent causes. 

Treatment. —The treatment given should be chiefly directed to the 
removal of the disease of which the pericarditis is a result. The pa¬ 
tient should be kept very quietly in bed, carefully protected from 
drafts, although not overheated by too much clothing, and should 
be given a nourishing and very simple, unstimulating diet. Fomen¬ 
tations over the seat of the pain, and the continuous use of warm 
compresses, are perhaps the most useful measures that can be em¬ 
ployed. Sometimes the disease is so severe that the heart-case be¬ 
comes filled and distended with fluid which gradually interferes with 
the action of the heart, and sometimes occasions death by interrupting 
it altogether. This may now be relieved by means of the aspirator, 
though a few years ago it would have been considered the height of 
folly to attempt tapping of the heart-case. 

ESDOCABDITIS—IA’FLAMMATIOA OF TIIF LINING NIENI- 
BRANE OF TIIE HEART. 

SYMPTOMS. — Palpitation; pain and uneasiness in the region of the heart; fever; 
restlessness; feeble pulse; shortness of breath ; patient insists on lying on his back; pe¬ 
culiar murmurs heard on listening to the chest. 

This disease affects the left side of the heart/ most frequently, 
choosing for its principal seat the valves. The result of the inflamma¬ 
tion is a production of little warty growths upon the valves, which in¬ 
terfere with their action; but the worst result sometimes occurs subse- 


1050 


DISEASES AND THEIR TREATMENT. 


quently, from the contraction of the parts affected by the inflamma¬ 
tion, causing stiffness and pressure, closure of the valves, and thus ob¬ 
structing the passage of the blood from the heart. Any one or all of the 
four valves of the heart may be affected. The usual results of valvu¬ 
lar disease of the heart are, enlargement, which is finally followed by 
dilatation; pulmonary congestion, which results from an obstruction of 
the free passage of blood from the lungs; congestion of the stomach, 
liver, spleen, and all internal organs including the brain, from the ob¬ 
struction of the venous circulation; general structural and func¬ 
tional derangement of all the internal organs; and finally, general 
dropsy, showing itself first in the feet and ankles, gradually extend¬ 
ing to the body, involving the abdominal cavities, chest, and up¬ 
per extremities, and ultimately resulting in death. One of the imme¬ 
diate dangers in this affection is embolism , which consists in the ob¬ 
struction of the artery with a small plug, which is formed in the heart 
by the adhesion to the excrescences upon the inflamed valves of por¬ 
tions of the fibrine of the blood, which are after a time dissolved and 
swept along with the blood current until they reach arteries of so 
small a size that they are stopped, and plugging the vessel, cut off the 
supply of blood from the part to which it is distributed. When this 
takes place in the brain, where it is most likely to occur, symptoms of 
paralysis appear, as loss of speech or memory of words, etc. 

Causes. —This disease, as stated with reference to pericarditis, 
rarely occurs by itself. It is most often due to rheumatism. It may 
also occur in consequence of the inflammation of the heart-case, pneu¬ 
monia, pleurisy, Bright’s disease, scarlet fever, and other eruptive 
fevers. 

Treatment. —The treatment of this affection must be the same as 
that recommended for pericarditis, together with the treatment neces¬ 
sitated by the disease of which it is the result, or with which it is 
connected, and that described for valvular disease of the heart. 

INFLAMMATION OF TIIF HEART. 

SYMPTOMS.—Weak action of the heart and feeble pulse; first sound of heart weak 
or absent. 

This is an inflammation of the substance of the heart itself. It is a 
disease of rare occurrence, and most frequently results from the high 
temperature incident to typhoid and other febrile diseases. 

Treatment. —The best treatment for this affection is that of a pre- 


VALVULAR DISEASE OF THE HEART. 


1051 


ventive character. This consists chiefly in the application, during the 
fevers which it is likely to follow, of packs, sponge baths, cold com¬ 
presses, cold enemas, and all other measures which are well known to 
control abnormal temperature. 

YALYULAR DISEASE OF TOE HEART. 

SYMPTOMS.—Palpitation ; heavy beating of the heart and shortness of breath, espe¬ 
cially on slight exertion or excitement; active congestion of the lungs ; congestion and tor¬ 
por of the liver with jaundice; dropsy; distress in the region of the heart, in some cases 
angina pectoris; congestion of the stomach, causing dyspepsia ; scanty and highly colored 
urine, sometimes bloody; murmurs. 

The cause and nature of this disease cannot be well understood by 
the reader, without careful study of the structure of the heart. This we 
have described in another connection, and would call attention to Figs. 97 
and 98, which show one of the valves of one side of the heart, open and 
closed. Various changes occur which are chiefly due to inflammation ; 
the valves of the heart may become thickened and contracted, so that their 
function is performed very imperfectly. Two forms of impairment of 
the valves occur, one which prevents the blood from entering or leaving 
the cavities of the heart freely, known as obstruction, the other which 
prevents the complete closure of the valve, and so allows the blood to re¬ 
enter the heart, after it has once been expelled from it, known as regur¬ 
gitation. The results of valvular disease of the heart are those which 
have already been described as resulting from endocarditis. 

Causes. —Rheumatism and pleurisy are the most common causes of 
valvular disease of the heart. Old age and syphilis are also productive 
of disease of the valves. 

Treatment. —This disease is one which is by its nature rendered 
incurable. Nevertheless, much can be done to prolong the life of pa¬ 
tients and to add to their comfort. The danger of sudden death is by 
no means as great as is generally supposed, as very few people suffer¬ 
ing with this affection meet with sudden death in consequence of it. 
It is necessary that persons having valvular disease of the heart 
should carefully avoid overtaxation of the heart by overexercise, 
either mental or physical, particularly the latter. They should 
never indulge in running rapidly, playing games requiring vigorous 
exercise, or in any exercise whatever requiring violent exertion. All 
depressing influences, as the use of tea and coffee, tobacco, alcoholic 
liquors, and especially sexual excesses, should be scrupulously avoided. 


1052 


DISEASES AND THEIR TREATMENT. 


Great care should be taken to avoid taking cold, to prevent liability to 
congestion of the lungs. The dropsy which occurs in the last stages 
of the disease should be treated by such measures as will excite vig¬ 
orous action of the skin, as the hot-air and vapor baths, wet-sheet 
pack, and vigorous friction of the skin. A milk diet has been recom¬ 
mended for dropsy. It is generally insisted upon, however, that the 
patient shall take a dry diet. We think it a mistake to deprive the 
patient of fluids, as the blood is so thickened that the vital functions 
are in some cases interfered with. A moderate quantity of fluid should 
be allowed. Turkish and Russian baths should be interdicted to the 
majority of patients. This is especially true of the Russian bath 
This should never be taken by persons suffering from serious valvular 
disease of the heart. Persons suffering from rheumatism should give 
the disease prompt and vigorous attention, as it is one of the most 
frequent causes of the malady, and intensifies it by repeated attacks. 

EMBOLISM AND THROMBOSIS. 

Embolism is the clogging up of an artery by means of a small clot 
of blood or a fragment of calcareous matter from the heart, fat glob¬ 
ules, hydatids or bacteria, which are carried by the current of blood 
to the point where embolism occurs. Thrombosis is a clot formed at 
the point where it is found. When any blood-vessel is completely 
closed by embolism or thrombosis, the part to which the blood is dis¬ 
tributed, if not supplied with blood in some other w T ay, suffers for 
want of nutrition. The brain, spleen, kidneys, lungs, and liver are 
most likely to be affected by embolism. A year or two ago we had 
under our care a patient in whom embolism of the large artery of the 
arm had occurred, the result of which was complete extinction of the 
pulse of that arm. As the patient subsequently died from a tumor in 
the chest, opportunity was afforded for a post-mortem examination. 
The obstruction was found at the upper part of the arm, the channel 
from that point downward being wholly obliterated. 

Treatment. —It is important that persons who have clots in any 
large blood-vessels in consequence of an extensive injury or a surgical 
operation, should keep very quiet until Jhe clots become thoroughly 
organized or permanently fixed in their location so as to prevent the 
danger of disengaging fragments and producing embolism thereby. 
Special symptoms arising from embolism or thrombosis should be 
treated according to the indications in each case. 


PALPITATION OF THE HEART. 


1053 


RUPTURE OF THE HEART. 

This accident occurs in consequence of fatty degeneration of the 
organ, excessive dilatation, aneurism, and other diseases by which the 
walls of the heart are weakened. It usually occasions instant death. 

PAEPITATIOA OF THE HEART. 

This is a functional disorder of the heart, probably dependent upon 
some sort of disturbance in the nerve centers having control of the 
organ. It consists in a rapid and disturbed action of the heart so in¬ 
tense as to be painfully perceptible to the patient. The heart, in some 
cases, seems to the patient to roll or turn over. In some cases there 
is an interruption of the beating of the heart, one, two, or often three 
beats being lost. The sensation of the patient during the suspended 
beating is that he is about to die, so that great alarm is occasioned. 
The attacks of palpitation usually occur at intervals, the patient in 
the meantime being wholly free from inconvenience. 

Causes. —Exposure to cold, the use of stimulants and of tea, coffee, 
and tobacco, sexual excesses, and especially self-abuse, are among the 
causes of palpitation of the heart. The palpitation also occurs as the 
result of indigestion or anjemia. Palpitation often accompanies organic 
disease of the heart. A careful examination should be made to de¬ 
termine whether or not the patient is suffering from valvular disease. 

Treatment. —The patient should have tonic treatment, nutritious, 
careful and regular diet, should abstain from excesses of all kinds, 
take abundance of sleep, with plenty of out-of-door exercise, and 
should abstain wholly from tobacco, coffee, tea, and spirituous liquors. 
Palpitation of the heart is often mistaken for real organic disease of 
the organ. We have met many cases in which patients supposed 
themselves to be the subjects of organic disease of the heart on account 
of the obstinate and long-continued palpitation of the organ. A 
young man who was under our care a year or two ago was a remark¬ 
able illustration of this fact. He had been examined by many physi¬ 
cians, and was by a majority supposed to have an organic affection of 
the heart. Notwithstanding, the improvement of his digestion caused 
the entire disappearance of his heart symptoms, and we have every 
reason for believing that the trouble was wholly functional, though it 
was so violent as to give him great discomfort and excite alarm. A 
careful regulation of the diet is in most cases all that is necessary to 


1054 


DISEASES AND THEIR TREATMENT. 


effect a cure. The exact nature of the diet should depend upon the 
particular condition of the stomach. Alternate hot and cold applica¬ 
tions to the spine and the application of galvanic electricity to the 
throat are deserving of strong recommendation as among the most suc¬ 
cessful measures of treatment in this disease. In chronic cases, relief 
will be obtained by wearing over the heart a tin or rubber bag filled 
with iced water, which must be frequently renewed. Sympathetic pal¬ 
pitation may be relieved by bending the head downward, allowing 
the arms to hang down. The effect of this measure is increased by 
holding the breath a few seconds while bending over. Another ready 
means which will relieve most cases very quickly is pressing strongly 
upon the large arteries on either side of the neck. This generally gives 
instant relief. 

Throbbing at the pit of the stomach is usually due to palpitation of 
the aorta, caused by irritation of the stomach. It may also arise from 
aneurism. Palpitation of other arteries, as those of the neck, temples, 
groins, and other parts of the body may occur. We recently had under 
treatment a patient who complained of palpitation in all parts of the 
body. The local application of cold is the best remedy. In case of 
aortic palpitation, the ice-pack to the spine may be employed. 

AXGIM PECTORIS. 

SYMPTOMS.—Intense pain in the region of the heart, sometimes extending down the 
left arm to the ends of the fingers; a sense of suffocation and of impending death; great 
pallor of the face; the pulse usually small, feeble, and irregular. 

Angina pectoris is a nervous disease of the heart, usually accompanied 
by fatty degeneration, valvular disease, obstruction of the coronary ar¬ 
teries or arteries of the heart, and various other derangements of the 
heart and aorta. 

Causes. —The direct causes of the disease are not known. Probably 
they are similar to those which give rise to other obscure nervous diseases. 

Treatment. —The most important of all measures consists in the 
proper regulation of the diet and regimen of the patient during the 
intervals of the attacks. By this means it may be hoped to ward off 
the disease. The best remedy for immediate relief of pain is nitrite 
of amyl, a powerful drug, three to five drops of which should be placed 
on the handkerchief and inhaled by the patient. Persons subject to 
these attacks should carry with them a small bottle containing a 
sponge saturated with the nitrite, which may be placed to the nose 
when necessary. 


ANEURISM OF THE HEART. 


1055 


BASEDOW’S DISEASE, OK EXOPHTHALMIC GOITRE. 

SYMPTOMS.—Remarkable rapid pulse, from one hundred to one hundred and forty a 
minute; unusual prominence of the eyes, giving them a staring or ferocious look; en¬ 
largement of the thyroid gland; debility and anaemia; mental depression; nervousness; 
sleeplessness; in women, amenorrhoea. 

This is undoubtedly a nervous affection which affects some parts 
of the circulatory apparatus, though it is a rare disease and not well 
understood. 

Treatment. —The eminent Dr. Flur says in reference to treatment, 
“ Hygienic measures are probably of greater importance than reme¬ 
dies.” The patient should be surrounded by cheerful influences, the diet 
should be palatable and nutritious, and abundant out-of-door exercise 
.should be taken. The application of electricity is recommended as an 
excellent remedy for this rare disease. 

AXEI RISM OF THE HEART. 

SYMPTOMS .— The symptoms resemble valvular disease of the heart, with pains much 
greater than in the latter affection. 

This disease consists in the formation of a sac in the walls of the 
heart which communicates with the cavity of the organ. The sac fre¬ 
quently increases in size through stretching. It sometimes becomes 
as large as the heart itself. Fortunately, the disease is quite rare, as it 
is almost certainly fatal. The principal cause of this malady is rheu¬ 
matism. 

Treatment. —The most that can be done for the patient is to re¬ 
strain him from all violent exertion and give him a careful, nourishing 
diet, withholding all alcoholic stimulants, tea, coflee, tobacco, and other 
narcotics. Perfect rest upon the back in bed for two or three months, 
and a very meager diet, has been recommended as a means of treatment 
by a very eminent Irish physician. 


DISEASE OF THE ARTERIES. 

The arteries are, as a general rule, quite free from disease, but not 
wholly so. The principal affections are, aneurism and calcification. 
Inflammation of the arteries is a very rare disease, occurring chiefly in 
very old age; but sometimes in syphilitic and other affections, a pecul¬ 
iar kind of inflammation of the coating of the arteries occurs. It is 
followed by a chalky deposit, which is known as calcification of the 


1 ().■>() 


DISEASES ANJ) Till:Hi TREATMENT. 


artery. We Lave met several eases in whieh this process Lad extended 
to swell a marked decree that the hardened arteries could be felt in 
various parts of the body, giving to the lingers the sensation of a pipe¬ 
stem broken in various fragments. Aneurism of the arteries is a dis- 
ease which frequently arises from this same kind of inflammation. Jt 
is further described in the section devoted to surgery. 

msr.tsi: of tiii: veiun. 

SYMPTOMS.—Pain on pressure ; swelling and redness following course of vein and 
extending toward heart; when suppuration occurs, chills and wandering pains; much 
disturbance of the system. 

Inflammation of the veins, or phlebitis, occurs occasionally, though 
less frequently than was once supposed. Jt is both a cause and a result 
of thrombosis. It is a dangerous disease, often causing death. 

Treatment.—The proper treatment, when it is known to occur, is 
continuous application of hot fomentations. The pationt should be 
kept very quiet to prevent clots from being dislodged and carried into 
the circulation. 


VAICKOSH VFIAS. 

This is a condition in which the veins are greatly dilated and be¬ 
come tortuous in their course. It is occasioned by occupations which 
require long standing upon the feet, by constipation, and especially, in 
women, by pregnancy. 

Treatment.—The disease is seldom cured; but its inconvenience 
may be greatly lessened by the use of the elastic silk stocking or the 
elastic bandage. The latter measure we very much prefer for the ma¬ 
jority of cases. The bandage should be applied from the toes to above 
the affected part. It should bo applied smoothly and with even press- 
uni. Little pressure is required, as the natural swelling of the limb 
in standing will produce all the tension necessary, although a very 
slight pressure may be employed in the application of the bandage 
with the limb in a horizontal position. The patient should take care 
to keep the affected limb horizontal or slightly elevated as much as 
possible, so as to encourage the flow of the blood toward the heart. 
Sometimes the dilation of the vein becomes so great that rupture occurs. 
In ease of such an accident, the patient should at once elevate his limb 
as high as possible and place a small roll of cloth, as a folded pocket- 
handkerchief, over the point of rupture, applying strong pressure over 
the compress. 


WHITE BLOOD. 


1057 


I *F¥. ANIMATION OF Till: LYMIMIATKN. 

SYMPTOMS.—Enlargement of a lymphatic gland, forming a painful lump usually felt 
in the side of the neck, in the arm-pit, in the knee, or in the groin, from which may bo 
seen radiating reddish lines having a cord-like feeling. 

Causes. —A poisoned wound, as a scratch received while dissecting 
or making a post-mortem examination. Absorption from an ulcer or 
a malignant disease is a common cause of lymphatic enlargement. 

Treatment, —Hot fomentations or warm compresses constitute the 
best treatment. It should be continued until the enlargement disap¬ 
pears or softens. When softening occurs, the part should be promptly 

lanced to evacuate the matter contained. 


LMCIITAIIA WIIITi: lll.OOl). 

SYMPTOMS.—Fullness in the left side, due to enlargement of the spleen, or enlarged 
lymphatic glands; patient pale and weak ; nosebleed or hemorrhago from the bowels; at 
last dropsy, fever, delirium or stupor, and death. 

This is a peculiar disease which has been understood only within 
the last few years. The principal symptom of the disease, aside from 
those mentioned above, is an increase of white blood corpuscles. 
These little bodies, which naturally exist in the blood in the pro¬ 
portion of one hundred to three or four hundred of rod-blood corpus¬ 
cles, in this disease become increased to such an extent ns to consti¬ 
tute from -so- to J, and in extreme cases, shortly before death, even 
one-half of the whole number of blood corpuscles. In these extreme 
cases it is stated that the blood has a whitish appearance; ami after 
death whitish clots are found in the heart and large blood-vessels 
looking like collections of pus. 

Cause. —Nothing is known of the cause of this peculiar malady. 
It has been observed that it is always connected, either with enlarge¬ 
ment of the spleen or of the lymphatic glands, from which it is sup¬ 
posed that the great increase in number of the white corpuscles is due 
to an excessive formation of these bodies by the glands naturally en¬ 
gaged in the blood-making process. There is also evidences that the 
increase of corpuscles is due to morbid activity in the connective tissue 
cells in various parts of the body. Cases often occur in which there is 
enlargement of both the spleen and the lymphatic glands. f l he spleen 
sometimes attains the size of seven or eight pounds. In a case of the 
disease which we met several years ago, the whole left side of the ab- 

07 


1058 


DISEASES AND TIIEIB TREATMENT. 


domen was filled by an enlarged spleen. Lymphatic tumors some¬ 
times reach an enormous size. Enlargement of the spleen from mala¬ 
rial poisoning sometimes results in this disease. 

Treatment. —It is fortunate that this disease is extremely rare, as 
it is equally difficult to cure. The remedies which have been most 
recommended have been quinine, iron, and preparations of iodine; 
but Prof. Niemeyer of Tubingen candidly remarks that by this mode of 
treatment “no case of recovery from Leuchmmia is known,” and that 
in a case treated by him improvement took place under an opposite 
mode of treatment. He adds, “ I afterward sent the patient to a wa- 



ing.” Even in this case, the disease returned after the lapse of a year 
or two, though it is possible it might have been held in check if the 
patient had continued under proper treatment. All sorts of experi¬ 
ments have been tried in the treatment of this disease. A few years 
ago, we met a man who had been suffering with the malady for two or 
three years. After having tried all sorts of remedies, he was at that 
time drinking warm beef blood every morning at one of the large 
abattoirs in New York. He had become so disgusted with the rem¬ 
edy, however, that he had made up lvis mind to abandon it, concluding 
that the disease with its consequences was to be preferred. Cases of 
recovery from this disease have been reported to have taken place in 
consequence of the operation of transfusion of blood. This operation 
consists in pumping into the veins of the patient a supply of healthy 
blood from another individual. The blood of the sheep is sometimes used 



BLUE DISEASE. 


1059 


instead, but human blood is undoubtedly much more effective. The 
operation is usually performed upon the arm. Fig. 317 shows the 
simplest mode of procedure. In some cases the blood is drawn from 
the arm of the individual supplying it, and is deprived of its fibrine 
by whipping before being injected into the arm of the patient. This 
plan lessens the danger of formation of clots, but is less effective than 
the more direct method shown in the cut. 

CTMOSIS—BLUE DISEASE. 

SYMPTOMS.—Blue or purplish color of the skin, lips, and under the skin ; coolness 
of the body ; palpitation ; shortness of breath ; bulbous enlargement of tips of fingers and 
toes; incurved nails; dropsical symptoms. 

Cause. —The cause of the peculiar coloration in this disease is some 
malformation of the heart or its large vessels, by means of which there 
is a mixture of arterial and venous blood so that the blood is not prop¬ 
erly purified. One of the most common causes of malformation is fail¬ 
ure of the foramen ovale, or the opening through the partition divid¬ 
ing the right and left auricle, to close after birth. This closure gener¬ 
ally occurs within a short time after birth, preventing mixture of the 
blood of the two sides of the heart. When it remains open the individ¬ 
ual becomes cyanotic. Sometimes other malformations occur, such as 
a transposition of the large arteries, the aorta arising from the right 
ventricle, and the pulmonary artery from the left, with various other 
deficiencies and abnormalities. 

Transposition of the heart sometimes occurs. A* few years ago we 
had a patient under treatment in whom the heart was found upon the 
right side, the liver being transposed to the left, and other internal or¬ 
gans, so far as could be ascertained, having undergone the same transpo¬ 
sition. No inconvenience was suffered from the peculiarity, the heart 
apparently performing its function as well as when in its proper position. 

Treatment. —Infants, born w T ith the deficiences described, generally 
die very early. Sometimes, however, individuals affected in this way, 
have been known to reach advanced life. No special treatment is indi¬ 
cated, as the disease is of an incurable nature ; but great care should be 
taken to protect the patient from all influences which will disturb the 
circulation in any way. The danger of taking cold should be especially 
avoided, with exposure to measles, whooping-cough, diphtheria, and all 
diseases which affect the respiratory organs. 


10G0 


DISEASES AND THEIR TREATMENT. 


\ 

DISEASES OF THE NERVOUS SYSTEM. 


The notable increase in the frequency of nervous diseases in modern 
times gives to this class of affections an importance far greater than has 
been attached to them at any previous period in the history of the race. 
A century ago, the literature upon the.subject of nervous diseases was 
comparatively a meager one ; but at the present time, there is probably 
no class of affections which commands a larger share of the attention of 
medical authors than this. Ziemssen’s encylopedia of medicine has four 
ponderous volumes devoted to the subject, and voluminous works on 
single diseases, or classes of diseases, of the nervous system are becoming 
very numerous. 

The cause of the great increase of attention given to this subject is, 
without doubt, the great increase in the number and frequency of nervous 
disorders. The increasing tendency in this direction is a subject of marked 
concern on the part of many observing and reflecting physicians; and 
it is a matter of importance to consider briefly, at least, some of the 
causes which have led to this remarkable development of a special class 
of diseases in recent times. 

Causes of Increased Frequency of Nervous Diseases. —First 

among the causes which have undoubtedly led to this state of things, 
may be mentioned the unnatural hurry and bustle of modern life, and 
the numerous sources of excitement and morbid nervous activity char¬ 
acteristic of our modern times. In business life, the sharp competition 
of trade is a continual goad to the man whose necessities or ambition leads 
him to desire pecuniary success. .New means of producing various com¬ 
modities must be invented, and new plans for creating a demand for the 
same must be devised, giving no opportunity for rest or recreation. In 
the haste to get rich, men forget the demands of physical law, and com¬ 
mit the grossest outrages against themselves, depriving their overwrought 
brains and nerves of the proper amount of sleep and necessary relaxa¬ 
tion. The desire for speculation has extended till it is no longer confined 
to the larger centers of trade, but extends to the smallest towns and vil¬ 
lages, and often to the most remote country districts. 

The hope of amassing wealth suddenly, leads men to incur the risk 
of losing the results of the small accumulations of years; and while wait- 



DISEASES OF THE NERVOUS SYSTEM. 


10G1 


ing for the turn of the wheel controlled by fickle fortune’s caprice, the 
mental and nervous strain often becomes so great that some of the del¬ 
icate threads which form the network of this most intricate of all the 
bodily systems, are snapped asunder, so that pecuniary wealth is only 
secured at the expense of the most wretched physical poverty. Many 
times the nervous system, which has, from intense hope and anticipation 
of greatly desired results, been stimulated to the highest degree, is, by a 
reversal of prospects, subjected to such a sudden revulsion that the 
mental and nervous equilibrium is destroyed, perhaps never to be re¬ 
stored. But it is not only in the world of trade and commerce that 
these disasters occur. In the world of politics, the strain is equally great, 
and the damaging results of overexcitement may be seen with equal 
frequency. 

So, too, in other departments in life. The scientist is continually 
taxed to the utmost limit by the endeavor to keep pace with the numerous 
discoveries and advances which rapidly succeed each other in every de¬ 
partment of scientific investigation. The literary student is over¬ 
whelmed with the attempt to familiarize himself with even a small frac¬ 
tion of the modern literary productions of merit, to say nothing of the 
productions of by-gone ages. In social life, competition in dress and dis¬ 
play through the desire for social distinction, together with the follies of 
fashionable dissipation, tell first and most powerfully upon the illy sus¬ 
tained nervous systems of the participants. 

In a large number of cases, the foundation for chronic nervous dis¬ 
eases is laid in infancy and early childhood. The popular methods of edu¬ 
cation, well designated as “ school cramming,” pervert and overstrain the 
mental faculties and the nervous system of a large proportion of all who 
are subjected to the process of being educated. Children are sent to school 
at too early an age, are kept in school too long at a time and too many 
hours a day, and are stimulated in every possible manner to exert them¬ 
selves to the utmost to accomplish in five or six years the mental work 
which a century ago was not accomplished in ten or twelve. The high 
schools of the present day present a much more extended curriculum of 
studies, and require of candidates for examination a degree of qualification 
far superior to the colleges and universities of the last century; yet it is 
expected that young men and women will complete their education at an 
age at which our great grandfathers would have considered themselves 
well advanced if fairly started. 

Everything in modern times seems to be conducive to mental and 


1062 


DISEASES AND THEIR TREATMENT. 


nervous overwork. Our railroads enable us to accomplish in a day 
journeys which would have required a week by the old-fashioned stage¬ 
coach. The telegraph and the still more recent telephone are rapidly 
supplanting the mail system, although in some States mails are 
carried with almost lightning speed by special trains, which load and 
unload their bags of letters without checking their speed, even re¬ 
newing their supply of water in {he same way. 

Another powerfully acting cause, and, perhaps, one quite as important 
as any that has been mentioned, is the great and increasing prevalence 
of the use of various stimulating and narcotic drugs. Alcoholic intem¬ 
perance produces a distinct class of nervous derangements, The same 
may be said of opium, of tobacco, and, as can now be clearly shown, of 
tea and coffee also. Dr. Richardson has lately called attention to the fact 
that chloral, a drug introduced into England by himself, has already 
come into such extensive use as to have given rise to a serious train of 
nervous disorders. Absinthe, hashish, and numerous other drugs, the 
habitual use of which has become more or less extensive, are also ac¬ 
countable for special disorders of the brain and nerves. The particular 
effects of these poisons have been more fully described elsewhere in 
this work. 

Other injurious habits which are productive of nervous diseases 
may also be mentioned, as errors in diet, particularly the use of stim¬ 
ulating condiments and of food deficient in nutritive elements, as 
wheat, deprived of its nerve-nourishing elements, in the form of su¬ 
perfine flour bread; sedentary habits of life ; late hours; deficiency of 
sleep ; exciting entertainments; improper dress; novel-reading; sexual 
excesses and vices; want of control of the passions ; all exhausting, 
depressing, and over-stimulating agencies. 

Lastly, we may mention as a cause of the great increase of nerv¬ 
ous diseases in modern times, hereditary influences. Nervous diseases 
of all kinds are much more frequent in the developing generation 
than in their parents. We have many times made the observation 
that the children of parents addicted to the use of tea and coffee, of 
tobacco or alcoholic liquors, suffer much more from the effects of these 
abuses, in various nervous derangements, than the individuals them¬ 
selves. Through the influence of these hereditary causes, the “ nervous 
temperament ” is becoming much more frequent. This fact is true 
with reference to the severe forms of this disease, as well as those 
of milder character. The marked increase of insanity in civilized 


PAIN. 


10G3 


countries, and the increasing frequency of what is now well recog¬ 
nized as the insane temperament, are evidences of the truth of this 
assertion. 

The only remedies for this disastrous tendency, which if not 
checked is destined to increase with each succeeding generation, is a 
thorough revolution in nearly all of the habits and practices of mod¬ 
ern civilized societies. How this might be accomplished, or whether 
a reform of such magnitude is possible, we will not here attempt to 
say. 

PAIS. 

Pain is one of the most common of all the symptoms manifested 
by the nervous system ; yet it is impossible to frame a definition 
which will exactly describe it. Indeed, it is impossible to formulate 
a definition of pain which will distinguish it from pleasure, the oppo¬ 
site condition. Numerous attempts have been made by philosophers 
as well as physicians to describe this most common of all symptoms, 
but without success. Notwithstanding, this need not be considered so 
great a misfortune, since every one knows what it is, making a de¬ 
scription unnecessary. We shall under this head, too, point out some 
of the principal kinds of pain, their significance, and the best methods 
of treatment to adopt for their relief. Pain has been classified as 
follows:— 

Inflammatory Pain .—This is the pain of inflammation, but varies 
in character, according to the part affected and the intensity of morbid 
action, being sometimes sharp and lancinating, as in the pain of pleu¬ 
risy, at other times throbbing,^as in an abscess in which pus is forming, 
or dull and continuous, when inflammation is only moderate in in¬ 
tensity and considerable in extent. 

Irritative Pain .—This is a pain which arises from some sort of 
irritation of a nerve. The irritation may be mechanical or chemical, 
or it may be due to causes too subtle to be discovered. 

Reflex Pain .—This variety of pain is felt at some point remote 
from the location of the morbid condition which gives rise to it. We 
see illustrations of it in cases of headache, neuralgia, and tender¬ 
ness of the spine which arises from disease of the uterus and ovaries 
in women, and in cases in which pain in various organs is excited by 
the irritation of worms in the intestinal canal. 


10G4 


DISEASES AND THEIR TREATMENT. 


Pain Originating in Nerve Centers .—This variety of pain is best 
illustrated by hysteria, a disease in which the difficulty undoubtedly ex¬ 
ists chiefly in the nerve centers, although the exact nature of the dis¬ 
eased condition has not yet been fully made out. Neuralgia of the va¬ 
rious parts of the body arising from tumors in the brain is also an ex¬ 
ample of this kind of pain. 

Numerous kinds of pain have been described by various authors, as 
tingling pain, often referred to as “ pins and needles,” aching, smarting, 
burning, gnawing, rasping, throbbing, lancinating, dull, heavy, etc., 
and various other modifications of pain. It is hardly possible to attach 
to each of these different kinds of pain a definite significance. It may 
be remarked that, in general, acute smarting or lancinating pain is indic¬ 
ative of active congestion or inflammation, while a dull, heavy, contin¬ 
uous pain indicates passive congestion. 

Causes. —Romberg has very well said, that pain is “ the prayer of 
the nerve for healthy blood.” Defective nutrition is undoubtedly the 
most common cause of pain. We often have very acute pain arising 
in consequence of a deficient supply of blood to the affected nerve- 
Congestion is also a frequent cause of pain, the distended blood-vessels 
subjecting the sensitive nerve fibres to an abnormal amount of pressure. 

Treatment. —From the earliest ayes there has been an earnest 
search for a universal panacea for pain. It is universally regarded 
as an enemy which should be contended against and subdued 
as quickly as possible. The physiologist, however, regards pain as a 
friend, since it gives warning of danger, and thus in many cases gives 
opportunity for averting the threatened calamity to the physical organ¬ 
ism. Pain is a sentinel which stands on guard to protect the citadel of 
life. When the faithful sentinel is lulled to sleep by the devices of 
anaesthesia, a limb may be severed from the body and the most exquis¬ 
itely sensitive organs may be subjected to violence without any remon¬ 
strance on the part of outraged nature. If anaesthesia were the natural 
condition, life could not long be maintained, for the body would 
soon be destroyed by the various destructive agents with which it'comes 
in contact. In view of these facts it is evident that before seeking a 
remedy for the relief of pain in any particular case, the question should 
be asked, What is the nature and cause of the symptom ? In the ma¬ 
jority of cases the treatment should be applied not directly for the 
relief of the pain itself, but for the purpose of removing the cause upon 
which the pain depends. When this is done, the pain ceases of itself ; 


PAIN. 


1065 


whereas, when the opposite course is taken, the sensibility to pain may 
be obtunded by depriving the nerves of their power of remonstrance 
while the cause still remains. As a general rule, the large class of drugs 
which are so extensively used for the relief of pain are utterly worthless 
as a means of cure, being simply temporary palliatives. In many in¬ 
stances, too, the very drug which relieves the pain temporarily, really 
increases the difficulty by paralyzing the efforts of nature to remove the 
morbid cause from which the pain arises. 

Cold is genei’ally the most efficacious remedy for the relief of pain 
when it is produced by active congestion or inflammation. Pain ac¬ 
companied by a great amount of heat generally calls for the applica¬ 
tion of cold. Some cases of neuralgia are best relieved by ice or cold 
compresses. The best remedy for the relief of the pain of a felon be¬ 
fore it reaches maturity is immersion of the hand and arm in water as 
cold as can be borne. Probably there is no one remedy of so universal 
application as a means of relieving pain as heat. It may be applied 
in connection with moisture by fomentations, or without, by means of 
bags filled with hot water, heated sand, corn meal, or some similar 
substance, hot bottles, bricks, etc. Either moist or dry heat is almost 
always efficacious in the pain of neuralgia. Pain arising from deficient 
circulation is also generally best relieved by hot applications. The 
pain of passive congestion yields to heat quicker than to any other 
remedy. The severe pain of a felon approaching maturity will often 
be relieved, as if by magic, by a hot spray or a fomentation. Uterine 
and ovarian pain are relieved by the hot vaginal douche. Bowel 
pains are relieved by hot fomentations and by large hot enemas. 
Severe nervous headache is often best relieved by fomentations or 
sponging the head with hot water. Fomentations to the bowels are 
most effective in sympathetic headache. The pain of rheumatism, 
acute sciatica, neuralgia, pleurodynia and pleurisy, yield best to hot 
applications. Excruciating pain arising from piles or a fissure of the 
anus may be often dissipated by sitting over a vessel nearly filled 
with very hot water. The terrible itching of pleuritis and the intol¬ 
erable pain of earache and toothache also yield to the application of 
heat. The pain accompanying inflammation of the veins, and the ex¬ 
treme pain and soreness arising from bruises, lacerations, fractures of 
bones, and many other accidents, are relieved, generally, more readily 
"by the application of heat than by any other means. The warm- 
blanket pack, and the Turkish, hot-air, vapor and Russian baths, are 


10G6 


DISEASES AND THEIR TREATMENT. 


the most effective means of applying heat. It can be utilized to the 
greatest advantage in the treatment of cases characterized by pain of 
a general character. Poultices of various sorts are generally no more 
effective than fomentations, in some cases less so. Their efficacy is 
wholly due in the majority of cases to the heat and moisture of the 
application. 



In exceptional cases, cold compresses will relieve the pains of rheu¬ 
matism more effectively than heat. Iced water is also sometimes es¬ 
sential as a remedy for the relief of toothache. For congestive head¬ 
ache, ice compresses applied to the head and neck are the proper meas¬ 
ures. The terrible pain of cancer may often be relieved by freezing 
when other remedies fail. This remedy also has the advantage in that 
it checks the progress of the disease as well as relieves the suffering. 
The injection of ice-cold water into the seat of pain sometimes relieves 
the severe pain of neuralgia almost magically. We have used it with 
fair success in a number of cases. Some recommend injection at the 
analogous part on the opposite side of the body. Injection is made 

























































PAIN. 


1067 


by means of the hypodermic syringe, the most approved form of 
which is shown in Fig. 318. Intense cold or freezing may often be 
used to advantage to prevent pain in the performance of slight sur¬ 
gical operations. 

Electricity occupies a very important place as a remedy for the 
relief of pain. As a general rule, the galvanic current is more effect¬ 
ive than the faradic, though the latter sometimes succeeds when the 
other fails. Electricity is the most useful in cases not characterized by 
inflammatory action. In congestion, it gives relief by causing contrac¬ 
tion of the extended blood-vessels. As a general rule, the positive 
pole should be applied at the seat of pain while the negative sponge 
is placed near by, at some point below, or at the origin of the nerve 
of the part. We have often felt exceedingly gratified for the assist¬ 
ance given us by this remedy in relieving the pain of suffering patients. 

Rubbing, gently stroking the part which is the seat of the active 
pain, will not infrequently secure prompt relief from suffering. This 
is especially true in the case of headache, pain in the joints, and in 
some cases of neuralgia and muscular rheumatism. Many popular 
liniments owe their efficacy almost wholly to the friction with which 
they are applied. It is well known that a liniment does no good 
unless it is well rubbed in. A remedy which many years ago was 
very popular for the relief of pain consisted wholly of olive-oil with 
the addition of a little beeswax. Gentle stroking of the head and 
spine will often give more complete relief in severe nervous headache 
and general nervous irritability than any other remedy which can 
be applied. 

Rest and Position are also effective means of relieving pain in 
certain cases. Severe headache generally requires a recumbent posture. 
Pain and neuralgia also demand rest. Pain arising from inflamma¬ 
tion in the extremities is generally relieved by elevation of the af¬ 
fected part. It is for this reason that the hand is carried in a sling 
when a person is suffering with a felon. Pain or chronic ulcer of the 
leg is also found to be relieved by elevation of the affected limb. 
Pressure also exercises a favorable influence upon pain in many cases, 
as seen in the beneficial effects derived from the rubber bandage and 
the elastic stocking in varicose veins of the limbs. A tight band 
about the head will sometimes relieve nervous headache when other 
means fail. Many persons who suffer with headache intuitively hold 
the head between the hands when the paroxysms of pain are severe. 


1068 


DISEASES AND THEIR TREATMENT. 


Pressure upon the affected side of the chest in pleurisy is sometimes 
very effective in relieving the sharp pain which accompanies respira¬ 
tion in this disease. Pleurodynia also yields to pressure with equal 
facility. 

Diet is in many instances a potent factor in the production of 
pain, and may be made equally effective in its relief. Abstinence from 
the use of flesh food will frequently relieve obstinate headaches and 
neuralgias, especially those arising from congestion. The terrible pain 
of aneurism of the chest may be relieved by abstaining from fluids as 
much as possible, so as to diminish the volume of the blood. The suf¬ 
fering from asthma and emphysema is greatly mitigated by the dis¬ 
use of sugar, starch, butter, and other food elements which are likely 
to form gases. The pain of ulcer of the stomach may be avoided by 
resorting to feeding by means of the rectum. Severe pain in the kid¬ 
neys and bladder is frequently relieved by copious water-drinking. 
The smarting, burning pain which follows urination when the urine 
is scanty and high-colored is generally very popularly relieved by 
this means. 

Drugs are to be employed as little as possible for the purpose of se¬ 
curing relief from pain. One reason for this is that in general they do 
nothing toward removing the cause of the symptom. Another still more 
important reason is, that, being simply palliatives, a tolerance of their 
pernicious influence is soon acquired by the system, so that their effect 
cannot be obtained without steadily increasing the size of the dose. 
It is through this means that the majority of opium-eaters, hashish 
devotees, and chloral users are led into the fatal snare. As a general 
rule, too, the drug employed for the relief of pain when it is long- 
continued creates a disease often worse than that which it is attempt¬ 
ing to cure. In cases of extreme suffering which are not relieved 
by any measures which have been mentioned, and especially in cases 
in which the pain is due to an acute cause, which can speedily be 
removed, or when the patient is suffering from a malady, the nature 
of which renders it incurable, opiates or any other drugs which will 
secure relief from suffering may be very properly employed, but 
should be used entirely under the supervision of a careful and 
intelligent physician. Nothing could be much more pernicious than 
the habit which many people have of keeping in the house some 
anodyne preparation, which generally contains more or less opium, 
in readiness for use on short uotice, whenever any member of the 


VERTIGO. 


1069 


family may happen to have pain, no matter how trifling may be the 
degree of suffering. One of the greatest obstacles to be overcome 
in the treatment of opium-eaters is the lack of fortitude on the part 
of the patient, a condition which has been brought about by the 
constant yielding to the disposition to avoid pain, no matter of how 
slight a character. It is possible for a person to receive injury from 
the strain upon the nervous system, occasioned by severe pain, but as a 
general rule, much more injury is done the patient by the drugs em¬ 
ployed for the relief of pain than would be occasioned by the pain it¬ 
self. The drugs which are generally employed for relieving pain not 
only do not reach the real seat of the disease, but by their paralyzing 
effect upon the nerve centers, in some degree interfere with the restor¬ 
ative efforts of nature, thus putting a real obstacle in the way of re¬ 
covery. Opium is especially damaging in this particular. It also has 
a well-recognized tendency to produce constipation of the bowels, in¬ 
activity of the liver, and, in fact, of all the other excretory organs, 
thus interfering with nutrition and producing a feverish condition of 
the system. It should be only resorted to as the last of all means for 
relieving pain. Belladonna, gelsemium, Indian hemp, and other al¬ 
lied remedies, are much to be preferred to opium, although they are 
somewhat less effective in action. Painful surfaces may frequently be 
relieved by the application of a solution of glycerine in water or by 
the employment of simple mucilaginous lotions of various kinds, as 
linseed tea, slippery-elm water, etc. A solution of tannin in glycerine 
of moderate strength is sometimes very effective as a means of reliev¬ 
ing pain. 

VERTIGO. 

Dizziness may be the result of too much or too little blood in the 
brain. It is a very frequent symptom of indigestion, being often caused 
by gas in the stomach. By pressure of the distended stomach upon the 
aorta, it interferes with the circulation of the blood in the lower ex¬ 
tremities and causes congestion of the head. The use of tobacco, tea 
and coffee, and alcohol, are frequent causes of severe, obstinate vertigo. 
This is especially true of tobacco. Exposure to great heat, either of 
the sun or other artificial sources, is a cause which is especially active 
in hot weather. Malaria sometimes produces vertigo. Loss of sleep, 
overwork, sexual excesses and abuses, and inhalation of impure air 
are very frequent causes. A few cases have been observed in which 


1070 


DISEASES AND THEIR TREATMENT. 


most obstinate vertigo was produced by disease of the ear. It has also 
in some cases depended upon diseases affecting the heart, brain, spine, 
kidneys, liver, or sexual organs. 

Treatment. —Attention to all the laws of hygiene, avoidance of the 
known causes, employment of a simple unstimulating diet comprising 
but a very small portion of meat, constitute the main essentials of the 
treatment of obstinate vertigo. When it is induced by congestion, a 
hot foot-bath should be employed with cold applications to the head, 
and the patient should sleep at night with his head elevated, and 
should avoid stooping. When the symptom is due to the opposite 
condition of the blood-vessels of the brain, or anaemia, the patient 
should remain in a horizontal position as much as possible, and should 
avoid rising suddenly from a recumbent or sitting posture. Upon the 
approach of an attack of vertigo, he should lie down at once, or bend 
the body forward with the head between the knees. Such other 
measures should be employed as are recommended for cerebral anaemia. 

NERVOUSNESS. 

This is a condition so exceedingly variable in character as to be 
very difficult of description, yet so common that few are unaware 
of its nature. It may perhaps be said to be a morbidly sensitive or 
irritable condition of the nervous system. A person who is nervous, 
is generally timid, being startled by the slightest noise or unusual 
circumstance. The unexpected appearance of a friend, the receipt of 
sudden news, or the occurrence of anything . outside of the usual 
routine, is likely to occasion trembling and perhaps a considerable 
degree of prostration. Nervous people are generally harassed with 
apprehensions, and imaginary difficulties; the little annoyances of life, 
winch in health pass unnoticed, appear in a greatly exaggerated light. 

Irritability of temper, and a disposition to complain, find fault and 
scold, are among the features of nervousness. In some people it as¬ 
sumes a form which is sometimes termed fidgets. The patient is una¬ 
ble to sit still or remain in any one position for any considerable length 
of time. If he sits, he is constantly moving his feet and twisting 
about in his chair. If he stands talking to a friend, he changes his 
position every few seconds. When he goes to bed, he finds it difficult 
to lie still long enough to get asleep, and general restlessness and dis¬ 
quiet keep him in constant motion. 

Nervousness is a symptom which accompanies a great variety of 


NERVOUS EXHAUSTION. 


1371 

diseases. Though generally looked upon as of trifling importance, it 
is really a difficulty worthy of serious attention. A person whose 
nervous system is in a healthy condition is never nervous. One of the 
most common causes of nervousness is some disorder of dffies- 
tion. All forms of dyspepsia are characterized by nervousness of a 
greater or lesser degree; and in nervous dyspepsia it is one of the 
most prominent symptoms. An inactive condition of the liver, consti¬ 
pation of the bowels, and in females disease of the womb and ovaries, 
are morbid conditions in which nervousness is prominent. The use of 
tea, coffee, tobacco, and alcoholic liquors, are each and all responsible 
for a very large share of the nervousness which prevails at the pres¬ 
ent day Sedentary habits, novel-reading, loss of sleep, dissipation, 
sexual excesses, and all causes which depress the nervous system are 
causes of nervousness. 

Treatment. —As nervousness is only a symptom, the first business 
of an individual suffering from it should be to ascertain its cause. 
When this is done, injurious influences should be at once removed, 
and in a majority of cases this is all that is required. When the dif¬ 
ficulty depends upon some local or general disease, the morbid condi¬ 
tion from which it arises should receive proper attention. 

General tonic treatment, especially the use of electricity, massage, 
and tepid sponge baths, are among the best measures of treatment. 
Special attention should be given to the diet. It should be unstim¬ 
ulating in character, condiments of various kinds being wholly 
avoided. As a general rule, meat should be taken in very small 
quantities, the less, the better, provided the patient has an appetite 
for other food and is able to digest fruits and grains. A sufficient 
amount of exercise should be taken in the open air each day, and the 
patient should have abundant opportunity for rest and recreation. 

NEURASTHENIA, OR NERVOUS EXHAUSTION. 

SYMPTOMS.—Tenderness of the scalp ; dilated pupils; headache; pain, pressure, 
and heaviness in the head; spots before the eyes; noises in the ears; irritability of 
temper ; melancholy; fear of lightning, of solitude, of society, and other morbid fears ; 
nervousness; peevishness; sleeplessness; bad dreams; morbid desire for stimu¬ 
lants; dryness of the skin; swelling of the hands and feet; tenderness of the spine, es¬ 
pecially of the lower end; palpitation of the heart; excessive ticklishness; cold hands 
and feet; nervous chills; in some cases, great debility. 

This disease includes a great variety of conditions which are 
closely related. Its real nature is a condition of the nervous sys- 


1072 


DISEASES AND THEIR TREATMENT. 


tem in which there is a deficient development of nerve force. A 
patient suffering from neurasthenia may be either thin, pale, weak, 
or he may be fleshy, muscularly strong, florid, full-blooded. He may 
be suffering with either hypersemia or anaemia of the brain, or may be 
free from either affection or liable to both conditions in alternation. 

Neurasthenia is one of the most frequent of all nervous disorders. 
It occurs in all grades of society, but is much the more frequent 
among the more cultivated classes. It seems indeed to be rapidly in¬ 
creasing from year to year. Although it cannot be classed with 
such grave affections as softening of the brain and locomotor ataxia* 
it is deserving of serious attention, since it not infrequently leads to 
much more serious disorders, prominent among which may be men¬ 
tioned the various forms of insanity. In some cases the brain is 
chiefly affected, while in others the spinal cord seems to be the prin¬ 
cipal seat of the disease. In still other cases both brain and spinal 
cord are equally affected. 

Causes. —All the general causes of the nervous diseases mentioned 
at the beginning of this section are active in producing neurasthenia. 
Among the most important of these may be mentioned excessive men¬ 
tal work, especially when of an irksome or worrisome character, loss 
of sleep, sexual excesses, especially youthful indiscretions, errors in 
diet, especially the excessive use of meat and the use of stimulating 
condiments. Alcoholic liquors and tobacco are exceedingly active 
causes of neurasthenia in men, while the use of strong tea and coffee 
are equally active in producing the disease in the opposite sex. 

The habitual use of opium, chloral, and other popular remedies for 
relieving pain and producing sleep, are exceedingly productive of neu¬ 
rasthenia. Any cause which diminishes nerve power by interfering 
with the nutrition of the nerves, or by occasioning an excessive expen¬ 
diture of nerve force, may be regarded as a cause of neurasthenia. 

Treatment. —Nearly all cases of neurasthenia are curable if the 
proper conditions and treatment can be supplied ; the majority of 
cases will recover in time with the simple abandonment of all the 
causes, and careful attention to hygienic measures. When the brain 
is the chief seat of the malady, the patient will generally be benefited 
by taking a large amount of exercise in the open air. In cases in 
which the spine is the seat of the difficulty, equal attention should be 
given to securing rest. Overexertion and fatigue should be carefully 
avoided. In the latter class of cases, the diet should be abundant and nu- 


XER VO US EXHA USTIOX. 


1073 


tritious, but unstimulating. The best authorities are agreed that a fruit 
and grain diet is much to be preferred to a flesh diet for neurasthenic 
patients. In regulating the diet, of course the conditions of the digest¬ 
ive organs must be taken into consideration. As a general thing, the 
patient may be allowed to take milk quite freely. In some cases milk 
is especially to be recommended as the chief article of diet. Sweet 
cream, when it agrees well with the stomach, is an excellent article of 
food for patients suffering with nervous exhaustion. If the patient is 
full-blooded and fleshy, a wet-sheet pack, vapor or hot-water bath once 
or twice a week will be advantageous. When the opposite condition 
exists, all kinds of reducing treatment should be avoided. 

Frequent tepid sponge baths, either with pure water or with a 
teaspoonful of salt to the pint, is a valuable tonic measure. In most 
cases a sponge bath can be taken daily with benefit. 

Faradization (p. 693), and central galvanization, are among the 
most valuable of all remedial measures. Alternate hot and cold appli¬ 
cations to the spine, ice packs of brief duration, and fomentations 
applied from the spine over the region of the stomach and liver and 
other painful points, are measures which we have used in many cases 
with very great success. 

It is important to have the thorough co-operation of the patient*. 
It is necessary that his entire confidence should be enlisted. Faith,, 
hope, and will-power will do much toward securing recovery, no mat¬ 
ter what remedies are employed. We have seen patients suffering 
with nervous debility gain rapidly when taking daily a single drop of 
medicine, the only property of which was a very bad taste, and with¬ 
out any other treatment; but the element of faith was strongly en¬ 
listed, and thus excellent results were secured through mental influ¬ 
ence alone. A lengthy course of treatment is required in some cases 
on account of the obstinate character of the conditions on which the 
nervous debility depends. The measures of treatment which have 
been recommended should be perseveringly employed, however, and 
in a great majority of cases success will be attained at last. 

68 


1074 


DISEASES AND THEIR TREATMENT. 


< i l<K\. OR IIYPEKiEJILl OF THE BRAD. 

SYMPTOMS. —ACTIVE : Wakefulness, or troubled, unrefreshing sleep; bad dreams; 
confusion of mind, with loss of power of concentration of thought; loss of memory, es¬ 
pecially of names; unintentional neglect of most important matters; fullness of the head; 
headache ; sensation of a tight band about the head, with various other strange and pe¬ 
culiar sensations ; frequent flushing of the face and throbbing of the arteries of the neck 
and temples; despondency; morbid fears; peevishness and great restlessness; morbid 
sensitiveness; dizziness; roaring or other noises in the ears; dread of loud sounds ; dis¬ 
turbance of vision by flashes of light, or black spots before the eyes; eyes often red, 
watery, and sensitive to the light; twitching of the muscles of the face, particularly of the 
eyelids and corners of the mouth; twitching and cramps in other muscles of the body; 
Jn many cases slight difficulty in the pronouncing of certain words.or syllables, especially 
when fatigued; thickness of speech; extremities feel large and awkward; pulse usually 
slow and full; digestion slow and imperfect; bowels constipated; urine scanty and dark 
colored. 

PASSIVE : Symptoms mostly the same as above, or less marked; drowsiness and 
.unnatural stupor are prominent symptoms. 

Hvperaeniia of the brain is a much more frequent disease than is 
generally supposed ; in fact, it is probably the most common of all 
nervous disorders. The failure to recognize this affection in its early 
stages not infrequently results, from a neglect of proper treatment, in 
much more serious and frequently incurable disease. There is good rea¬ 
son for believing, also, that this disease in its severer forms is not infre¬ 
quently mistaken for insanity, patients being confined in lunatic asylums 
in consequence of temporary mental derangement wholly due to a con¬ 
gestion of the brain, which would readily yield to simple rest, seclusion 
from exciting causes, and a proper plan of treatment. The symptoms 
given above are chiefly those which appear in the simpler forms of the 
disease and in its earlier stages. If the malady is not checked, much more 
serious results ultimately occur. Among the principal of these are apo¬ 
plexy, epilepsy, convulsions and insanity. 

Causes. —Active congestion is produced by any cause which occa¬ 
sions the flow of a large quantity of blood to the head. Passive conges¬ 
tion is occasioned by all causes which interfere with the return of the 
venous blood from the brain. Among the principal causes of active 
congestion may be mentioned mental overwork, loss of sleep, excessive 
mental anxiety, and the use of alcoholic liquors, opium, quinine, bella¬ 
donna, and various other drugs ; also certain articles of diet, particularly 
excessive quantities of animal food, and stimulating Condiments, as mus¬ 
tard, spices, pepper, etc. Overeating and eating too fast, by producing 


HYPEREMIA OF THE BRAIN. 


1075 


disorders of digestion, are frequent causes of active congestion of the 
brain. Constipation of the bowels is also a frequent cause, not only by 
exciting a feverish condition of the circulation, but by occasioning severe 
straining at stool. Exposure to the rays of the sun in hot weather or 
to excessive heat at any time when fatigued, frequently produces most 
severe active congestion. Passive congestion is occasioned by any con¬ 
striction about the neck, as a tight collar or cravat, by the pressure of 
the large thyroid gland as in goitre, by tight lacing, and by many 
of the causes already mentioned. Both active and passive congestion 
are produced by the various forms of heart disease. Both active 
and passive congestion are frequently met with in cases of long-standing 
affections of the stomach, liver, lungs, and other internal organs. Uter¬ 
ine disease is a very frequent cause of cerebral congestion in women. 

Treatment. —The sufferer from cong-estion of the brain should 
carefully ascertain the cause of the disease, and should then, without de¬ 
lay, change his habits and mode of life, so as to secure the most com¬ 
plete avoidance of all exciting causes. If he is actively engaged in bus¬ 
iness, he should, if possible, take a journey, leaving all his cares behind. 
If, however, this cannot be done, or if the case has reached so severe a 
stage that a journey would be impracticable, the most complete relief 
from care and seclusion from exciting causes should be secured at home, 
and an energetic course of treatment should be pursued. One of the 
most efficient measures for active congestion is the application of ice and 
cold compresses to the whole head, or to the nape of the neck. Appli¬ 
cations should be made once or twice a day, and should be continued 
from half an hour to an hour at a time. In most cases the cool applica¬ 
tions to the head should be accompanied by the hot leg or sitz bath. 
Wearing of the wet head-cap continually, night and day, for a few 
weeks is another useful measure. The hot-air bath, wet-sheet pack, 
rubbing- wet-sheet, and the half bath, are also excellent measures. The 
hot half bath may be used daily to great advantage. Other baths, in 
case the patient is quite strong, may be used daily for a time, then 
every other day. In less vigorous patients, such vigorous treatment as 
packs and hot-air baths should not be employed more often than two to 
four times a week. 

Persons suffering from passive congestion require less vigorous treat¬ 
ment than those suffering with the active form of the disease. In the 
majority of cases, the proper indications in passive congestion are such 
as will have a tendency to remove the cause of obstruction to the return 


107G 


DISEASES AND THEIR TREATMENT. 


of the blood to the head. We have frequently obtained better results 
by the employment of hot fomentations to the back of the neck, or be¬ 
tween the shoulders, with cold applications applied to the top of the 
head, than by the use of cold alone. 

Galvanism may also be applied with excellent effect in many cases. 
The best methods of application are as follows: 1. Place the positive 
pole at the base of the head, and the negative pole upon the spine, six or 
eight inches below ; 2. Place the poles of the battery upon the bony 
prominences just behind the ears, thus passing the current through the 
head ; 3. Apply the current by the method known as central galvan- 
ziation, in which the negative pole is placed at the pit of the stomach, 
and the positive at the top of the head—the hair being moistened—the 
latter, after one or two minutes, being applied to the sides of the neck 
and the spine. 

Sleeplessness is best relieved by the wet head-cap, continuous com¬ 
press, or cold-water bag applied to the head, and the hot foot-bath, taken 
at night just before retiring. In many cases, these measures are greatly 
aided by the application of fomentations over the stomach, and wearing 
of a wet bandage about the bowels at night. The patient should sleep 
with his head elevated. In many cases it is better to elevate the head 
of the bed than to bolster the patient up with pillows. When the 
bowels are constipated, great care should be taken to keep them open 
by means of enemas, if necessary. Laxative drugs should not be taken 
if their use can possibly be avoided; and cases are very rare in which 
they are really required. 

Great care should be bestowed upon the diet, which should consist 
almost wholly of fruits and grains. The patient should take neither 
coffee, tea, nor alchoholic liquors of any kind. Tobacco in all forms 
should be discarded. Stimulating condiments should also be disused. 
The diet should be made as simple as possible, and the patient should 
use great care to avoid overeating and to masticate his food thoroughly. 
When the patient is troubled with acidity, gas, and heart-burn, great 
benefit may be derived by the use of pulverized charcoal after each 
meal. We frequently use a mixture of one part of pepsin with three of 
charcoal with excellent effect. The patient may take from half a tea¬ 
spoonful to a teaspoonful of the char goal half an hour after eating. The 
use of charcoal crackers is also advantageous. Other symptoms of indi¬ 
gestion should be treated according to directions given elsewhere. 


AN JEM I A OF THE ERA IX. 


1077 


A\EMU OF THE HRIIA. 

SYMPTOMS. —ACUTE: Fainting; pallor; dilated pupils; pulse weak, frequent and 
threadlike ; sighing respiration ; cold extremities. 

CHRONIC: Vertigo; especially on rising from a lying or sitting posture ; headache, 
epecially at the top or back part of the head, often confined to a small spot; ringing in 
the ears ; great sensitiveness to noise; in many cases, drowsiness in day time, wakeful¬ 
ness at night; pain m head and eyes, excited by reading; pupils dilated; eyes sensitive 
to light; nausea and vomiting, sometimes convulsions ; great debility ; pulse weak, either 
slow or frequent; palpitation of the heart; symptoms of dyspepsia. 

The symptoms of anaemia of the brain frequently resemble so closely 
those of the opposite condition that the two may be easily confounded. 
The mistake need not be made, however, if attention is given to the 
causes by which the condition has been produced. It should also be ob¬ 
served that one of the conditions is usually relieved by measures which 
aggravate the other; for example, active congestion is aggravated by 
lying down or stooping forward, while in anaemia the symptoms are ag¬ 
gravated by rising up and are often wholly relieved while the patient 
remains in the horizontal position. The dilated pupil of anaemia is also 
a characteristic symptom, the pupil being contracted in congestion. 

Causes. —Anaemia of the brain is most common in women, as con¬ 
gestion of the brain is most frequently met with in men. One of the 
most common causes of anaemia is loss of blood from hemorrhoids ; ex¬ 
cessive flowing at menstruation, or in child-birth, particularly in mis¬ 
carriage, and abortions. It may also be occasioned by hemorrhage 
from the nose, by great loss of blood in surgical operations or by acci¬ 
dental hemorrhages. Among other causes may be mentioned exposure to 
cold ; poor food ; the use of tobacco ; excessive mental work ; lack of 
exercise in the open air ; dyspepsia ; sexual excesses, especially secret 
vice; seminal losses ; and uterine disorders. 

Treatment. —The essential or most important measures of treat¬ 
ment, are those which will improve the patient’s general nutrition. He 
should take a very nourishing diet, which may include, with advantage 
in some cases, a considerable proportion of animal food, especially if the 
digestive organs are somewhat weak. Abundance of sleep should be 
taken, and the patient should ride out in the open air and sunshine daily, 
and take other gentle exercises. Care should be taken, however, to avoid 
much exercise, and the patient should, for a time at least, spend the 
larger share of the twenty-four hours in a horizontal position. A con¬ 
siderable amount of mental exercise may be taken to advantage after 


1078 


DISEASES AXD THEIR TREATMENT. 


quite a degree of improvement has been secured, except in a few cases in 
which the affection is the result of mental overwork. The employment 
of massage, inunction, and applications of electricity to the spine, etc., are 
beneficial. Advantage will also be derived from the use of a very mild 
galvanic current, passed through the head by placing the two poles upon 
the bony prominences behind the ears. 

APOPLEXY. 

SYMPTOMS .—WARNING: A sensation of weight and fullness in the head; head¬ 
ache and dizziness, especially on stooping; noises in the ears ; sometimes temporary 
deafness; blindness or double vision ; frequent nosebleed; nausea; numbness in limbs, 
especially on one side; incoherent remarks; thickness of speech ; drowsiness or stupor; 
partial paralysis, affecting the face, eyelids or the limbs; heaviness or stiffness in the 
limbs; slow and irregular pulse; irritability of temper. 

MODE OF ATTACK : May begin in three ways. 1. The patient falls suddenly, un¬ 
conscious and motionless; face flushed; appearance of deep sleep with snoring; pulse 
full and slow; sometimes convulsions or rigid contraction of the muscles. 2. Sudden 
pain in the head; faintness; pallor; nausea; sometimes vomiting; sometimes patient 
falls unconscious; in other cases only slight loss of consciousness, patient suffers with 
headache and gradually becomes dull, stupid, and finally unconscious. 3. Sudden paral¬ 
ysis of one side; loss of motion but not of consciousness; may come on during sleep, 
the patient finding one side paralyzed on awakening. 

DURING ATTACK: Partial or complete unconsciousness; pulse small at first, gen¬ 
erally becomes full and strong and usually slow; sometimes interrupted; respiration 
slow and snoring; froth about the mouth ; cold clammy sweat; face pale ; eyes dull and 
staring, usually looking away from paralyzed side; one or both pupils dilated; teeth set. 

Apoplexy is a quite common cause of death, though probably not so 
common as it is sometimes thought, as many of the deaths attributed to 
apoplexy are really due to some other cause, particularly disease of the 
heart. The symptoms described vary in different cases, according to the 
immediate causes from which they rise and the particular part of the 
brain affected. In the worst cases of apoplexy the injury to the brain 
consists in the rupture of a blood-vessel, a clot being formed in the brain- 
substance by means of which the function of the affected part is de¬ 
stroyed. In some cases the clot formed is so large, and the consequent 
injury is so great, that instant death occurs. In other cases, death re¬ 
sults after a considerable lapse of time through the suspension of certain 
important functions. In still other cases, death is occasioned by the in¬ 
flammation itself set up about the clot, which acts as a foreign body in 
the brain. This inflammation generally begins within from two to eight 
days after the attack occurs. The milder attacks of apoplexy are occa- 


APOPLEXY. 


J(J7!> 


sioned by the formation of a very small clot or by a sort of concussion 
of the brain due to sudden and extreme congestion. Cases also occur in 
which part of the brain becomes suddenly disabled by the blocking up of 
an artery with a small clot which usually comes from the heart. This, 
is termed embolism. 

The symptoms of inflammation sometimes resulting from the form¬ 
ation of a clot are pain and heaviness in the head, delirium, con¬ 
traction of the paralyzed limb, especially affecting the flexor muscles, 
congestion of the face, elevation of the temperature with decrease of the- 
frequency of the pulse and respiration. The apoplectic attack may last 
two or three hours or several days. It finally terminates in one of three- 
ways. It may gradually pass off' within a short time, leaving the patient- 
well or nearly so. It may end in partial recovery, the mind remaining 
somewhat impaired and some parts of the body paralyzed ; or it may 
terminate in death. In the majority of cases there is more or less loss of 
sensation as well as power of motion in the affected parts. Sensibility- 
returns quite early, however, even when muscular paralysis remains. 

Among the symptoms which remain in severe cases after tilt- 
acute attack is over may be mentioned the following :' Paralysis of the 
limbs, usually affecting the side of the body opposite the point of injury 
in the brain ; that is, if the injury to the brain occurs upon the left side, 
the paralysis will be upon the right side. The opposite of this is true, 
however, respecting the muscles of the face. The extensor muscles, or 
those upon the outer side of the limbs, are generally affected the most 
seriously. The result of this is contraction of the flexor muscles, which 
cause various distortions, such as closing of the hand, drawing of the 
arm toward the opposite side of the body, etc. The arms are generally 
affected more than the legs; the lower extremities generally recover 
the most rapidly. According to Trousseau, when the opposite of this is 
true, the improvement is only temporary, and the patient is almost cer¬ 
tain to die within a short time. Paralysis of the tongue is shown by di¬ 
vergence of the organ from the direct line when it is protruded. In se- 
vere cases it is protruded with difficulty, and turns toward the paralyzed 
side. The disturbances of sensation are not always complete paralysis, 
sometimes being the loas of natural sensibility which is replaced by pe¬ 
culiar sensations, one of the most common of which is that of ants craw 1 - 
ing on the skin. This is known as formication. Sight and hearing are 
sometimes seriously affected. Mental disturbances, sometimes severe, at 
other times verv slight, are generally more or less prominent, being- 


f 


1080 


DISEASES AND THEIR TREATMENT. 


shown in feebleness of intellect, loss of memory, stupidity, childishness, 
peevishness, irritability, inclination to w r eep. Sometimes there is gradual 
loss of intelligence, resulting in imbecility. Insanity rarely occurs. A 
very common result is loss' of memory of words. The patient seems to 
be able to think correctly but cannot remember the names of objects. 
If the name is spoken, he will usually recognize it, but cannot speak the 
word himself when he wishes, though he may be able to repeat it when 
he hears it spoken. Numerous examinations after death have shown 
that in these cases there is an injury of a certain portion of the brain 
upon the left side which is believed to be, in view of the facts stated, the 
organ of language. Bed-sores sometimes occur upon the paralyzed side 
within a few days after the attack. Swelling of the joints is also an oc¬ 
casional result. 

A person who has had one attack of apoplexy is more liable to an¬ 
other than if he had not had the first attack, and the liability increases 
with the number of attacks; but the popular supposition that the 
third is necessarily fatal is an error. 

When the person falls in a fit of unconsciousness, it is sometimes 
difficult to determine whether he is suffering with apoplexy or with some 
other affection. In some cases, it is impossible to determine at first the 
real nature of the attack. The flushing of the face, and the slow, full 
pulse, will generally distinguish apoplexy from fainting, or syncope. 
The thermometer also furnishes a means for distinguishing it from deep 
intoxication, as in apoplexy the temperature is always higher than nat¬ 
ural, while in a person who is dead drunk, it is a little below the normal 
standard. 

Causes. —Apoplexy occurs more often in males than in females. 
With respect to age, the disease is rare before twenty-two years, and in¬ 
creases in frequency with the increase of age from twenty-two years 
upward. It occurs most often during the cold season of the year, and ac¬ 
cording to the observations of Sarmani the hours from three to five o'clock 
in the afternoon, and two to four in the morning, are those in which the 
greatest number of cases occur. A very important predisposing cause 
of the disease is a weakening of the arteries of the brain. This is very 
likely to take place in old age. It is also a very frequent result of the 
use of alcoholic liquors. The tendency to this disease seems also to be 
hereditary, although the idea which once prevailed that persons with 
large heads, short thick necks, prominent abdomens, and a tendency, 
to accumulate flesh, are particularly liable to this affection, is erroneous 


APOPLEXY. 


1081 


since careful observations show that .persons quite the opposite 
in the particulars mentioned are equally liable. Among the ex¬ 
citing causes may be mentioned, the use of opium, alcoholic liquors, and 
other stimulants and narcotics; overeating, and the use of stimulating 
and indigestible food; excessive joy, rage, terror, and other strong men¬ 
tal emotions ; great physical exertion; straining at stool induced by 
constipation ; sexual excesses, especially in persons over fifty ; tight 
clothing about the neck ; tight-lacing ; severe vomiting ; hard cough¬ 
ing or sneezing ; immoderate laughter ; exposure to great heat ; pro¬ 
longed hot baths ; cold bathing and heart disease. 

Treatment.— We will consider the treatment of this affection under 
four separate heads as’follows :— 

1. Preventive Treatment. —This consists chiefly in the careful avoid¬ 
ance of all the known exciting causes of the affection. The predispos¬ 
ing causes should also be avoided as far as possible. A person who lias an 
hereditary tendency to the disease should exercise especial care, and avoid 
every exciting cause, and should especially abstain from the use of all 
kinds of stimulating food. Flesh diet is especially injurious for such 
persons. The diet should consist almost wholly of fruits and grains. 
Milk may be used freely, but eggs and fish should be used only in mod¬ 
eration. Tobacco, alcohol, tea, and coffee should be utterly discarded. 

2. Treatment During the Attack. —When a patient falls in an 
apoplectic attack, or is found in a state of unconsciousness exhibiting 
symptoms of such an attack, energetic measures should be employed at 
once. To relieve the pressure of blood in the head, ice should be freely 
applied all about the head, the head being first thoroughly wetted with 
ice water so as to secure an immediate effect. The shirt collar should 
be unbuttoned and all clothing about the neck loosened. The head 
should be raised and the extremities and other parts of the body thor¬ 
oughly warmed by the application of artificial heat by means of hot 
bottles, jugs or rubber bags filled with hot water, heated bricks, bags of 
heated sand or salt, etc. 

If the attack is the result of overeating, having followed a heavy 
meal, an emetic should be given with a large quantity of warm water, 
so as to prevent violent efforts in vomiting. If the patient does not 
vomit readily, vomiting may often be induced by tickling the throat 
with the finger or a feather. Bleeding, a measure so often practiced in 
apoplexy, is of very doubtful necessity. Trousseau remark with refei- 


10s2 


DISEASES AND THEIR TREATMENT. 


ence to bleeding, “No physician, however, thinks of bleeding for the ex¬ 
travasation of blood under the skin, for he knows how perfectly absurd 
such a practice woidd be, and would excite an adverse reaction. There 
is no difference between it and the cerebral clot.” 

Dr. Hammond says, “ I have never bled a patient for cerebral hem¬ 
orrhage since 1849, and I am sure that I have had no reason to regret 
the abandonment of the practice.” If the bowels are constipated, 
they should be relieved by a large, warm-water enema. If water 
alone is not effective, strong soap-suds may be employed, or a little 
extract of senna may be added to the water used. The routine prac¬ 
tice of giving a cathartic at once is to be condemned. 

3. Treatment Immediately After the Attack .—Put the patient in 
a quiet room. Give him a good nurse and exclude all visitors. Con¬ 
tinue the application of cold compresses or ice to the head until the 
danger of inflammation is past, which will be after seven or eight days ; 
keep the extremities well warmed; relieve the bowels daily or every 
other day by the use of the enema. If the bladder is paralyzed, the 
urine should be drawn with a catheter two or three times a day. It 
should be recollected that in some cases when the bladder is paralyzed 
there will be continual dribbling of urine. The patient’s diet should 
consist of simple, easily digested food, as milk, oatmeal porridge, sim¬ 
ple soups, etc. Rich, stimulating food, especially meat and fats of all 
kinds, should be strictly prohibited. In case the patient is uncon¬ 
scious and unable to swallow food, he should be nourished by means 
of nutritive solutions injected into the bowels. See “ Nutritive Injec¬ 
tions,” page 787. 

If the fever rises quite high, sponge baths or cool compresses 
about the trunk of the body should be used as in fever from any 
other cause. * A cool enema taken at a temperature of 65° to 80° is a 
very excellent means of reducing the temperature in these cases. 
These measures should be employed whenever marked evidences of 
fever make their appearance. The use of blisters applied to the 
wrists, ankles, and calves of the legs, are in the highest degree absurd. 
The application of the blister to the back of the neck is also of very 
questionable propriety. Bed-sores should be treated by means of 
alternate hot and cold sponging applied for 20 or 30 minutes twice a 
day. They should be covered during the intervals with oiled silk or 
gutta-percha tissue, smeared with vaseline containing ten drops of 
carbolic acid to the ounce. See also “ Bed-Sores ” in section devoted 
to surgery. 


Al'Ul'LEX Y. 


1083 


f. Treatment of the After-Results. — We consider it specially 
important that the public should he rendered intelligent respecting- 
this part of the treatment of this disease, as a large share of the cases 
of paralysis of long standing might have been cured quite rapidly if 
the proper treatment had been applied at the proper time. Mo active 
measures should be employed so long as there are evidences of irrita¬ 
tion of the brain or danger from inflammation. By the end of two or 
three weeks, however, if the patient still remains paralyzed, systematic 
efforts should be begun, to enable him, so far as possible, to regain the 
use of his limbs and to prevent deformity. These measures consist, at 
first, in daily bending and manipulation of the affected limbs. All 
the joints should be moved to prevent stiffening, and the limbs should 
be manipulated thoroughly so as to secure a vigorous circulation. 
Movements described in Figs. 250-266, in the section devoted to 
“ Medical Gymnastics,” are particularly adapted to these cases. It is 
also important that the patient should be required to move his limbs 
by his own effort as much as possible without too great fatigue. If 
he is unable to do this, he should be required to make an effort to per¬ 
form the motion given to the limb by the attendant. The effect 
will be much the same as if he moved the limb himself with a little 
help, though he really takes no part in it. This point is quite an im¬ 
portant one, as, in many cases, the patient remains paralyzed after the 
nervous connection which has been interrupted is fully restored, simply 
from want of voluntary control which has been lost through the long 
disuse of the affected part. The only way in which this difficulty can 
be overcome is by the plan suggested. The movements should he ap¬ 
plied only five or ten minutes each day at first, but can be gradually 
increased to fifteen or t\venty minutes twice a day. 

Electricity is an invaluable remedy in the treatment of paralysis. 
Bv means of this agent the paralyzed muscles may be made to con¬ 
tract the same as though controlled by the will. Electricity may bv 
applied in various ways. The most effective modes of application, 
however, are general and local faradization. For general directions 
for the use of electricity, see pages 693-703. Most of the paralyzed 
muscles may be made to contract by passing rapidly over them a large 
sponge electrode, using a current sufficiently strong to produce slight 
pain or contraction of the muscles. In some cases, however, it is nec¬ 
essary to apply the electric current in a more precise manner by local 
faradization. Tins is particularly necessary in a case of long standing 


1084 


DISEASES AND THEIR TREATMENT. 


in which the muscles do not easily respond to the stimulation of the 
electricity. In these cases, one pole of the battery should be placed 
in the foot bath in which the feet are also placed, while the other is 
applied successively to the various points indicated by dots in Figs. 319 
and 320. The nerves which control the various muscles of the body are 
most easily affected at these points. In some cases of paralysis of very 
long standing, the muscles will not respond to the faradic current until 
after a more or less prolonged course of treatment. Electricity may 
also be administered with o-reat advantage by means of the electro- 
thermal and the electro-vapor baths. When there is a great loss of 
sensation, it is sometimes necessary to apply electricity by means of a 
wire brush passed over the skin after it has been thoroughly dried. 

Mechanical movements of various sorts, or movements administered 
by machinery, are in many cases very useful. Baths of various kinds 
are also of very great advantage, especially daily sponging of the body 
with tepid water or salt and water. Sponging of the surface of the 
affected parts with water as hot as can be borne is a very excellent 
means of restoring lost sensibility. Alternate hot and cold rubbing, 
employing extremes of temperature as great as can be borne without 
discomfort, is also a very useful measure. The.application of fomen¬ 
tations daily, or every other day, and daily manipulation or kneading 
of the bowels, is a very good means of restoring the activity of the in¬ 
testinal canal and relieving constipation. When the skin is dry, in¬ 
unction with vaseline should be employed two or three times a week. 
Every possible means should be employed to improve the patient’s 
general nutrition. The diet should be nourishing and unstimulating. 
The less animal fats and condiments that are taken the better. The 
patient should be got out into the open air and sunshine as much as 
possible, and, when practicable, should be given daily sun-baths. Not¬ 
withstanding the employment of all the most approved remedial agen¬ 
cies, the most of cases will improve very slowly. Some will make 
very little improvement. A few will be restored to perfect health, 
but all, or at least nearly all, cases may be benefited more or less. 
Even though little improvement should be seen for several weeks, or 
even months, treatment should be patiently continued with unrelax¬ 
ing thoroughness, as most remarkable results have often been obtained 
even when all efforts have seemed to be fruitless for several months. 
We have treated many cases of paralysis, and have sometimes seen 
patients recover in a few weeks, while other cases have required as 
many months to accomplish even a small amount of improvement. 






































1086 


DISEASES AND THEIR TREATMENT. 


SCT-STROltE. 

SYMPTOMS.—Sudden pain in the head; fullness and pressure at the pit of the stom¬ 
ach ; sometimes nausea and vomiting; weakness, especially in the legs; dizziness; 
sight dim and indistinct; objects appear of one color, usually blue or purple; sometimes 
convulsions or delirium; insensibility: stupor; snoring or moaning respiration; pulse 
frequent and weak; skin dry and hot. 

Causes. —The affection known as sun-stroke is produced not only 
by exposure to the sun’s rays, but by exposure to great heat from any 
source. Persons employed in glass-works, laundries, and in similar oc¬ 
cupations, are subject to sun-stroke or heat-stroke, as well as those who 
are exposed to the sun’s rays. It generally occurs, also, in persons 
who are debilitated by great fatigue, or who have ceased to perspire. 
The affection is much more frequent in persons who are addicted to 
alcoholic stimulants than in others. 

Treatment. —When a person falls with sun-stroke, he should ar 
once be carried to a cool, shady place. His clothing should be re¬ 
moved and cold applications should be made to his head and over the 
whole body. Pieces of ice may be packed around the head, or cold 
water may be poured upon the body from a water pot. The shower 
pack, described on page 644, is by far the best remedy known for this 
affection. The great source of danger is the high temperature, which 
sometimes rises as high as 110 degrees. In addition to the measures 
suggested, the ice pack to the spine, and the cold enema, may also be 
employed. In many cases, complete recovery does not take place, the 
patient remaining more or less subject to some of the symptoms which 

follow immediatelv after the attack. 

%/ 


rEVKK. 

SYMPTOMS. —ACUTE: Fever; sometimes chill and convulsions; pulse hard and 
rapid; vomiting; constipation; severe headache, which is aggravated by light and 
noise; alternate pallor and flushing of the face; eyes red and staring ; pupils dilated; 
delirium; patient cross-eyed; restlessness; muscles twitching; after three or four 
days, less fever; slow pulse ; pupils dilated; stupor. 

CHRONIC: Symptoms obscure ; little or no fever; dullness; change of the disposi¬ 
tion ; paralysis in some cases ; headache and impairment of the mind, following an injury 
to the head. 

Under the head of brain fever we have included two affections, 
known as simple meningitis, or inflammation of the membranes of the 
brain, and cerebritis, or inflammation of the brain substance. Our 
reason for doing this is that the symptoms of the two affections are 


SOFTEN TNG OF THE BRAIN. 


10S7 


so near alike that it is often difficult or impossible for the most care- 
i'ul physician to distinguish between them; in fact, in many cases, 
both affections occur at the same time, thus making the two diseases 
one. Another form of inflammation of the brain, known as tubercular 
meningitis, is considered separately. Brain fever sometimes be¬ 
gins very insidiously, the symptoms not being at first sufficiently 
marked to attract serious attention, so that in many cases the real 
nature of the difficulty is not understood until the patient has reached 
an almost hopeless condition. This is especially true of chronic in¬ 
flammation of the brain, the final result of which is frequently the 
formation of an abscess. Brain fever beginning thus gradually has 
frequently been mistaken for insanity, and patients have been taken - 
to an insane asylum instead of receiving proper treatment. 

Causes. —The causes of inflammation of the brain are not very well 
understood, as many cases occur which cannot be traced to any distinct 
cause. It is known, however, that inflammation of the brain may be 
excited by blows upon the head, by exposure to the heat of the sun, and 
by the use of alcoholic drinks. 

Treatment. —The essentials of treatment are keeping the patient 
very quiet in a dark room, and applying cold to the head by means of 
cloths wrung out of iced water; or, ice compresses. In severe cases, the 
hair should be cut very close, so as to allow of the more complete cooling 
of the head. Only the most bland and unstimulating food should be 
taken, and it should be given cold. The cold enema is a very excel¬ 
lent measure of treatment in this and other affections characterized by 
high fever. In the second stage of the disease, when the pulse becomes 
slow, the pupils dilated, and the patient dull or stupid, in consequence of 
effusion into the brain, the treatment should be such as will have a ten¬ 
dency to produce absorption. This can seldom be accomplished, but it 
will be worth while to make a trial of alternate hot and cold applications 
to the base of the skull in eonj unction with the other measures described. 

SOFTEXISG OF TIIF BRAIT. 

SYMPTOMS,—Pain in the head; dizziness; impairment of intellect; drowsiness; 
despondency; slow and hesitating speech; loss of speech ; prickling and twitching of the 
limbs ; sight and hearing impaired; appetite good; tendency to accumulate flesh ; in ad¬ 
vanced stages of the disease, sometimes partial paralysis; weak pulse; vomiting; snor¬ 
ing breathing; unconsciousness. 

In softening of the cerebellum, usually pain at the back of the head; dimness of vis¬ 
ion ; paralysis; tottering gait; tendency to walk backwards: dizziness; dullness of 
hearing. 


1088 


DISEASES AND THEIR TREATMENT. 


Causes. —Softening of the brain may result from inflammation^ 
from the cutting off* of the supply of blood by an apoplectic clot, or bv 
injury to the skull by a severe blow. It is most likely to occur in old 
age. We have seen some cases in young men, in whom it was due to 
self-abuse. It is also produced by the use of alcoholic liquors, and by 
exposure to intense cold. Excessive brain work has been put down as 
one of the chief causes of the disease, probably on account of its frequent 
occurrence in persons who do a great deal of brain labor. We think, 
however, that this is a mistake. It is more probable that in these cases 
it is due to sedentary habits and errors in diet, two causes which act to¬ 
gether to produce congestion of the brain, and defective nutrition of the 
organ. 

Softening of the brain is by no means so common an affection as is 
generally supposed. A large share of the cases of so-called softening, 
are simply active or passive congestion, which in many cases, results 
from sedentary habits and abuse of the stomach. The real disease is a- 
very formidable one, and is seldom if ever cured. 

ODURATI03i. OK H.4RDEAIAG OF THE BRAIN. 

SYMPTOMS.—Shooting pain in the head; trembling of the upper or lower limbs, or 
of the head; dizziness; melancholy ; epileptic convulsions ; paralysis occurring in differ¬ 
ent parts of the body ; loss of the sense of touch at the ends of the fingers or toes without 
the loss of the sense of pain ; dimness of vision; impairment of hearing; a stooping atti¬ 
tude; a jog-trot gait. 

There are two forms of induration of the brain ; in one, the whole 
brain is affected uniformly ; in the other the induration occurs at scat¬ 
tered points through the brain. The symptoms of the first variety of 
the affection are so nearly like those of softening of the brain, that they 
cannot be distinguished. The symptoms of the second variety, or what 
is called multiple cerebral sclerosis, are those given above. In many 
cases both the brain and the spinal cord are affected. The disease is 
quite rare, though we have met with a few cases. 

Causes. —This serious affection is attributed to excessive mental 
strain, long-continued loss of sleep, alcohol, and syphilis. The last 
two causes mentioned are undoubtedly the most common of all. The 
hardening effect of alcohol upon the brain and all other soft tissues, is 
shown by the immersion of the tissues of a dead animal in spirits for 
a few days. It is well known that when alcohol is received into the 
system, the brain receives the largest quantity of any organ except 


TUMORS OF THE BRAIN. 


108a 


the liver. In cases in which persons have died in a drunken fit, the 
fluid found in the ventricles of the brain has sometimes shown evi¬ 
dence of the presence of a large proportion of alcohol by bursting into 
a flame upon the application of a match. In a case which came under 
our observation a few years ago, the hardening of the brain seemed to 
be the result of accident. The patient was a lad about seventeen 
years of age. When a small boy, he had received a blow upon the 
head, in consequence of a fall. Some months afterward, he began to 
sutler with epileptic fits, which continued till his death. The develop¬ 
ment of his body seemed to cease at the same time, although the head 
continued to increase somewhat in size. The patient lived some years, 
finally dying of consumption in a state of complete helplessness and 
imbecility. Upon making a post mortem examination of the brain, we 
found it to be hardened throughout to a very remarkable degree. It 
was also considerably shrunken, the space around it being filled with 
serous fluid. 

Treatment. —Little or nothing can be done to cure or check the 
progress of this disease, except when it occurs as the result of syphilis, 
in which case, thorough treatment for the original disease will, in 
some cases, effect a cure. 

HYPERTROPHY AYR ATROPHY OF THE RRAIY. 

There is some evidence that the brain occasionally becomes over¬ 
grown in consequence of disease. This overgrowth does not consist, 
however, in an increase of the nerve cells and fibers of the brain, but 
in excessive development of the connective tissue substance of the 
organ. This condition is known as hypertrophy. Atrophy is the op¬ 
posite condition, in which the brain becomes shrunken. The symp¬ 
toms of both affections are so very obscure that they cannot be dis¬ 
tinguished, during life, from other diseases. When atrophy affects but 
one side of the brain, life may be continued many years, as each half 
of the brain is complete in itself. 

TUMORS OF THE RRAIY. 

• 

SYMPTOMS, — Headache, confined to a small space ; constant dizziness; momentary 
loss of consciousness ; roaring in the ears; sensation of ants crawling; numbness in dif¬ 
ferent parts of the body ; bright spots before the eyes ; irritability of mind; delirium; 
epileptic convulsions; vomiting; paralysis; loss of vision. 

Causes. —By far the most common cause of tumors in the brain is 
69 


1090 


DISEASES AND THEIR TREATMENT. 


syphilis, although the disease may arise from unknown causes. We 
met with a case of the latter kind a few years ago in which the pa¬ 
tient had for a number of years, at intervals of several weeks or months, 
suffered repeated attacks of what appeared to be a severe form of 
neuralgia, accompanied by contraction of the muscles of the neck. 
The disease gradually increased until finally impairment of vision be¬ 
gan, and, after a time, sight was entirely lost. The pain in the head 
now became at times almost unendurable, and resisted all remedies. 
We pronounced the case one of tumor of the brain, occurring at the 
base of the skull, at such a point as to press upon the optic nerve. 
The patient was a native of Switzerland. He returned to his relatives, 
who took him to several of the principal hospitals of that country, to 
consult the eminent physicians in charge. Our diagnosis of the case 
was confirmed, and the case pronounced a hopeless one. The patient 
was still living the last we heard of him, several years after he re¬ 
turned to his native country, but was in such a sad condition that he 
was expected to die at almost any time. 

Treatment. —As might be readily supposed, treatment is of little 
consequence in this affection. The most that can be done is to give 
attention to the patient’s general health, and palliate his symptoms as 
much as possible. 

SPIRAL MESISGITIS. 

SYMPTOMS -. — High fever; wakefulness; burning pain in the spine, extending to the 
limbs, which increases by pressure; spasm of the muscles of the neck and back; some¬ 
times head drawn back ; weakness of the lower limbs or partial paralysis ; difficulty in 
breathing; sense of constriction in the neck, back, and abdomen; retention of urine; 
priapism ; obstinate constipation, followed by diarrhea; great prostration, sometimes de¬ 
lirium and unconsciousness. 

This disease is an inflammation of the membranes of the spinal cord. 
It is a very serious malady, but, fortunately, is not very common. The 
most frequent causes are injuries to the spine, Pott’s disease, rheuma¬ 
tism, and exposure to severe cold and wet. Inflammation of the spine 
also occurs in cerebrospinal meningitis, a disease which is considered 
under the head of infectious diseases. 

This disease sometimes occurs in a chronic form, which may suc¬ 
ceed an acute attack, or be developed gradually. The symptoms are 
essentially the same as in the acute form of the disease, though less 
marked. 


PARALYSIS OF THE LOWER LIMBS. 


1091 


Treatment. —Thp patient should be kept very quiet in bed, and 
should take a simple, unstimulating diet. Fomentations, and alter¬ 
nate hot and cold rubbing of the spine, together with warm applica¬ 
tions to the extremities, constitute the best treatment. If the bowels 
are constipated, they should be relieved by enemas. Care should be 
taken that the bladder is relieved regularly two or three times a day. 
In chronic cases, galvanism should be applied to the spine, one pole 
being placed at either end of the spine, and faradic electricity should 
✓ be applied to the paralyzed muscles. The two kinds of electricity 
should be used alternately, each three times a week. 

ISFLAMM1TIOX OF TIIE SPIRAL CORD-MYELITIS. 

SYMPTOMS:—Slight fever ; dull, aching pain in the back ; gradual loss of motion 
and sensation in the limbs ; loss of control in the bladder and rectum; sensation as of a 
cord tied around the body; tenderness of the spine; pain induced by applying a hot 
sponge over the seat of disease ; formation of bed-sores ; prickling ; sensation of cold 
and heat; numbness ; nervous sensations in the limbs. 

This affection is an inflammation of the substance of the cord itself. 
Suppuration, softening, or induration may result. The disease is gen¬ 
erally caused by exposure to great heat or cold, or by sexual excesses. 
The most that can be done is to palliate the patient’s sufferings by 
good nursing, as there is no known remedy by which a cure may be 
effected. 

A form of inflammation of the spine which occurs in small children 
is a cause of infantile paralysis, under which head it is considered in 
the section devoted to diseases of children. 

PARALYSIS OF TOE TOWER LIMBS—PARAPHLEGIA. 

SYMPTOMS. — Weakness; numbness; tingling in feet and legs, increasing to complete 
loss of sensation and motion; paralysis of the bladder and rectum ; urine bad smelling 
from decomposition in the bladder; cramps; twitching of the limbs ; great debility. 

Causes. —Paralysis of the lower part of the body may result from 
inflammation of the spinal cord or its membranes, from congestion, or 
anfemia of the cord, from hemorrhage or apoplexy of the cord, or from 
an injury. 

Treatment. —When due to congestion or inflammation, continuous 
cold should be applied over the affected part by means of ice compresses 
or the spinal ice-bag. If the difficulty is due to an opposite condi¬ 
tion, fomentations, alternate hot and cold applications, and the appli- 


1092 


DISEASES AND THEIR TREATMENT. 


cation of ice three or four times a day, four or five minutes at a time, 
are among the useful measures. When the disease is chronic, gal¬ 
vanic electricity can he applied to the spine to advantage, and the 
limbs should be daily exercised by means of thorough friction and 
massage, and should be treated two or three times a week with faradic 
electricity. Local applications of faradic electricity to the rectum and 
over the bladder should be applied as a means of restoring power to 
those parts when paralyzed. We have sometimes obtained excellent 
results by this mode of treatment. 

spoil IRRITATION, on SPINAL AN EJIIA. 

SYMPTOMS.—Tenderness of the spine, at one or more points, which is increased by 
pressure; pain produced in the spinal cord by percussion and by motion of the spinal col¬ 
umn ; vertigo; headache; noise in the ears; disturbed sleep; neuralgic pains in the 
back and chest; neuralgia of the stomach; nausea and vomiting; heart-burn; palpita¬ 
tions; difficulty in breathing; pain beneath the breast; pains in the lower limbs; diffi¬ 
culty in urination ; ovarian pain. 

This affection is a very common one, especially among women. 
We do not, however, consider it to be a primary disorder, as we have 
never yet met with a case of spinal irritation in which there was not 
some affection of the digestive, generative, or other organs to which it 
could be fairly attributed. The morbid condition in this affection is 
supposed to be lack of a proper quantity of blood, and deficiency in the 
quality of the blood circulated through the spinal cord. The pain is 
located almost wholly external to the spinal cord. It is, as was just 
mentioned, symptomatic of other internal affections. 

Causes. —Sexual excesses of various kinds, particularly self-abuse, 
is one of the most common of all the causes of this disease. We have 
met many cases in which the disease was produced by the last-men¬ 
tioned cause in both sexes. One of the most marked of these we may 
be pardoned for describing in some detail* The patient was a young 
lady from a western city, whose adopted parents, after consulting 
many different physicians for a peculiar disease of the breast, placed 
her under our care. We found her a good-looking young woman 
about seventeen years of age, rather pale and considerably emaciated, 
very nervous and hysterical, and suffering with severe pain in the left 
breast, which was swollen to nearly double the natural size, hot, tense, 

*This case we have more fully described in a work entitled, “Plain Facts for Old 
and Young.” 



SPINAL ANAEMIA. 


1093 


pulsating, and extremely tender to the touch. Occasionally she would 
experience paroxysms in which she apparently suffered extremely, 
being sometimes semi-conscious, and scarcely breathing for hours. 
The spine was also extremely sensitive to the touch. We suspected 
the cause of these peculiar manifestations at the outset, but every 
suggestion of the possibility of the suspected cause was met with a 
stout denial and a very deceptive appearance of innocent ignorance 
on the subject. All treatment was unavailing to check the disease. 
Though sometimes the symptoms seemed to be controlled, a speedy re¬ 
lapse occurred, so that no progress toward a cure was made. Finally 
our conviction that our first impression respecting the case was cor¬ 
rect became so strong that we hesitated no longer to treat it accordingly. 
By most vigilant observation, evidences of the soul-coi’rupting vice 
were detected which we considered unmistakable, and then the young 
woman, who had pretended such profound ignorance of the matter, con¬ 
fessed to an extent of wickedness which was perfectly appalling. 
Every paroxysm was traced to an unusual excess of sinful indulgence. 
So hardened was she by her evil practices that she seemed to feel no 
remorse, and only promised to reform when threatened with exposure 
to her parents unless she immediately ceased the vile practice. In 
less than ten days the mysterious symptoms which had puzzled 
many physicians disappeared altogether. The swollen, tender breast 
was no larger than the other, and was so entirely restored that she was 
able to strike it a full blow without pain. Upon examination we 
found that the spinal tenderness had also disappeared. 

This is by no means the only cause of spinal irritation. We have 
found very many cases in which it was evidently due to disorders of 
digestion, to diseases of the womb, and to various other diseases. 

Treatment.— The proper plan of treatment consists in removing 
the causes, so far as possible, by the employment of such remedies as will 
improve the general condition of the patient, and the application to the 
spine of such remedies as will increase the quantity of blood circulating 
through it. The best remedies for this purpose are the use of fomenta¬ 
tions to the spine, and galvanism. Fomentations should be applied for 
an hour or two at a time, and should be employed several times a day. 
The hot-water bag is an excellent means of applying heat. Hot sand¬ 
bag's, or bags filled with heated corn-meal or salt, are also convenient 
methods of applying it. Galvanism is, however, by far the best means, 
when it can be employed. It may be employed in two ways : first, 


1094 


DISEASES AND THEIR TREATMENT. 


with the two poles at equal distances above and below the tender por¬ 
tion of the spine ; and, secondly, with the positive pole directly over the 
seat of pain, and the other at a little distance either above or below. 
The application should not be continued more than two or three minutes 
at a time without interruption, and not more than twelve or fifteen min¬ 
utes altogether. Electricity may be used daily with advantage. In 
cases in which the patient complains much of a burning sensation in the 
feet and limbs, this may generally be relieved by the application of the 
tepid compress over the tender portion of the spine. This may be worn 
during the intervals between the applications of heat or electricity. 

The disease is, in some cases, very obstinate, but may be considered 
as curable in almost every case, if the treatment is continued a suffi¬ 
ciently long time. Rest in bed, is, in most cases, a very essential meas¬ 
ure of treatment. The evils of confinement in bed may be relieved by 
daily massage, with an inunction two or three times a week, and local 
applications of electricity to the muscles of the body every other day. 
The application of sun heat to the spine by means of burning glasses 
has been lately recommended as an excellent remedy in this affection, 
but we have not yet had an opportunity of giving it a trial. 

The diet of the patient should be very simple and unstimulating. 
Milk can be used freely, together with fruits and grains. When the pa¬ 
tient is quite anaemic, meat may be taken once a day ; but we protest 
against the excessive use of animal food, which is recommended by some 
physicians, as serious results may follow from the introduction of an ex¬ 
cessive amount of nitrogenous food into the system. We know of one 
case in which the patient was treated by the plan referred to under the 
advice of an eminent physician and who was discharged as cured, but 
died within two weeks of acute Bright’s disease of the kidneys, which 
was undoubtedly produced by the excessive use of meat during her 
treatment. 

In many cases, this disease is very obstinate, apparently resisting the 
most thorough treatment for months; but, in almost every case, a cure 
may be effected at last by perseverance in the use of the remedies rec¬ 
ommended. 

lOCO-MOTOK ATAXIA. 

SYMPTOMS.—Begins with dull, heavy pain in the small of the back; pain shooting 
down the limbs ; sensation of a cord tied around the body ; or, it may begin with vertigo, 
epileptic fits, various disturbances of the sight, or contraction of the pupils. When fully 
developed, disorders of motion; loss of sensibility; toes feel too large for the shoe, or as 


NEURALGIA. 


1095 


if there was something between them or under them; burning pain in the soles of the 
feet; prickling and numbness in the limbs; pricking of the skin of the limbs not felt as 
soon as usual; sense of touch diminished; patient feels as though walking on bladders ; 
cannot stand still with eyes shut; difficulty in guiding the feet; in walking, feet placed 
with flapping motion ; cannot walk in the dark or without looking at the feet or ground; 
diminished sensibility in the fingers ; patient cannot button clothes, pick up a pin, or touch 
the end of the nose readily with eyes shut; in advanced stages, the bladder and rectum 
become paralyzed. 

This disease is a very peculiar affection. It often begins so stealthily 
that it is frequently quite advanced before its real nature is recognized. 
Its most characteristic symptom is the manner in which the patient 
walks, which resembles the gait of a drunken man. The disease is now 
well understood to be the result of induration of a portion of the 
spinal cord. 

Causes. —Probably the most powerfully acting causes of this dis¬ 
ease are sexual excesses and the use of alcoholic liquors. There are also 
grounds for strong suspicions that it is one of the evil results of the use 
of tobacco. Syphilis is another cause which is active in quite a propor¬ 
tion of cases. There are other obscure causes. 

Treatment. —This disease is a very obstinate malady, often resisting 
every measure of treatment, although it is very slow in its progress, 
generally requiring from five to ten years to complete its course, and, in 
many cases, a much longer time; The best remedies are rest, careful 
diet, daily employment of galvanism, and hot and cold applications to 
the spine, hot sponging and the application of faradic electricity to 
the affected muscles, and massage. By the use of these measures, we 
have succeeded in greatly relieving cases in which other remedies had 
been tried in vain. The treatment must be persisted in for a long time, 
although little or no improvement is seen, in the hope of checking the 
progress of the disease if nothing more is accomplished. 

NEURALGIA. 

SYMPTOMS:—Pain either constant or intermittent; may be continuous with frequent 
exacerbations; when it occurs in paroxysms is described as darting, tearing, or lancina¬ 
ting, and is often very severe ; an attack may last a few minutes, or may continue sev¬ 
eral days ; pain usually follows the course of the nerve, along which small, tender points 
may be felt on pressure with the end of the finger; pain is generally shifting, changing 
from one nerve to another; it is usually confined to one side; there is, generally, no 
fever. 

Causes. —The principal cause of neuralgia is defective nutrition of 
the nerves. Romberg has very aptly said that pain is “ the prayer of 


1096 


DISEASES AND THEIR TREATMENT. 


a nerve for healthy blood.” Disorders of digestion are very often ac¬ 
companied with neuralgia in various parts of the body. The same is 
true of anaemia, which, in many cases, also depends upon derangement 
of the digestion. Neuralgia may also be caused by pressure of a tumor 
upon a nerve trunk, by the contraction of a cicatrix, or scar, in which 
the end of a nerve trunk is entangled. In malarial diseases it is often 
due to malarial poisoning. In cases in which it is due to malaria the 
paroxysms generally occur at regular intervals. Neuralgia is one of 
the symptoms of lead poisoning. High living, particularly the excessive 
use of meat, may be fairly set down as one of the causes of this affection. 
It may also frequently be the result of taking cold, or exposure to cold, 
of dissipation, loss of sleep, and especially the use of tobacco, alcohol, 
and of tea and coffee. In many cases it is connected with rheumatism 
and gout. 

Treatment. —Improve the patient’s general health by a wholesome, 
simple, and nutritious diet, and the employment of tonic baths, as a daily 
sponge bath, aud massage in feeble cases. The use of electricity by general 
faradization two or three times a week, sun baths, exercise in the open 
air, and all other known means, are a matter of first importance in the 
treatment of this disease. Ordinary neuralgia may almost always be re¬ 
lieved by either moist or dry heat. In some cases, cold applications give 
more relief than hot. It is impossible to tell, without trial, whether cold 
or hot will be most effective. In many cases, it is also necessary to 
give the patient a warm bath of some kind. The Turkish, Russian, hot¬ 
air, electro-vapor, and electro-thermal baths are particularly useful in 
these cases. A blanket pack is also a very excellent remedy which we 
have used very many times with success. Probably the best of all known 
means for relieving neuralgia is the use of electricity. It often succeeds 
when all other remedies fail. The galvanic current is generally the 
most effective, though sometimes the faradic current acts the best. The 
positive pole should be applied over the painful part, and the negative 
pole near by, or on the nerve center from which the affected nerve orig¬ 
inates. Sometimes the pain is temporarily aggravated by electricity, 
but more often it is relieved during the application. It frequently re¬ 
turns, however, so that repeated applications are necessary. The cur¬ 
rent should be applied from twenty to thirty minutes daily. We have, 
in several instances, succeeded in curing obstinate cases of neuralgia by 
hot and cold applications, when other means have been ineffectual. 
Quite prompt relief has been obtained by freezing the skin over the af- 


HEMICBANIA. 


1097 


fected part. This treatment is administered by making a mixture of 
equal quarts of salt and shaved ice, wrapping quickly in a piece of thin 
muslin, and applying it over the affected part. From three to five min¬ 
utes is as long a time as is necessary to produce the desired effect. When 
the disease is evidently the result of malarial poisoning, which is shown 
by its regularity, the patient may resort to the use of some of the prep¬ 
arations of Peruvian bark in case relief is not obtained otherwise. Opium 
should be seldom used in this affection, never when its use can be avoided, 
since so many cases of confirmed opium-eating have originated in the 
use of the drug for neuralgia. The remedies which have been recom- 
mended for this disease are almost innumerable. But few of them are 
anything more than palliative, and most are worthless even for giving 
temporary relief. Other methods of treatment will be mentioned in con¬ 
nection with the description of special forms of neuralgia. 

H EMCRA m-MIGBAO E. 

SYMPTOMS.—Attack usually begins in the morning, with heavy, uneasy sensations ; 
slight chilliness ; disposition to gape; headache, confined to one side, which rapidly in¬ 
creases, becoming exceedingly severe ; eyes sensitive to light; pulse generally slow; at 
the height of the attack, nausea, retching ; billious vomiting. 

This is a very common affection. It occurs more often in women 
than men, very frequently at the menstrual period. 

Causes. —Attacks are generally attributed to taking cold, unusual 
nervous fatigue, or loss of sleep. We are convinced, however, that in 
many cases, probably the majority, errors in diet are the real cause of 
the disease. In scores of instances, we have known the affection to disap¬ 
pear entirely upon the discontinuance of the use of tea, coffee, and of 
the tobacco habit. 

Treatment. —For temporary relief, the best measures are fomenta¬ 
tions to the affected side of the head, and copious warm drinks until the 
stomach is relieved. Warm full or sitz baths will often cut short the 
attack. In case the vomiting is persistent, small sips of hot drink, or of 
iced water, or small bits of ice, may be taken with benefit. 1 omenta- 
tions over the stomach, or applied to the spine just back of the stomach, 
are also useful measures. In order to obtain permanent relief, the pa¬ 
tient should abandon all known causes of the affection. It is especially 
important that he should confine himself to a very simple diet. Tea and 
coffee, alcoholic liquors, condiments of all kinds, much animal food, espe¬ 
cially fat meat, animal fats of all kinds, hot bread, pastry, and every- 


1098 


DISEASES AND THEIR TREATMENT. 


thing difficult of digestion should be entirely avoided. Exercise in the 
open air, tonic baths, general applications of electricity, massage in feeble 
patients, sun baths, and all other remedies which improve the general 
health should be employed. This disease has been pronounced incurable 
by some of the most eminent physicians, but we have had the pleasure 
of relieving, permanently, so many patients who have long suffered with 
this troublesome complaint, that we feel justified in asserting that it can 
be cured by the persistent employment of proper remedies. 

FACEACHE, OR FACIAE WEIIRALGIA. 

This is one of the most common forms of neuralgia. The pain is 
usually confined to one side of the face. It may be excited by cold, by 
decayed teeth, or by causes which are unknown. In some cases the pain 
is attended by contraction of the muscles of one side of the face, when 
it is termed tic-douloureux. This form of disease generally occurs in 
persons considerably advanced in years. 

Treatment. —Hot applications to the face, together with hot foot or 
sitz-baths, and the use of electricity, are the most useful measures. The 
application of cold to the seat of the pain sometimes gives relief when 
hot applications are ineffectual. In one case of several years’ standing, 
we succeeded in effecting a cure by the injection of a few drops of chlo¬ 
roform beneath the skin, just in front of the ear; but this measure is 
rarely necessary if the others mentioned are faithfully tried, together 
with the use of the necessary means to improve the general health. 

LUMBAGO. 

SYMPTOMS.—Pain in the back, increased by muscular exercise; patient cannot 
straighten without great suffering; many tender points found about the seat of pain. 

Causes. —The causes of this form of neuralgia are said to be cold, 
rheumatism, malaria, great exhaustion from overwork. It seems to be, 
in some cases, the result of severe straining and lifting. 

Treatment. —Rest; fomentations, or hot and cold applications to 
the back, and the employment of hot baths will generally secure quite 
speedy relief. Some cases are very obstinate, however, and quite ex¬ 
haust both patient and physician. In a very obstinate case, in which 
the patient suffered extremely with spasmodic pains and cramps in the 
back, relief was obtained by continuous stretching of the body, the pa¬ 
tient being held by straps passed under the arms, while being stretched 
by weights attached to the lower extremities. Treat the same as sciatica. 


SCIATICA. 


1099 


INTERCOSTAL NEURALGIA. 

SYMPTOMS.—Pain in the chest, either upon one or both sides ; in females most often 
felt under the breast; pain usually continuous; respiration painful, laughing, coughing, 
sneezing, exceedingly so. 

This disease is often mistaken for pleurisy and other diseases of the 
lungs. When it affects the left side also, it is often thought to indicate 
heart disease. Upon careful examination of the patient, however, it will 
be found that the pain is confined to the spaces between the ribs, and is 
most severe near the sternum, beneath the axilla, and at the spine. 
These points are also found to be tender upon pressure, which shows that 
the disease is confined to the nerve trunk. In many cases of intercostal 
neuralgia, the pain extends down the inner side of the arm, affecting two 
fingers upon the inner side of the hand. The pain is sometimes so very 
severe as to render the patient almost helpless. 

Causes. —This form of neuralgia is much the most common in 
women, in whom it is most generally associated with neurasthenia or 
nervous debility, dyspepsia, or disease of the reproductive organs. It is 
often attributed to taking cold. 

Treatment. —The affection is best relieved by fomentations or hot 
and cold applications to the spine, opposite the affected parts. The 
strong galvanic current, applied to the sensitive nerves, is also of great 
service. The positive pole should be placed upon the spine, and the neg¬ 
ative passed along the course of the affected nerves, or placed successively 
for a few seconds at each of the sensitive points. Attention must also 
be given to the improvement of the patient’s general health, by proper 
diet and general tonic measures. 


SCIATICA. 

SYMPTOMS.—Begins as a dull, heavy ache in the back and upper portion of the 
thigh; pain gradually becomes more intense, and is increased by motion of the affected 
limb ; sometimes accompanied by cramps in the muscles of the limb. 

This is, perhaps, the most common of all forms of neuralgia. A pa¬ 
tient who has had one attack is much more liable to subsequent ones. 
The disease sometimes passes away in a few days, but generally lasts 
from four to twelve weeks, and may become chronic. 

Causes. —The causes of sciatica are essentially the same as those 
which produce other neuralgias. It is sometimes produced by sitting on 
a hard chair a long time. Severe exertion with the limbs also some- 

O 


1100 


DISEASES AND THEIR TREATMENT. 


times excites an attack. Cases are mentioned in which it has been occa¬ 
sioned by an enlarged prostate gland ; a predisposition to the disease 
is produced by a weak or depressed state of the system. 

Treatment. —In addition to hot baths, hot packs, hot fomentations, 
hot and cold applications, and the use of electricity, all of which reme¬ 
dies have been fully described in the description of treatment for neu¬ 
ralgia, obstinate cases sometimes require still other measures. We have, 
in some instances, obtained relief by a method of freezing, described on 
page 1097. In other cases, we have succeeded by the injection of cold 
water by means of the hypodermic syringe, the injection being made at 
the seat of pain, as near as possible to the affected nerve. Pricking the 
nerve with a needle, in some cases gives magical relief. The practice of 
nerve stretching has lately been recommended for cases which are not 
otherwise relieved. The operation is a somewhat formidable one, it be¬ 
ing necessary to open the tissues down to the nerve trunk, draw out 
the nerve, and stretch it with considerable force. Good results have been 
reported in the use of this measure in quite a number of cases ; but we 
have never resorted to it, having found other measures effective in all the 
cases which we have treated. In a few very obstinate cases we have 
found it necessary to resort to the injection of a few drops of chloroform 
by means of the hypodermic syringe, the injection being made into the 
nerve itself, or as near to it as possible. The method of treatment 
known as electro-puncturing has also been used by a number of eminent 
physicians with great success. It consists in applying electricity to the 
nerve itself by means of a needle passed into it. A very mild current is 
used. 


CRURAL NEURALGIA. 

In this affection, the large nerve on the anterior and inner side of 
the limb is affected. The symptoms of the disease, with the exception 
of the location of the pain, are the same as those of sciatica. Causes 
and treatment are also essentially the same. 

HEADACHE. 

Headache, as a symptom of disease, is present in a great variety of 
conditions. It is nearly always present in acute fevers. It is also pres¬ 
ent in most organic diseases of the brain and spine, as well as in many 
affections of other internal organs, as of the heart, stomach, kidneys, 
liver, and reproductive organs. When present in connection with 


ANjEMIG headache. 


1101 


other diseases, it is sometimes the result of disturbance of the circula¬ 
tion incident to those affections, or it may be due to nervous sympa¬ 
thy. The following varieties of headache may be mentioned:— 

Congestive Headache. —In this form of headache the head is hot; 
face flushed; arteries of the neck throbbing ; eyes red; and patient 
complains of a bursting feeling, as though the brain were too large for 
the skull; the hands and feet are generally cold. 

Treatment .—This headache is best relieved by derivative measures 
applied to the extremities and the application of cold to the head and 
neck. When it is persistent, it may be necessary for the patient to 
wear the wet head cap for several days. If complicated with neural¬ 
gia, fomentations should be applied for fifteen to twenty minutes at a 
time, three or four times a day, the head being kept cool by cold com¬ 
presses during the intervals. Among the most frequent causes of con¬ 
gestive headache are errors in diet, tight lacing, defective clothing of the 
feet and the limbs, taking cold, and especially the use of tea, coffee, 
and alcoholic liquors. All these causes must be scrupulously avoided. 
The patient should restrict himself to a careful diet, using very little 
flesh-meat, and avoiding- condiments altogether. But few kinds should 
be taken at a meal, and the patient should eat sparingly. A short 
course of eliminative treatment, consisting of packs and warm baths 
should be resorted to when the patient is quite fleshy and plethoric. 
When there is great coldness of the lower extremities, the hot foot 
bath, alternate hot and cold rubbing, and the leg pack, are excellent 
measures for restoring the balance of the circulation. Persons who 
are subject to congestive headaches should sleep with the head ele¬ 
vated, so as to check, in some degree, the tendency of blood to the head. 

Anaemic Headache. —In this kind of headache, the condition of 
the brain is just the opposite of that in the variety just described. 
The organ contains too little blood instead of too much. It occurs 
most often in aged or feeble persons, and persons suffering with nerv¬ 
ous debility, anaemia, and other diseases characterized by poverty of 
the blood. This form of headache may be recognized by the fact that 
the patient often feels dizzy when sitting up or standing, and is re¬ 
lieved by lying down. It generally affects the top of the head, may 
also be located at the back part or in the forehead. It is not of a 
throbbing character. May often be described by the patient as a 
gnawing pain. The pupils are usually dilated, and the tendency to 
faintness upon assuming an upright position is marked. 


1102 


DISEASES AND THEIR TREATMENT. 


Treatment .—The patient should lie quietly in bed, with the head 
depressed a little below the level of the feet, at least not bolstered up 
by pillows. Cold should be applied to the back of the neck, or be¬ 
tween the shoulders, and continuous warmth to the top and front 
part of the head, by means of fomentations, or the hot water bag. 
Electricity is a very useful measure in this form of* headache. 
The galvanic current may be employed, placing the positive pole upon 
the forehead and the negative at the back part of the head; or the 
faradic current may be used, the negative pole being placed at the 
lower part of the spine, and the positive at the top of the head. 

Sympathetic Headache.— This form of headache may arise from 
disturbance of the stomach, liver, or from irritation of the uterus or 
ovaries. Headache arising from disturbance of the stomach or liver is 
generally felt in the front part of the head just above the eyes. The 
temples are also sometimes affected. Headache from uterine or ovarian 
irritation is chiefly felt at the top of the head. 

Treatment .—This form of headache can be permanently relieved 
only by the cure of the disorders upon which it depends. Temporary 
relief will generally be obtained by the application of a fomentation 
over the part with which the headache is sympathetic, as over the re¬ 
gion of the stomach, in stomach headache, and over the lower part of 
the bowels in uterine and ovarian headache. In some of the latter 
cases, a hot fomentation over the spine, followed by a rubbing with the 
hand, dipped in cold water is an excellent means of affording relief. 
Wearing the wet abdominal bandage at night, and, in severe cases, both 
night and day, for a time, will often relieve a persistent headache due to 
derangements of the stomach and bowels. The wet compress, worn 
over the lower part of the spine, is very frequently effective for the re¬ 
lief of headaches which depend upon irritation of the uterus or ovaries. 
A hot vaginal douche, used daily, and frequent sitz baths, are also ex¬ 
cellent measures in the latter cases. 

Sick, or Bilious Headache. —This form is characterized by a 
throbbing, splitting pain in the temples. The patient also feels sickness 
at the stomach, and generally vomits a large quantity of undigested 
food followed by bile, before relief is obtained. It is caused by errors in 
diet. Persons who suffer from this form of headache, habitually, are 
subject to bilious dyspepsia, and should follow the directions for treat¬ 
ment prescribed for that disease'. Generally relief may be obtained by hot 
fomentations to the head, followed by tepid compresses, hot fomentations 


ST. VITUS’ DANCE. 


1103 


over the stomach and bowels, and hot drinks. When the bowels are 
constipated, as they generally are, the patient should take a large warm 
water enema. When possible to do so, warm sitz and full baths should 
be taken, as great relief is generally afforded by these means. Patients 
subject to bilious headache should avoid the use of tea, coffee, fats of all 
kinds, tobaoco and spirituous liquors, which are among the most positive 
causes of the disease. 

Nervous Headache. —This form of headache closely resembles the 
preceding in its symptoms, but is generally confined to one side of the 
head. It is elsewhere described under the head of hemicrania, or mi¬ 
graine, which see for treatment, etc. 

Headache from Other Diseases. —The headaches of fever, and 
the headaches which are present in connection with various other diseases, 
as gout, neuralgia, rheumatism, diseases of the heart, kidneys, and 
organic affections of the brain and spinal cord, are cured only by the re¬ 
lief of the primary diseases of which the headache is symptomatic. 
When these are curable, the headache will disappear as improvement in 
the disease takes place. When incurable, as in organic disease, the pain 
in the head will, of course, be obstinately persistent. 

CHOBEA-ST. TITUS’ DANCE. 

SYMPTOMS.—At first, slight twitching of the muscles of the face and limbs on one 
side ; after a time, nearly all the muscles of the body become affected; constant restless¬ 
ness ; articulation indistinct; twitching of the muscles increased by slight movement; 
sometimes contractions so strong as to throw the patient upon the floor; digestion im¬ 
paired, bowels constipated. 

Causes. —The causes of this disease are not well understood, neither 
is it known what part of the nervous system is affected in this disease. 
It is probable, however, that it is chiefly due to defective nutrition of 
the brain and spinal cord. We have always found the disease associated 
with impaired digestion and an inactive state of the bowels. We have 
also observed that the disease is likely to occur in the children of parents 
who are addicted to the use of tobacco and alcoholic liquors. It more 
often affects girls than boys, and is most common between the ages 
of six and fifteen years. Chorea has frequently prevailed in epidemics, 
especially among factory employees. 

Treatment. —The disease is rarely, if ever, fatal, though it may con¬ 
tinue a long time if proper treatment is not administered. The most 
important of all are such hygienic measures as will improve the patient s 


1104 


DISEASES AND TIlEIli TREATMENT. 


general health. The food should be of the most nutritious character. 
The patient should take little or no meat, but abundance of oatmeal, 
cracked wheat, graham bread, and other whole-grain preparations. 
Exercise in the open air should be taken daily. The bowels should be 
moved daily by enemas, if they do not move spontaneously ; but the 
application of measures recommended for constipation will generally re¬ 
lieve this difficulty without the constant use of enemas, which is to be 
avoided when possible. Daily massage and sponging of the whole body 
in tepid water is also important as a measure of treatment. In addi¬ 
tion, we usually employ the ice pack, or hot and cold applications to the 
spine. These applications should be made daily, from ten to twenty min¬ 
utes at a time. They are frequently followed by almost immediate 
relief, which is at first temporary, gradually becoming more perma¬ 
nent. Galvanism of the spine, and central galvanization are means 
which should be employed in obstinate cases. We have often used them 
with excellent effect. Daily gymnastic exercises are very useful. This 
plan is used in the hospital for children at Paris. Drs. Gray and Tuck- 
well report in the London Lancet the successful treatment of a large 
number of cases, and assert that “ the hygienic plan is alone sufficient to 
cure chorea and quite as promptly as any drug.” 

EPILEPSY, OR FALLING SICKYESS. 

SYMPTOMS. — Convulsions, or fits, in which the patient falls ; violent jerking of the 
muscles; frothing at the mouth; biting of the tongue; face at first livid, afterward red 
and swollen ; attack generally followed by disposition to sleep for one or two hours. 

This disease is so common that it needs but a very brief description. 
The symptoms described above are those which occur in a se¬ 
vere case. In milder cases, there may be simply a slight loss of con¬ 
sciousness for a few seconds, after which the patient resumes what¬ 
ever occupation he may have been engaged in at the time of the at¬ 
tack. If walking across the room, he stops suddenly with a startled 
aspect, oi’ with the eyes rolled upward. If eating at the table the at¬ 
tack may be signalized by dropping the knife or fork. This form of 
the disease is known as Pettitmal. The severe form of the disease is 
just preceded by peculiar sensations which the patient recognizes as 
premonitory of the attack which is termed the aura. In some cases 
the patient utters a peculiar cry at the beginning of the attack, which 
may consist of a slight jerking of the toe or finger, or in a peculiar 
sensation at the pit of the stomach. The epilepsy is a very chronic 


EPILEPSY, OR FALLING SICKNESS. 


1105 


disease. In many cases, it is well established before its real nature is 
recognized, the attacks at first being so slight as to pass unobserved. 
In many cases, especially in children, they occur in the night, so that 
neither the patient nor his friends, for a long time, are aware of the 
existence of the disease. 

Causes. —This affection originates from, quite a variety of causes, 
among the chief of which are hereditary influences, sexual excesses, the 
use of alcoholic liquors and tobacco, syphilis, excessive mental labor, and 
errors in diet. We have met a number of cases in young men in 
which the disease was clearly traceable to self-abuse. In several cases 
of adults which we have treated, other sexual excesses have been prac¬ 
ticed, of which the disease was clearly the result. In our opinion, er¬ 
rors of diet have much more to do with producing this disease than is 
generally supposed. We have rarely met with a case in which there 
was not marked disturbance of the digestion, and have noticed partic¬ 
ularly that the worst attacks, in patients suffering with the disease, 
almost always follow some excess in eating or other dietetic trans¬ 
gression. Excess in the use of animal food may also be charged with 
producing a strong tendency to this disease, if it is not a directly excit¬ 
ing cause. 

Treatment. —This is an exceedingly obstinate disease, and has long 
been looked upon as almost incurable. Undoubtedly there are many 
cases in which the disease is incurable in character on account of the in¬ 
curable nature of the conditions by which it is produced. When a 
marked tendency to the disease is inherited, and when it arises from the 
formation of tumors in the brain, or of other organic changes in the 
nerve centers, no remedies which can be employed will be found of any 
special utility. Our experience in the treatment of this affection con¬ 
vinces us, however, that in a large proportion of cases a cure can be ef¬ 
fected. In order to accomplish this, the patient must comply rigidly 
with every needful requirement. The diet must be plain and simple, 
consisting almost wholly of fruits, grains, and vegetables. Milk and 
eggs can be used in moderation, but the less meat the patient takes, the 
better. Those who have had the most experience in the treatment of 
epilepsy, insist that a vegetable diet is one of the essential features of 
successful treatment. Bad habits of every sort, and the use of tobacco, 
alcoholic liquors, and of tea and coffee, must be wholly abandoned. 
The patient must practice rigid continence. Every possible atten¬ 
tion should be given to building up the general health by exercise in 
70 


1106 


DISEASES AND THEIR TREATMENT. 


the open air, and regular and adequate sleep, and attention to all the 
laws of hygiene. It is not only necessary that the patient should eat 
the right kind of food, but he should be particularly careful to avoid 
excess in eating. One of the peculiar features of this disease is a vora¬ 
cious appetite with a tendency to eat very rapidly. If the appetite can¬ 
not be controlled in any other way, the patient should be placed on an 
allowance. We have in some instances found the difficulty in control¬ 
ling the patient’s appetite one of the greatest obstacles to recovery. The 
most effectual remedial measures are general baths, taken with sufficient 
frequency to secure thorough cleanliness and activity of the skin. In ad¬ 
dition, fomentations over the stomach and liver may be taken daily in 
connection with the warm leg bath, alternate hot and cold applications 
to the spine, particularly the upper part, and the application of galvan¬ 
ism in the form known as central galvanization, together with galvan¬ 
ization of the spine. In some cases of very inveterate character, we have 
found it advantageous to employ bromide of potassium for a time, in order 
to destroy the periodicity of the paroxysms, when they occurred with 
great frequency. In some cases, in which the bromide of potash has been 
wholly ineffectual in checking or keeping off the paroxysms, we have 
been able to accomplish the desired result by means of the other measures 
described. 

During the attack, care should be taken to prevent the patient do¬ 
ing himself injury, as by falling upon some sharp object or upon a hot 
stove. We had, sometime since, a patient who had broken both 
ankles, and otherwise injured himself, by falling from the balcony of 
a hotel during an epileptic fit. Many patients carry with them a 
wedge of wood, to be placed between the teeth when the symptoms of 
an attack make their appearance, thus preventing biting the tongue, 
which is sometimes a very unpleasant feature of the disease. In pa¬ 
tients in whom the attack is preceded by an aura, the fit may some¬ 
times be kept off by the prompt application of proper treatment. When 
the aura is felt in the limb, as is very often the case, simple pressure 
of the limb against some hard substance, or placing the hand in cold 
water will in many cases prove effectual. In a case now under our 
care, the patient is generally able to resist the attack by grasping 
with firmness the handle of a cane which he always carries with him 
for the purpose. The paroxysm itself is seldom attended with im¬ 
mediate danger, although the contortions are sometimes so frightful as 
to excite great alarm. 


HYSTERIA. 


1107 . 


HYSTERIA. 

SYMPTOMS.—Patient laughs or cries immoderately without cause; has hallucin¬ 
ations; all the senses perverted; morbidly sensitive to light and [sound; breast sen¬ 
sitive; pain in ovary; headache; wandering pains in the chest, abdomen, joints and 
spine, especially between the shoulders; loss of sensation in the skin ; paralysis of cer¬ 
tain muscles; sometimes loss of voice; sensation as of a ball rising in the throat; con¬ 
traction of the muscles ; violent spasms ; disorder of digestion with symptoms of nerv¬ 
ous dyspepsia; changeable temper; sometimes large quantity of pale urine; in some 
cases delirium or stupor. 

The above is a very inadequate description of this peculiar disease; 
in fact, a complete description would include a list of the symptoms of 
all known diseases, since there is no known malady which may not be 
imitated by hysteria. The affection is not, as many people suppose, 
wholly an imaginary disease, but is really a malady of considerable 
gravity. A healthy person never suffers with hysteria. There is al¬ 
ways some disease of the nerve centers, although it is not possible to 
say exactly what is the real nature of the disease. Many authors 
think that when it occurs in females, as it almost always does, the af¬ 
fection has a close relation with the ovaries. The peculiar phenomena 
exhibited by the “ Jumpers ” or “Jumping Frenchmen” of the lum¬ 
bering regions of Maine, is probably due to a species of hysteria. 

Causes. —Hysteria almost always occurs in females, and most fre¬ 
quently between the ages of fifteen and twenty-five. In rare in¬ 
stances it affects men as well as women. We have met a few cases of 
this kind. The most common causes are sexual excesses, novel¬ 
reading, perverted habits of thought, and idleness. It occurs most 
frequently among young ladies who have been reared in luxury 
and who have never learned self-control, but who have had every 
whim and fancy gratified until self-gratification has come to be their 
greatest aim in life. It is a notable fact that hysteria rarely or never 
occurs among the women of uncivilized nations. It is stated that be¬ 
fore the war, the disease was unknown among the negro women of the 
South, though it has occasionally been met with since the emancipa¬ 
tion. 

Treatment. —This disease may be considered as curable in nearly 
all cases. Indeed it is not, of itself, a fatal malady; but mental and 
moral, as well as medical, treatment are essential. The patient must be 
taught self-control; the mind must be, by some means, drawn away 
from herself. The most effective means of interrupting the paroxysm 


1108 


DISEASES AND TIIEIB TREATMENT. 


is the application of cold in some form to the head and spine. Either 
the cold pour, or the ice pack may be employed with almost certain 
success. To prevent the recurrence of the paroxysms, the pa¬ 
tient’s health should be improved as much as possible by abundant ex¬ 
ercise in the open air, wholesome diet, plentiful sleep, and general 
tonic treatment. Sitz baths may be used, in most cases, to advantage, 
one or two a week, the temperature ranging from 92° to 93° at the be¬ 
ginning of the bath to 88° or 85° at the conclusion. The bath may 
last fifteen or twenty minutes with advantage. With patients whose 
blood is poor, massage and inunction two or three times a week should 
be employed. A daily spinal ice pack, continued from ten to twenty 
minutes, may be used with advantage. Galvanism to the spine is an¬ 
other useful measure. When there is paralysis of sensation and motion, 
faradic electricity should be applied to the paralyzed parts. 

CATALEPSY. 

SYMPTOMS.—Sudden loss of consciousness; patient remains motionless in the same 
position as when attacked; slight rigidity of the muscles. 

This affection is similar to trance. It occurs most often in hysterical 
women, sometimes in men. The length of the attack may vary from a 
few minutes to several hours, or even days. Ecstasy is a peculiar form 
of this affection in which the patient does not lose consciousness but ex¬ 
periences a great exaltation of feeling, and is subject to various illusions 
and hallucinations. History gives us numerous and very interesting ex¬ 
amples of this disease, many of which have been made the means of very 
extensive religious deception. 

TETAHUS-LOCKJAW. 

SYMPTOMS.—Begin suddenly ; muscles of the throat and jaw usually affected first; 
sensation of stiffness and difficulty in swallowing; jaw becomes set, mouth dosed, teeth 
clenched; mouth drawn to one side; in children, mouth partly open and lips puckered; 
muscles of the back, neck, and abdomen hard and tense ; violent spasms every few min¬ 
utes ; sometimes body bent back in the form of an arch, patient resting on head and heels; 
pulse frequent and feeble; great thirst, but difficulty and great increase of pain on at¬ 
tempting to swallow; frightful suffering. 

This disease most frequently occurs in adults, though it is not un¬ 
known in children, in whom it generally occurs soon after birth. It is 
a very fatal disease, death generally occurring within three to fourteen 
days. When life is prolonged more than two weeks the prospect of re¬ 
covery is greatly increased. 


SHAKING PALSY. 


1109 


Causes. —The most common cause is lacerated or contused wounds, 
especially wounds in which foreign bodies are left in the tissues, as from 
splinters, rusty nails, glass, bullets, etc. Wounds of the extremities are 
much more likely to give rise to tetanus than those of any other part of 
the body. It is generally believed by physicians that the affection is 
most often caused by taking cold in a wound, and not by the wound 
alone. In infants, it always occurs within one to live hours after the 
fall of the navel string, and probably arises in the same way as from 
wounds. The disease generally makes its appearance within nine days 
after the occurrence of the wound; when the interval is longer than 
this, it is said to be chronic. The disease is most common in tropical 
countries, and affects negroes more than people of other nationalities. 

Treatment. —Nearly all known remedies which affect the nervous 
system have been tried; the majority, however, without any effect, as 
the disease still continues to be one of the most fatal maladies which 
the physician has to encounter. The most effective remedy is the con¬ 
tinuous application of the ice pack to the spine. Ice bags or rubber 
bags filled with ice-cold water, frequently changed, should be employed 
if possible; care should be taken to keep other portions of the body 
dry. Prof. Niemeyer recommends the use of warm baths. Either the 
full bath or the hot-air bath may be employed. Probably the most 
effective is the Russian bath, in which the patient can lie full length 
while the bath is being administered. Care should be taken to give 
the patient an ample supply of fresh air at all times. This is espe¬ 
cially necessary on account of diminished ability of respiration. When 
the patient is not able to swallow without great suffering, as is gener¬ 
ally the case, nutritive injections should be employed. See page 738. 

PARALYSIS AGITAWS—SHAKING PALSY. 

SYMPTOMS.—Trembling in some portions of the body, usually the arm or leg ; tremb¬ 
ling ceases when asleep ; diminished muscular power. 

There are two forms of this affection. The symptoms given above 
describe the simple form of the malady, which seems to have no fatal 
tendency, and, in most cases, is curable by the use of proper remedies. 
In this form of the disease, the trembling does not generally extend 
very far beyond the part first attacked. In the more serious form of 
the affection, the trembling gradually extends from the part attacked 
until the whole body becomes affected ; the patient assumes a stooping 
posture ; general paralysis of the whole body supervenes, which finally 
leads to a fatal termination. 


1110 


DISEASES AND THEIR TREATMENT . 


Treatment. —The most effective measures of treatment are hot 
and cold applications to the spine, galvanization of the spine and 
muscles, together with the daily use of hot sponging the affected 
muscles. The general health should be improved by the use of tonic 
measures and a nutritious diet. These measures are generally effect¬ 
ive, if perseveringly used, in the mild form of the affection, but ac¬ 
complish nothing more than to retard the progress of the severer form, 
which is always fatal. 

MUSCULAR ATROPHY—WASTING PALSY. 

SYMPTOMS.—Begins with loss of strength in arms and legs; pain in the affected 
muscles; slight quivering of the muscles ; most often commences in the upper extremi¬ 
ties; generally begins with wasting of the muscles of the hand, the wasting extending to 
the arm and shoulder, and then to the whole body. 

As pain is one of the first symptoms felt, the disease is often taken 
for rheumatism or neuralgia, its real character not being: discovered 

O 7 o 

till marked wasting: has occurred. 

Cause. —Overuse of the muscles is probably the principal cause 
of this affection. It occurs most frequently in professional dancers, 
blacksmiths, athletes, and others who habitually practice great exer¬ 
cise of certain muscles. 

Treatment. —Galvanization and faradization of the affected mus¬ 
cles, hot and cold rubbing, hot sponging and massage applied to the 
affected parts. Galvanism and hot and cold applications to the spine 
are serviceable in some cases. Drugs are of no value. 

NEURITIS—INFLAMMATION OF A NERVE. 

SYMPTOMS,—Neuralgic pain in the affected nerve, with loss of sensation in the parts 
to which it is distributed; pain continuous; nerve tender; pressure upon nerve causes 
pain in the parts in which the nerve ends; twitching of the muscles in the affected part; 
generally no fever. 

It is sometimes difficult to distinguish neuritis from neuralgia, 
since the pain of neuralgia is not infrequently caused by inflamma¬ 
tion of the affected nerve. Recovery from neuritis is very often in¬ 
complete, the patient continuing to suffer pain in the nerve, and numb¬ 
ness in the parts supplied by it. Inflammation of the sciatic nerve is 
a common cause of obstinate sciatica, in consequence of the sheath of 
the nerve becoming thickened. 

Cause. —The most common cause of neuritis is injury of the nerve, 


FACIAL PARALYSIS. 


1111 


or an inflammation of the adjacent parts. The inflammation is some¬ 
times rheumatic in character. 

Treatment. —Rest; ice along the course of the nerve ; in case the 
ulnar nerve of the arm is affected, the whole arm may be enveloped 
in ice-cold compresses. It is also well to keep it elevated, so as to in¬ 
duce contraction of the blood-vessels. Hypodermic,injections of ice- 
cold water into, or near, the nerve, and the use of a strong galvanic 
current, applied for half an hour once a day is effective in severe cases. 
Galvanism, faradization, hot sponging, fomentations, and alternate hot 
and cold applications, are the best remedies for the effects which may 
remain after the subsidence of acute inflammation. 

FACIAL. PARALYSIS. 

SYMPTOMS.—Patient cannot close the eye on the paralyzed side; cannot wink ; tears 
run o^er the lower lid upon the cheek; face drawn to one side, most evident when patient 
smiles. 

This affection involves paralysis of the seventh cranial nerve, 
which is the nerve of motion of nearly all the muscles of the face. 
It produces a very unpleasant deformity. The side of the face af¬ 
fected is without expression, remaining motionless when the patient 
laughs or smiles. If he attempts to whistle, the mouth is puckered to 
one side. In eating, the food accumulates between the teeth and the 
cheek on the affected side, making it necessary for the patient to use 
his finger to dislodge it. 

'Causes. —Cold; inflammation of the facial nerve; disease of the 
heart; injury to the temporal portion of the skull. 

Treatment. —Galvanic electricity applied to the affected parts daily 
or every other day. Faradic electricity is sufficient in mild cases; 
electricity in some form is essential. Care should be used not to em¬ 
ploy too strong a current when using galvanism about the eye. Pinch¬ 
ing and manipulation of the affected muscles is an excellent means of 
restoring their function. On account of the eye remaining open, it is 
subject to many sources of irritation, as dust, cold winds, etc. The 
patient may remedy this difficulty to a considerable extent by closing 
the eye with the finger, or holding the lids together by means of a 
strip of adhesive plaster. An eminent New York surgeon, Dr. Det- 
mold, has invented an ingenious means of relieving the deformity to a 
considerable degree. It consists of a smooth hook, made of gutta¬ 
percha or silver wire, which is hooked into the corner of the mouth on 


1112 


DISEASES AND THEIR TREATMENT. 


the affected side and connected by an elastic band to the ear. This 
simple instrument draws the muscles of the mouth into proper shape, 
and not only relieves the deformity, but when used continuously for a 
long time, does much toward effecting a cure. An ingenious surgeon 
has suggested the use of a double hook, made of zinc and copper wire 
bound together by copper wire, one end being attached to the ear and 
the other to the corner of the mouth. The electric current generated 
helps the cure. 


TEMPORARY PARALYSIS. 

A slight temporary paralysis is sometimes produced by pressure 
upon a nerve trunk. Temporary paralysis of the arm is often pro¬ 
duced by lying upon it during sleep, or falling asleep with it hanging 
over the back of a chair in such a way as to allow it to press upon the 
nerve. When the paralysis is slight, the arm is said to be “ asleep.” 
It may also be produced by a blow upon an exposed nerve, as by a 
sudden blow upon the elbow at the point popularly termed the “ crazy 
bone,” or “ funny bone.” “ Crutch paralysis ” results from the pres¬ 
sure of a crutch in its use in walking. 

Treatment. —Rest, rubbing, hot and cold applications, and the use 
of electricity, are all the measures usually required to effect a speedy 
cure. 


MIMETIC SPASM OF THE FACE. 

SYMPTOMS. — Grimaces, usually of one side of the face only, such as wrinkling the 
forehead, blinking the eyes, twitching of the nostrils, drawing down the corners of the 
mouth ; spasm is excited by motions of the body, even by walking ; contractions; sighing 
during sleep. 

This is a very curious disease, giving to the patient, in many in¬ 
stances, a very comical appearance. In some cases it attacks the little 
muscles of the external ear, which are not ordinarily under the control 
of the will, sometimes keeping the ear in constant motion for hours at 
a time. Contractions are not usually accompanied by pain. The 
spasm is, in some cases, continuous, the features of one side of the face 
remaining drawn for a long time ; in others, a quick jerking movement 
occurs at short intervals. When continuous, the spasm of the mus¬ 
cles is termed “ tonic;” the interrupted spasms are termed “clilonic.” 

Causes. —The most common are cold, injuries to the face, decayed 
teeth, and abnormal mental emotions. 


WRITER'S CRAMP. 


1113 


Treatment. —Warm baths, galvanism to the affected part, and at¬ 
tention to the patient’s general health, are the most effective measures. 
The disease is obstinate, and frequently does not yield readily to treat¬ 
ment. In severe cases, pressure over the principal branches of the 
facial nerve should be applied. The pressure is most effective just in 
front of the lower portion of the ear. It may be made continuous by 
means of a spring attached to a hard pad. Division of the affected 
muscles has been tried in some cases. 


TORTICOLLIS—WRY SECli. 

SYMPTOMS—Ear of one side drawn toward collar-bone, twisting the head; spasm 
interrupted or continuous; when both sides are affected, spasmodic nodding, or head 
bent forward. 


This peculiar affection is very often 
combined with spasm of the face. 
Its causes are quite obscure, though 
in many cases the disease is traced 
to exposure to cold. It may arise 
from disease of the vertebrae. 

Treatment. —Wry neck sometimes 
resists the most energetic treatment. 
The majority of cases, however, can be 
relieved, and in time, cured. Expe¬ 
rience shows the best remedies to be 
the application of electricity to the 
muscles of the sound side, division of 
the affected muscle, and the wearing 
of such an apparatus as is shown in 
Fig. 321. 



Fig, 321. Splint for Wry Neck. 


WRITER S CRAMP. 

SYMPTOMS.—At first, fatigue and sense of insecurity in arm and hand; patient 
grasps his pen too firmly; fingers seem clumsy; pen jerked up and down by twitching 
of the muscles of the hand and arm. 

Under the head of writer’s cramp may be included a number of al¬ 
lied diseases affecting other muscles than those of the hand; thus we 
have cobbler’s cramp, milker’s cramp, and blacksmith’s cramp, as well 
as writer’s cramp. 

Cause. —The principal cause which has been assigned to this affec- 



1114 


DISEASES AND THEIR TREATMENT. 


tion, is the long-continued use of a single set of muscles in a particu¬ 
lar way, as in writing, milking, and other occupations. The most 
recent explanation of the nature of the disease is, that it is chiefly 
due to an increase of the power of automatic movement in the affected 
parts. It is well known that when certain movements are many times 
repeated, they may after a time, become automatic, that is, are per¬ 
formed without the direct action of the will. It has been suggested 
that writer’s cramp is an exhibition of this faculty in an exaggerated 
degree, due to a long continued use of one set of muscles in the same 
way. It is said that copyists are much more likely to be affected with 

the disease than editors, au¬ 
thors, and others who com¬ 
pose as they write. This ex¬ 
planation does not seem to us 
very satisfactory, however, 
since walking, an act which 
becomes almost completely 
automatic, is not affected by 
any disturbance of this sort. 
The observation mentioned 
with reference to the class of persons affected, may be readily ex¬ 
plained by the fact that with the copyist the motions of the hand are 
more uniform and continuous. Authors write as they think, some¬ 
times fast, sometimes slowly, and often with frequent pauses, which 
affords opportunity for the muscles to rest. It has been noticed that 
this affection has arisen since the introduction of steel pens, and 
hence it is attributed in some decree to their use. It is also thought 
that the disease is encouraged by anything which restricts the motions 
of the muscles of the arm, as a tight coat-sleeve, an elastic, or any 
other means of constriction. 

Treatment. —In many cases, absolute rest of the affected muscles is 
necessary. This frequently necessitates a change of occupation. Every 
possible attention should be given to improvement of the general health. 
The application of galvanism to the affected muscles is an effective remedy 
m many cases. Hot sponging, alternate hot and cold applications, and 
massage, are also of use. Some patients obtain the needed relief of the 
affected part by learning to write with the other hand ; but, unfortu¬ 
nately, in many cases, this also becomes affected. Some relief from the 
disagreeable jerking may be obtained by the use of quill or stub pens. 



Fig 1 . 322. Apparatus for Relief of Writer’s Cramp. 




1115 


* 


CRAMP. 


Still more benefit may be derived by the use of a simple apparatus 
shown in Fig. 322, which consists in a rounded part, to be held in 
the hand, to which is attached an adjustable pen-holder and pen. 
By means of a screw, the pen-holder may be placed at any an¬ 
gle necessary. The fore and middle fingers are supported by rests at 
the sides of the instrument, while the thumb lightly grasps the rounded 
portion in the palm. This enables a person to write without putting 
the hand in the usual position, in which the pen is grasped by the 
thumb and forefinger. Fastening a sponge to the pen-holder at the 
point at which it is held, sometimes answers the same purpose. Some 
persons find relief to a considerable degree by grasping the pen between 
the first and second fingers, instead of between the thumb and fore¬ 
finger. 

CRAMP. 

This term is applied to a sudden spasmodic contraction of a single 
muscle or set of muscles. It most frequently occurs in the calf of the 
leg. It sometimes extends to the whole body. It is often very pain¬ 
ful. In many cases the spasm is preceded by a crawling or tingling 
sensation, or stiffening of the parts affected. 

Treatment. —When the cramp is confined to a single muscle, as in 
cramp of the leg, it may be relieved by simply grasping the muscle 
and pressing it with considerable force. 

A gentleman who was much troubled with this peculiar affection, 
and to whom we recommended compression as a remedy, had made 
for the purpose, two straps, furnished with a buckle at each end, 
which he always carried with him. Whenever he felt the first symp¬ 
toms of attack, he would apply the straps to the calves of the legs, 
where the cramp always began, buckling them as tightly as possible. 
The application of heat and cold to the spine, with fomentations to the 
affected part, are useful measures. When the cramps extend to va¬ 
rious parts of the body, a general warm bath will usually afford relief. 
Some cases are best relieved by applications of ice to the spine. Ice 
may be applied by the ice pack, or by rubbing a piece of ice, inclosed 
in a piece of muslin, up and down the spine. The patient should be 
kept as quiet as possible, as the least motion will often induce a return 
of the spasms after they have ceased. Gentle manipulation of the 
affected muscles, if very cautiously performed, will sometimes relieve 
the tendency to spasm. 


1116 


DISEASES AND THEIR TREATMENT. 


StEEPlESSMESS, OB INSOMNIA. 

This is a serious symptom of disease of the nervous system which 
should not be neglected. When an individual cannot sleep, his nerv¬ 
ous system will rapidly get out of repair, and serious disorders will 
make their appearance in consequence of nervous debility induced by 
want of rest. Sleeplessness is often a precursor of insanity, of which 
it is not infrequently an important symptom. In many cases, the 
mental disease is due loss of sleep for a protracted period. When 
an individual discovers that he is becoming habitually sleepless, 
perhaps lying awake several hours every night, not obtaining more 
than one-half, the proper amount of sleep, he should at once give seri¬ 
ous attention to the matter, for the purpose of remedying the cause. 

Causes. —The patient may be deprived of sleep in consequence of 
pain in some part of the body, as from neuralgia, from severe head¬ 
ache, or from other painful affections, or he may toss about, anxiously 
longing for sleep, but kept awake by mere nervousness. In other 
cases the immediate cause of inability to sleep is activity of the intel¬ 
lect, the mind continuing so active that sleep is impossible. 

The principal causes of sleeplessness are eating before retiring, ex¬ 
cessive brain work, too little physical exercise, indigestion, the use of 
tea and coffee, tobacco-nsing, the use of alcoholic liquors, and high liv¬ 
ing, especially the excessive use of meat and stimulating condiments. 
Constipation, biliousness, heart disease, asthma, and other affections 
which produce congestion of the brain and an irritable condition of 
the nervous system, are frequent causes of deficient sleep. 

Treatment. —A person who suffers from sleeplessness should avoid 
the use of tea and coffee, tobacco, alcoholic liquors, and all other stimu¬ 
lants and narcotics, but should especially avoid eating late at night. 
Eating just before retiring has been recommended for sleeplessness, and, 
in some cases, a palliative effect is certainly produced, but the ultimate 
result is an aggravation of the difficulty instead of relief. If a per¬ 
son suffers “ faintness ” or “ all gone feelings ” at night, so that he can¬ 
not go to sleep, he should take a few sips of cold water or a glass of 
lemonade. As complete relief will generally be obtained as from eat¬ 
ing, and the stomach will be saved the unpleasant task of attempting 
to digest a meal when it should be resting with the remainder of the 
body. A warm bath just before retiring, a wet-hand rub, a cool 
sponge bath, gentle rubbing of the whole surface of the body with the 


SLEEPLESSNESS, OR INSOMNIA. 


1117 


dry hand, massage, galvanism applied to the head and spine, hot and 
cold applications to the spine, and the application of a fomentation 
over the stomach, are all useful measures for the relief of sleeplessness. 
When the feet are cold, they should be thoroughly warmed by a hot 
foot or leg bath, and thorough rubbing. In many cases, the alternate 
hot and cold foot bath or the shallow cold foot bath are more effective 
than the hot foot bath. When the head is congested, these measures 
should be supplemented by the application of cold to the head, as the 
cold compress, the ice-cap, or a cold pour. In some cases a tight ban¬ 
dage about the head and a cold compress laid over the eyes, after the 
patient goes to bed, is effective. Persons suffering with hypersemia or 
congestion of the brain, should raise the head of the bed a few 
inches, so as to diminish the tendency of the blood to the brain. 

Persons who suffer for want of sleep from sedentary habits are 
benefited by a walk in the evening, just before retiring, or gentle cal¬ 
isthenics. In most cases it is important that the patient should retire 
early. This is especially the case with persons whose sleeplessness is 
connected with neurasthenia or nervous debility. Unfortunately, in 
many of these cases, the patient feels better in the evening than in 
any other part of the day, and consequently is very reluctant to go to 
bed, especially when he has the unpleasant prospect before him of 
tossing uneasily about till day-break. The disposition to put off re¬ 
tiring until a late hour should not be yielded to, as the unusual ex¬ 
hilaration felt in the evening is an unnatural condition, which, if en¬ 
couraged, will aggravate the difficulty. All exciting influences should 
be avoided in the evening The patient should keep himself as quiet 
as possible. In man cases it is necessary to forbid conversation or 
reading, or even amusement of any sort which will excite the nerves 
or mental faculties. Hot-water bags, hot jugs, and bed-warmers of all 
descriptions, are of use for individuals whose circulation is unusually 
defective, though, in some cases, these means of relief may become a 
source of damage when depended upon too largely and for a great 
length of time. Attention should be given to the bed and the sleep¬ 
ing apartment. Feathers should be discarded. The bed should be 
neither too soft nor too hard, and should be thoroughly aired daily. 
An abundant supply of fresh air should be introduced into the bed¬ 
room in such a way as to secure its admission without drafts. As a 
general rule, a fire in a sleeping room, at the time of retiring, is dis¬ 
advantageous. Care should be taken that the bed be thoroughly 


1118 


DISEASES AND THEIR TREATMENT. 


warmed and the apartment dried during the day, but the room should 
be at least ten degrees cooler at night than is required for comfort dur¬ 
ing the day. 

Various devices have been proposed for the benefit of persons who 
lie awake at night for hours, unable to get to sleep on account of ex¬ 
cessive mental activity, such as counting, repeating over some simple 
formula of words, etc. The best means of this kind we have ever* 
become acquainted with, is the practice of prolonged deep inspirations. 
The lungs should be slowly filled to their utmost capacity, and then 
emptied with equal slowness, repeating the respiration about ten times 
per minute, instead of eighteen or twenty times, the natural rate. In 
the majority of cases in which sleeplessness is not due to any special 
exciting cause, this plan is quite effective. We have often recom¬ 
mended it with entire success. Simply stroking the head will often 
soothe the nerves of a patient till he readily falls asleep. This is not 
due, however, to any mesmeric or magnetic influence on the part of 
the rubber. 

When a person falls asleep upon first going to bed, and after sleep¬ 
ing two or three hours, awakes, and is unable to get to sleep again, re¬ 
lief will in many cases be obtained by getting out of bed, and rubbing 
the whole surface of the body with the dry hand. Simply walking 
about the room for a few minutes, exposing the skin to the air, will 
have a quieting effect upon the nerves, so that when the person re¬ 
turns to bed he will quickly fall asleep. It is especially important 
with most persons who do not sleep well, that rest should be undis¬ 
turbed after the patient falls asleep at night. Great care should be 
taken to avoid waking such a person, as if not roused he may sleep 
quietly until morning, when, if wakened, he will lose the whole night’s 
rest. 

The use of drugs for the purpose of inducing sleep should be 
avoided as much as possible. Opium is especially harmful, and its use 
should not be resorted to when it can be, by any possible means', dis¬ 
pensed with. Sleep obtained by the use of opiates, is by no means a 
substitute for natural sleep. The condition is one of insensibility, but 
not of natural refreshing recuperation. Three or four hours of natural 
sleep will be more than equivalent to double that amount of sleep ob¬ 
tained by the use of narcotics. When a person once becomes depend¬ 
ent upon drugs of any kind for producing sleep, it is almost impossible 
for him to dispense with them. It is often dangerous to resort to 


SOMNA MB ULISM. 


1119 


their temporary use, on account of the great tendency to the forma¬ 
tion of the habit of continuous use. The use of opiates for securing 
sleep is one of the most prolific means by which the great army of 
opium-eaters is annually recruited. Chloral, bromide of potash, whisky, 
and other drugs, are to be condemned almost as strongly as opium. 
If any sleep-producing agent besides the simple remedies mentioned 
must be employed, lupulin, gelsemium, belladonna , and Indian hemp, 
are to be recommended rather than opium; but these should not be 
used except under the directions of a physician. A hop pillow is a 
popular remedy of some reputation for producing sleep. We have no 
doubt that it is beneficial in many cases. 

SOMXAMBU1ISM. 

Sleep-walking must be regarded as a nervous disorder, or at least 
symptomatic of a disordered condition of the nervous system. It most 
often occurs in persons of a hysterical temperament, being very common 
in persons suffering from hysteria. In this class of persons it may be 
induced by anything which occasions disordered sleep. It always oc¬ 
curs in connection with dreams, which are sometimes of such a vivid 
character as to occasion violent exertion on the part of the patient. 
For further explanation of sleep-walking, see page 14G. 

Treatment. —When the person is found to be addicted to sleep¬ 
walking, careful inquiry should be made respecting the condition of his 
health, particularly that of the nervous system, and treatment should be 
applied accordingly. All causes likely to excite the nervous system should 
be removed. In order to prevent the patient from doing himself harm, he 
should be carefulty watched during the night. When this is impossible 
the door of the sleeping appartment should be locked, and the window 
so arranged as to prevent egress. It has been recently suggested that 
sleep-walking may be cured by placing by the side of the sleep-walker’s 
bed a strip of sheet-iron, tin, zinc, or other metal of such length and 
width that when he puts his feet out of the bed they will rest upon the 
metal. It is claimed that the sensation produced by contact with the 
cold metal will awaken the person. A strip of wet carpet has been suc¬ 
cessfully used in the same way. We have known several instances in 
which somnambulists have narrowly escaped death from falling from a 
high window, being caught and restrained just in time to prevent the 
catastrophe. 


1120 


DISEASES AND THEIR TREATMENT. 


HOMESICKNESS, OB NOSTALGIA. 

Although homesickness is generally regarded as a mere notion on 
the part of the patient, it is, in reality, in many cases, a disease, and 
should be treated as such. Cases have occurred, in which, through the 
depressing influences of nostalgia, the most disastrous results have oc¬ 
curred. Patients generally lose appetite, become sleepless, greatly debil¬ 
itated, and sometimes sink into a state of melancholia. 

Treatment. —The proper treatment of homesickness includes mental 
and moral, as well as medical, measures. The patient should not be 
lectured and scolded for his strong desire to return home, although he 
should be encouraged to exercise as much self-control and restraint over 
his feelings as possible. Pains should be taken to divert his attention 
from the cause of his depression by means of amusement, diversion of 
mind, variety of diet, and surrounding him with as many favorable con¬ 
ditions as possible. In the majority of cases, the difficulty will dis¬ 
appear after a few weeks, though it may persist for some time. 

HYPOCHONDRIA. 

This disease derived its name from the supposition that it was de¬ 
pendent upon disease of the liver. The malady assumes a great variety 
of forms. The patient is generally moody and desponding, the degree 
of sadness sometimes being so great that nothing will provoke a smile. 
The patient imagines himself to be the victim of almost any number of 
incurable diseases. If the mind is relieved of one cause of apprehension, 
some other equally groundless one will be quickly discovered. Hypo¬ 
chondriacal patients seldom sleep well. They exhibit in their minds great 
want of resolution and lack of mental force and vigor. Their circulation 
is generally poor, hands and feet being nearly always cold. The diges¬ 
tion is disturbed in nearly all cases. 

Causes. —A very frequent cause of hypochondria is sexual excesses in 
youth, the consequences of which, though bad enough, are sometimes 
immensely exaggerated. An inactive condition of the liver, derange¬ 
ment of the digestion, nervous debility, and various other functional dis¬ 
turbances of the body, may give rise to hypochondria. 

Treatment. —It is important that this affection should receive 
prompt and thorough attention, as, in many cases it is a precursor of in¬ 
sanity. When taken in its early stages, almost every case is curable by 
proper measures, which consist in removing all the real causes of the af- 


IXSANITY. 


1121 


fection, and then endeavoring to convince the patient of the non-exist¬ 
ence of the imaginary evils. When the digestion is disturbed, such 
treatment as has been recommended for the.various forms of indigestion 
should be applied. The same should be done in case the liver is affected 
Nervous debility requires the treatment which has been recommended 
for this condition. In many cases, traveling will be of great benefit to 
the patient, though this is not to be recommended in all cases. If the 
difficulty does not disappear in a short time by the carrying out of the 
above suggestions, an intelligent physician should be consulted. 

irVSAMTV. 

This is an affection which has given rise to an immense amount of 
discussion among physicians, philosophers, and moralists, from the 
earliest ages down to the present. Mental derangement has been uni¬ 
versally considered one of the most terrible calamities which could be¬ 
fall an individual. The exact nature of the disease, however, was never 
thoroughly understood until the darkness which surrounded it was 
dispelled by the modern investigation of the subject. The old idea of 
insanity held it to be a disease of the mind or soul. This theory is 
no longer tenable, however, in the light of modern investigations re¬ 
specting the nature of the mind and its relation to the brain. As has 
been elsewhere shown, see page 137, mind is simply the result of the- 
activity of the brain, although it cannot be called a secretion, as it has- 
been termed by some. It is just as much a result of the activity of the 
cells of the brain, or of certain parts of it, as the bile is a result of the- 
activity of the cells of the liver, or gastric juice of the cells of the 
peptic glands. So-called mental disease is really disease of the mind- 
producing organ, or the brain. Thus, properly speaking, insanity is 
not a disease of the mind, but of the brain itself. This theory is 
amply sustained by hundreds of post-mortem examinations which have- 
been made at institutions for the insane, where the most thorough and 
full investigations of this subject have been carried forward. The 
general principle can now be well sustained that every case of serious: 
mental disease is accompanied by certain definite changes in the sub¬ 
stance and cell structure of the brain, and* the amount and character 
of the mental disorder is exactly proportionate to the nature and loca¬ 
tion of the tissue-changes in the brain. 

Insanity has been variously defined by different authors, and the 
great diversity in the definitions given suggests very strongly the fact- 

71 


1122 


DISEASES AND THEIR TREATMENT. 


that an absolutely perfect definition, which shall include all cases 
which properly belong under this head, without including any others, 
is impossible. A late writer on the subject defines insanity as being 
“ a manifestation of disease of the brain, characterized by a general or 
partial derangement of one or more faculties of the mind, and in which, 
while consciousness is not abolished, mental freedom is perverted, 
weakened, or destroyed.” One of the greatest obstacles which is 
presented in the study of insanity is the difficulty of distinguishing be¬ 
tween natural eccentricity and real mental derangement. There is no 
sharp dividing line between the cases in which mental derangement 
may be so slight that the individual is simply said in popular phrase 
to have “ a kink in the head ” or, as in Scotland, “ a bee in the bon¬ 
net,” and those in which the mental disorder is so pronounced as to 
render the individual incompetent to perform the ordinary duties of 
life. In other words, it is often very difficult to say whether an indi¬ 
vidual is really insane, or whether he is exceedingly odd, or eccentric. 
Some have even gone so far as to say that entire sanity is much more 
rare than some degree of insanity. Perhaps this is an extreme view 
of the matter, but it may safely be said that there are far more insane 
people engaged in the active duties of life, following their accustomed 
vocations, with greater or less success, than are found within the walls 
of lunatic asylums. 

Certain symptoms which are present in cases of insanity should 
be defined, in order to render a description of the disease intelligent. 
The principal are illusion, hallucination, delusion, incoherence and 
delirium. 

Illusion is a false, exaggerated, or perverted perception of some¬ 
thing which is really appreciated by the senses; for example, the pa¬ 
tient, seeing a small object moving across the floor, may think it to be 
a mouse or a reptile, having an illusion of sight. A person suffering 
with illusion of the sense of hearing, may pervert the gentle patter of 
rain into a conversation held between two persons in a neighboring 
room. The sense of touch, taste, smell, etc., may all be subject to illusion. 
This is not by any means a positive symptom of insanity, as the best of 
us are subject to illusion at times, and it has been very sagaciously sug¬ 
gested that it is nothing more than probable that we never appreciate 
objects exactly as they are, that our senses never inform us with abso¬ 
lute correctness, perhaps, of the objects with which we come in contact. 
This accounts for the difference in individual judgments in some mat¬ 
ters, and in the judgment of the same individual at different times. 


INSANITY. 


1123 


Hallucination. —This is a false perception which has no founda¬ 
tion whatever, originating entirely within the brain. The perception 
is wholly imaginary, and not, as in the case of illusion, a simple per¬ 
version of a real perception. A person affected with hallucination sees 
pictures and images upon a blank wall. He imagines himself sur¬ 
rounded by various persons or objects when he is quite alone. A very 
curious fact is that persons who may be absolutely deprived of any of 
the senses may suffer with hallucinations of the lost sense; as, for in¬ 
stance, a woman who had been totally deaf for years, being unable to 
perceive the loudest noises, not noticing even the firing of a cannon, 
when suffering with hallucination, was constantly troubled with voices 
whispering in her ears. 

Delusion. —A person may suffer with both hallucinations and illu¬ 
sions and yet be perfectly aware of the imaginary character of his per¬ 
ceptions ; but when the mind is so affected that hallucinations and illu¬ 
sions are considered as realities, the individual is subject to delusion. 
Although delusion is a much more serious mental derangement than 
either illusion or hallucination, it is by no means a positive test of in¬ 
sanity, as it has often been considered to be, by both legal and medical 
authors. As a recent writer remarks, if delusion were a test for in¬ 
sanity, “ one-half of the world would be trying to put the other half 
into lunatic asylums.” 

Incoherence. —An individual is incoherent when he puts words 
together without proper relation to each other, so that they do not 
make sense. 

Delirium. —Delirium is a condition of the mind in which all the 
previously mentioned symptoms are present, together with inability to 
sleep, active pulse, and great restlessness. It is very common in acute 
fevers. 

Mental disease assumes a very great variety of forms, according to 
the different portions of the brain affected or the different faculties in¬ 
volved. We shall not attempt to go into an elaborate consideration of 
the subject, however, but will briefly call attention to some of the most 
common forms of the disease, which are termed mania, melancholia, 
and dementia. 

Causes. —The causes of insanity include all of the numerous causes 
to which attention has been called in the first part of this section, as 
productive of nervous disease. Anything which tends to interfere 
with the nutrition of the brain may become a cause of insanity. 


1124 


DISEASES AND THEIR TREATMENT. 


Among the special causes, may he mentioned excessive mental exer¬ 
tion, powerful emotions, unrestrained passions, sexual excesses, disor¬ 
ders of the digestion, iho use of opium, alcohol, and tobacco, general 
disorders of the system, disease of the kidneys, liver, and other in¬ 
ternal organs, organic disease cf the brain, spinal cord, etc. One form 
of insanity makes its appearance during pregnancy, or after child¬ 
birth. It seems to be dependent upon this particular condition. Re¬ 
ligion has been charged with producing insanity in persons who have 
given themselves up to religious exercises in an immoderate degree, 
but we seriously doubt whether genuine religion is in any case the 
real cause of mental disease. Religious fanaticism may lead to insan¬ 
ity, if, indeed, it may not be considered one form of mental disease. 
We have found by direful investigation of a number of cases of so- 
called religious insanity, that some other cause really lay at the foun¬ 
dation of the disorder, as unrequited affections, disappointment in love, 
or some other condition in which the emotions were strongly involved ; 
loss of sleep ; long standing nervous disease, etc. 

In not a few instances, we have found the real cause of so-called re¬ 
ligious insanity to be self-abuse; indeed, we are thoroughly satisfied 
that sexual excesses are responsible for a much larger proportion of 
mental disease than is generally supposed to be the case. Heredity is 
also a very common cause. It has long been thoroughly established 
that a tendency to insanity runs in families. The children of epilep¬ 
tics are likely to be insane. The notable increase of insanity is one 
of the most alarming features of the times. At the present time there 
are more than forty thousand lunatics, recognized as such, in the 
United States, while there is, undoubtedly, a much larger number of 
individuals who are suffering with a moderate degree of mental dis¬ 
order, but have thus far been able to escape detection. 

Mania. —In this form of mental disease nearly all the mental fac¬ 
ulties are generally affected. The patient suffers with illusions, hallu¬ 
cinations, and delusions. The controlling influence of the will over 
the mental faculties is lost. The patient is subject to impulses of 
various kinds. The mind may be either morbidly excited and exalted, 
or in the opposite condition. The disease generally begins with de¬ 
pression and a disposition to be alone, sleeplessness, symptoms of dys¬ 
pepsia, and of other derangements of health. The patient complains 
of pain and fullness of the head, confusion of thought, and the usual 
symptoms of congestion of the brain. He also manifests irritability 


GENERAL PARALYSIS OF THE INSANE. 


1125 


of temper and such peculiarities of behavior as are likely to attract 
the attention of friends, and arouse a suspicion that something is wrong 
with him. As the disorder becomes fully developed, mental disturb¬ 
ances make their appearance, and may assume almost any form, from 
simply harmless delusions or hallucinations to an uncontrollable dispo¬ 
sition to commit violence upon himself or upon his attendants. There 
is generally a marked change in disposition. The patient will fre¬ 
quently hate, with great intensity, persons and things for which he 
has entertained great fondness. A mother will conceive a desire to 
kill her child, a husband to take the life of his wife. More often, 
however, the disposition to violence is turned upon the individual him¬ 
self, as in suicidal mania. A person suffering with acute mania has a 
frequent, feeble pulse, and sometimes some fever. Speech is noisy and 
incoherent; he will often refuse to eat or drink, making it necessary, 
in many cases, to employ force in order to prevent starvation. Mania 
may become chronic, though it has a general tendency to recovery. 
Finally the most active symptoms subside, some settled delusion tak¬ 
ing possession of the patient. Wheh recovery takes place, it is gener¬ 
ally within a year and a half or two years. The longer the disease 
continues after two years, the less the likelihood of recovery. When 
the disease continues for a long time, there is generally a gradual 
loss of intelligence which finally results in dementia or imbecility. 

Melancholia. —This is one of the most terrible forms of mental dis¬ 
ease. Like mania, it is preceded by premonitory symptoms which arc 
essentially the same as those given for the disease just described. Pa¬ 
tients suffer with many of the symptoms of mania, but, as a general rule, 
there is less activity. The state of depression continues. The patient sel¬ 
dom develops violent symptoms; he is usually passive and easily con¬ 
trolled, but is haunted continually by hallucinations and illusions, often 
of the most terrible character. Melancholia, when attended by paralysis 
or imbecility, is an almost hopeless disease. It usually terminates in 
dementia. 

Dementia.—This is a condition toward which all forms of insanity 
tend. There is a general loss of intelligence, or failure of all the mental 
powers. When confirmed, it is an entirely hopeless condition. 

PARESIS, OR GENERAL PARALYSIS OE THE IYSAYE. 

The symptoms of this disease are slight trembling of the hand, espe¬ 
cially wdien extended, and of the tongue, when protruded, and lips, when 


1126 


DISEASES AND THEIR TREATMENT. 


speaking. There is a marked change in character and disposition. The' 
patient is subject to extravagant delusions, speech is thick, gait is shuffling 
and resembles that of a drunken person; in an advanced stage of the 
disease, convulsions may appear. The disease lasts from a year and a 
half to four years. It is almost certainly fatal. The principal causes 
are intemperance and dissipation. 

Treatment. —There is probably no disease in the treatment of which 
so marked improvements have been made in modern times as in the 
case of insanity. In ancient times, and, indeed, in times very near to 
the present, the insane have been treated like wild beasts. As soon as 
evidence of mental disorder was discovered, they were considered at once 
as doomed, and no efforts made to ameliorate their condition. Many 
times they were treated with great inhumanity and cruelty. Indeed it 
has only been within the last century that the treatment of insanity has 
been made, in any degree, rational; and often, at the present day, there 
are evident opportunities for further improvement. It is of great im¬ 
portance that the first beginnings of mental disease should be detected; 
hence every individual should becoftie, to some extent, intelligent on the 
subject. When a person shows, in a marked degree, any of the symp¬ 
toms above mentioned, he should be carefully watched. If the individ¬ 
ual himself feels strange impulses, and an almost uncontrollable disposi¬ 
tion to take his own life, or do violence to others, he should at once con¬ 
sult an intelligent physician, or put himself under the watchcare of some 
one sufficiently intelligent to care for him. There is good reason for be¬ 
lieving that no small proportion of the crimes of violence committed are 
due to temporary or obscure mental disorders. 

In the treatment of the insane, attention must be given to every 
function of the body, as well as to that of the brain, since the disease of 
the brain often depends upon disease of other organs. Disease of the 
digestive organs, producing malnutrition of the brain, is one of the 
most common of all causes of insanity, and we doubt not that many 
who are now inmates of insane asylums might have been readily 
cured, had this fact been recognized and the difficulty removed at the 
outset. We have treated quite a number of cases in which the 
patient had been confined for a longer or shorter period in an insane 
asylum, and by giving attention to improvement of digestion, thus 
securing better nutrition of the brain and nervous system, have suc¬ 
ceeded, in nearly every instance, in restoring the patient to complete 
mental soundness. 


GENERAL PARALYSIS OF THE INSANE. 


1127 


In women, the condition of the reproductive organs should receive 
particular attention, as local irritation in these organs not infre¬ 
quently occasions the most serious mental aberration. 

The question of confinement in an asylum is one of very serious 
moment. It is often decided without a careful consideration in all 
its hearings. When the condition of the patient is such as to make 
physical restraint necessary, and when this cannot be secured at home, 
together with intelligent medical supervision, or when the disease is. 
so thoroughly confirmed that the prospect for recovery is exceedingly 
small, undoubtedly confinement in a well regulated asylum is the 
best disposal that can be made of the patient; but when the individual 
has still sufficient intelligence to appreciate his condition, it seems as 
though confinement in an asylum with large numbers of other indi¬ 
viduals, suffering with all the grades of mental disease, must be, in a 
high degree, detrimental to the patient’s recovery, especially when the 
aversion to such confinement is exceedingly strong on the part of the 
patient. These difficulties exist, of course, in a much less degree in 
small institutions, where but very few patients, or only cases of a 
mild character are received; but by far the most preferable plan, is. 
that which has been for many years pursued in Holland, where certain 
country districts are devoted to the treatment of the insane, patients- 
being placed separately in the families of farmers who are employed to 
care for them under competent medical directors. Not more than one 
or two patients are generally received into a family; and they are 
treated as members of the household, and are thus saved from the pos¬ 
sibility of any sort of damaging influence from asylum confinement and 
restraint, and especially the contact with other individuals in a con¬ 
dition similar to, or worse than, their own. 

In acute mania, in which there is marked congestion of the brain,, 
the treatment elsewhere prescribed for congestion, or hyperannia, of 
the brain should be administered. The patient should be kept as quiet 
as possible, the diet should be nutritious but unstimulating. If the 
fever is considerable, the patient should have frequent sponge-baths. 
If he will not submit to treatment, the cool air-bath can be readily 
administered with good effect. When it becomes necessary to employ 
drugs for the purpose of controlling the mental excitement, bromide of 
potash is to be preferred to almost any other, but no drug should be 
administered without the advice of a physician. In addition to all 
other remedies which may be employed, mental and moral treatme nt 


1128 


DISEASES AND THEIR TREATMENT. 


should not be neglected. Efforts should be made to cultivate the pa¬ 
tient’s will-power and self-control, and lead him to appreciate his con¬ 
dition and to co-operate with the treatment as far as possible. Thanks 
to the modem advances in the management of this affection, it is now 
by no means so hopeless as it was formerly supposed to be; and by 
perseverance in the proper line of treatment, a large number of re¬ 
coveries may be hoped for, especially if early attention is given to the 
•disease. 

In conclusion, we wish to remark, that from a personal acquaintance 
with the superintendents of a number of large State asylums for the in¬ 
sane, we are thoroughly convinced that the prejudice which in some 
parts prevails against these institutions is altogether unfounded. The 
numerous stories which are circulated respecting the cruelties practiced 
in the management of patients are generally put in circulation by pa¬ 
tients who have been discharged before complete recovery has taken 
place, and are generally unreliable. Superintendents of insane asylums 
.are, as a rule, humane and kind-hearted men, and do all in their power 
dor the relief of patients under their charge. 

IDIOCY AID OIBECItITY. 

Idiocy is a condition of mental deficiency existing from birth, the in¬ 
dividual being born with a deformed or undeveloped brain, just as per¬ 
sons may be born with deficient development of the limbs or of any 
•other part of the body. The mental deficiency is shown by an unusually 
•small head, which is very much flattened in front, the average diameter 
•of the head being about thirteen inches, or five or six inches less than 
usual in health. Various other physical deformities are also present, as 
•deficient development of the teeth, protrusion of the upper jaw, giving 
the child an ape-like appearance. In some cases the resemblance to 
dieep or monkeys is very great. The degree of mental development in 
idiots is often much less than that of the higher animals. Their habits 
;are exceedingly filthy, the natural instincts which characterize the lower 
animals being apparently absent. In some cases, however, a considera¬ 
ble degree of intelligence is manifested in certain directions, such as abil¬ 
ity to calculate correctly, a fondness for and appreciation of music, etc. 

Cretinism is a form of mental deficiency in which goitre and other 
•deformities are seen. It is found chiefly in certain parts of Switzerland, 
particularly in the deep gorges of the Valais, where it is supposed to be 
•due to climatic influences, although its origin is not well understood. 


IDIOCY AND IMBECILITY . 


1129 


Imbecility is a condition of mental weakness which comes upon an 
individual born with a healthy brain. It frequently follows infantile 
convulsions. It is very often the result of softening of the brain, or hy¬ 
drocephalus. All degrees of mental deficiency are shown by imbeciles. 
They generally eat voraciously, are very mischievous in disposition, fre¬ 
quently destroying whatever they can get their hands upon. Imbeciles 
do not show the peculiar deformities noticeable in idiots, being born in a 
normal condition. 

Much attention has been given to the study of the causes of idiocy 
and imbecility. The best authors attribute idiocy chiefly to two causes,— 
intemperance and marriage of relatives. Plenty of instances have been 
observed in which idiotic children are the offspring of intemperate par¬ 
ents. Morel, who has investigated this subject very thoroughly, shows 
the connection between habits of vice and intemperance and idiocy as 
follows; “ In the first generation there is alcoholism and immorality; in 
the second, hereditary drunkenness, maniacal outbursts, and general 
paralysis; in the third, sobriety, homicidal mania, melancholia, confirmed 
mania, homicidal tendencies ; in the fourth, feeble intelligence, stupid¬ 
ity, early mania, idiocy, and, finally, extinction of the stock.’’ 

Statistics have also been collected to show that the marriage of 
nearly related pei - sons, as of cousins, has a marked tendency to produce 
idiocy in the offspring. Recent investigations have shown that this 
tendency does not necessarily exist on account of individuals being rela¬ 
tives, only as each one possesses similar tendencies, which, by combination, 
are intensified. The danger in the marriage of relatives is that some 
lurking tendency of this kind will be, by intensification, brought out in 
the children. Fortunately, idiots and imbecile persons are usually sterile. 
A peculiar form of imbecility of a very low grade is produced in chil¬ 
dren by thp use of narcotics, as of “ Mrs. Winslow’s Soothing Syrup,” and 
similar quack nostrums containing opium. 

Dr. Archibald, superintendent of the State asylum for feeble-minded 
children, asserts that he has found, by careful investigation, that self¬ 
abuse is a cause of a very large proportion of the cases of imbecility 
which come under his care. 

Treatment.— Notwithstanding the apparently hopeless character of 
these cases, much has been done in modern times to ameliorate their 
condition. It has been shown, by actual experiment, that almost every 
case may be in some degree benefited by a persevering course of train¬ 
ing, with good treatment. The most hopeful cases are those which are 
healthy in other respects, being free from epileptic fits, paralysis, and 


1130 


DISEASES AND THEIR TREATMENT. 


other serious diseases of the nervous system. The prospect is most fav¬ 
orable when treatment can be begun at an early age, preferably not later 
than twelve or thirteen years. In several parts of this country, as well 
as in England, there now exist excellent institutions for the treatment of 
the feeble-minded, in which a systematic course of instruction and train¬ 
ing is carried out, the excellent results of which are seen in many cases, 
by the rescuing of clouded intellects from almost total mental obliv¬ 
ion to a condition in which the individual is able to support himself by 
some form of simple labor. There is a marked tendency on the part of 
idiots and imbeciles to form vicious habits. Some years ago, we saw in 
a large hospital in New York City an idiot who was suffering with the 
worst form of venereal disease. 

LEAD PALSY—WRIST-DROP. 

Various nervous symptoms arise from poisoning the system with 
lead. These may be either slight or extremely severe. Among slight 
symptoms may be mentioned headache, dizziness, fullness and constric¬ 
tion of the head, all of which symptoms are aggravated by mental work. 
In many cases tremor is present, especially in the hands. The trembling 
is sometimes extensive, but generally consists in simply slight tremulous 
motions, especially when the muscles are contracting. In severe cases of 
lead poisoning, the patient may suffer with delirium, convulsions, or 
coma. One of the most common of all symptoms arising from lead 
poisoning is colic, which generally precedes the more severe phase. 
Lead paralysis, the subject of this article, is simply one of the symptoms 
which arises from plumbism, or poisoning from lead. The most com¬ 
mon form of paralysis is what is termed “ wrist-drop,” in which the ex¬ 
tensor muscles of the arm are paralyzed so that the patient cannot ex¬ 
tend his arm or raise the wrist. The paralysis also extends t^ the flexor 
muscles, or those on the inside of the arm, as well as those on the upper 
side, but in a less degree. When the disease continues for some time, 
wasting of the muscles occurs and various distortions of the limb through 
contraction. The muscles of the limbs are also liable to be affected, as 
Avell as the muscles of respiration and other groups of muscles. The 
sensibility of the skin is rarely affected. Paralysis occurring through 
lead poisoning is distinguished from that originating otherwise by the 
fact that the individual has been exposed to this cause, and especially by 
the appearance of a bluish line around the edges of the gums. This dis¬ 
ease occurs most often in persons who work with lead, as lead founders. 


ALCOHOLISM. 


1131 


manufacturers of lead paint, painters, plumbers, printers, etc. Lead 
poisoning is also frequently produced by drinking water which has 
passed through lead pipes, or which has been stored in lead-lined cisterns 
or tanks, or collected from roofs covered with lead or lead-tin, or kept 
in vessels of lead or lead-tin. Smokers are exposed to lead poisoning be 
the use of cigars which have been wrapped in lead foil. The use of hair 
dyes containing lead is another very common cause of lead poisoning. 
In a case which we met some time ago, lead paralysis was produced iu 
a young lady by the use of lead paint as a cosmetic. The use of lead 
plasters and lotions applied to ulcers or other surfaces, has resulted in 
lead poisoning. 

Treatment. —In a majority of cases, this affection can be cured, 
provided the cause is removed. The use of electricity is indispensable, 
and, in bad cases, the galvanic current must be applied, as in most cases 
the paralyzed muscles cannot be made to contract by the faradic current. 
It is necessary to employ very strong currents in order to produce con¬ 
traction. When contraction cannot be induced, the case is a hopeless 
one. Every attention should be given to the improvement of the gen¬ 
eral health. It is claimed that lead may be eliminated from the body 
by the use of iodide of potash. This drug should not be employed ex¬ 
cept under the care of a physician. Electricity may be used with bene¬ 
fit as often as every other day. It should be accompanied with sham¬ 
pooing, massage, and passive movements of the affected muscles. When 
contractions have occurred, various mechanical devices are sometimes 
necessary. Characteristic nervous symptoms are produced by the intro¬ 
duction into the system of mercury, arsenic, and various other drugs, the 
symptoms of which are described elsewhere. 


ALCOHOLISM. 

SYMPTOMS. — Tremor, and unsteadiness, especially of the upper extremities, after a 
time of the lower limbs, most marked in the beginning ; loss of muscular power; great 
nervousness, which is temporarily relieved by alcoholic liquors ; insensibility of skin ; af¬ 
fections of the sight, hearing, smell, and taste; in some cases, convulsions of an epileptic 
character; spasmodic twitching of the muscles; greatly exaggerated nervous irritability : 
great irritability of temper; loss of intellectual and moral capacity. 

The above are but a few of the train of symptoms which are pres- 
ent in the chronic form of alcoholic poisoning. These symptoms may 
occur only after the long-continued use of alcoholic liquors or after a 
short continuance of the habit, according to the temperament and other 


1132 


DISEASES AND THEIR TREATMENT. 


conditions of the individual. The proper treatment consists in aban¬ 
donment of the exciting cause, and improvement of the general health. 
Simply diminishing the quantity of liquor taken, will have little effect 
to relieve the disorders present in this disease. The patient must abstain 
entirely from the use of this subtle poison. 

DELIBIOI TREMENS. 

SYMPTOMS.—At first, toss of appetite, nausea, and vomiting, especially in the morn¬ 
ing; either diarrhea or obstinate constipation ; tongue coated and dry; great debility; 
pulse feeble and rapid; skin cold and moist; sleep unrefreshing, and disturbed by fright¬ 
ful dreams; patient generally wakeful; in most cases, headache and dizziness; more or 
less mental disturbance ; confusion of ideas; trembling of the muscles, first noticed in the 
tongue when protruded. When fully developed, wild expression on the face; hallucina¬ 
tions, illusions, and delusions ; patient frightened by horrid fancies, as of reptiles and erri- 
fying objects seen all about him; entire absence of sleep; considerable fever; extremities 
cold; head greatly congested; patient talks incessantly; pupils strongly contracted; in 
some cases, convulsions. 

Delirium tremens, although generally produced by the use of al¬ 
cohol, is also sometimes occasioned by the use of tobacco, all the char¬ 
acteristic symptoms being present. The condition is one of intense 
poisoning of the nervous system, the nutrition of which is greatly in¬ 
terfered with. In delirium tremens from the use of alcohol, there is 
always present great congestion and often inflammation of the stom¬ 
ach, sometimes renTlering the patient unable to retain food. In some 
cases the patient suffers with incessant vomiting for several days. 
The attack generally continues from three to five days. Ability to 
sleep is a very favorable symptom, as the patient generally awakes 
feeling refreshed. 

Treatment. —The treatment of this disease by means of opiates, 
large doses of bromide of potash, chloral, etc., is very often unsuccess¬ 
ful, especially in severe cases. The best treatment consists in keeping 
the patient as quiet as possible, applying ice or cold pours to the 
head. The cold shower bath may be employed with advantage when 
the fever is high and cerebral congestion very great. When the pa¬ 
tient refuses to eat, his strength may be sustained by the use of nu¬ 
tritive injections. See page 738. There is usually such a high degree 
of inflammation of the stomach that food will not be digested if eaten ; 
and it would probably be well to adopt this plan of feeding in nearly 
all cases. The patient should be kept in a darkened room, and guarded 
against all avoidable disturbances. Great exhaustion results from 


THE OPIUM HABIT. 


1103 


the violent muscular exertion generally made by the patient; these 
should be restrained as much as possible. When a sufficient number 
of attendants cannot be secured to hold the patient in bed, the arms 
and feet may be tied together by means of wide bands, as towels or 
sheets, thus rendering the patient much more easily controllable. 
When necessary, the straight jacket, shown in Fig. 323, which is 
frequently used in insane asylums, may be employed. 

In the effort to reform persons who have been addicted to drink, 
the idea should not be entertained that any substitute for liquor can 
be found. Anything which would be a 
substitute for its effects would be equally 
as bad as the liquor itself. The much ad¬ 
vertised “ Cinchona Cure ” is an unmiti¬ 
gated fraud. As prepared by Mr. D’Unger, 
the professed discoverer, it is simply an 
alcliolic liquor, flavored with “ red bark,” 
one of the varieties of the Cinchona tree, 
from which quinine is obtained. Prof. 

Earle, physician to the Washingtonian “ In¬ 
ebriates’ Home,” in Chicago, has recently 
exposed the matter in a Chicago medical 
journal. He has traced the after-history 
of a number of drunkards whom D’Unger 
publicly claimed to have cured ; but nearly 
all of whom have since been under Dr. 

Earle’s treatment at the “ Inebriate’s 
Home.” Not a single one was in the least 

degree improved by the “ Cinchona Cure.” Some of his mixtures con¬ 
tain as high as twenty-four per cent of alcohol, a larger proportion 
than is found in ale, or most wines. Prof. Earle gives it as his opin¬ 
ion that the “ Cinchona Cure ” has made more drunkards in Chicago 
within the past year than any one of the saloons in that city. 



tiit: opi i"3i iiabit. 


As in the case of inebriety, opium-taking is at first merely a 
habit, but finally develops into a formidable disease. The morbidc on- 
dition established by the long-continued use of opium is, if possible, 
even more serious than chronic alcoholism. This disease has been 
very appropriately termed opiism, or opiomania. The habit is in- 









1134 


DISEASES AND TIIEIII TREATMENT. 


duced in the majority of cases by the use of opium for the purpose of 
relieving pain or inducing sleep. For a number of years past, we 
have had, almost constantly, patients under treatment for the relief of 
this habit, and in tracing the history of these cases we have, in every 
instance, found that the habit had originated with a physician’s pre¬ 
scription. This fact, together with many others to which attention 
has been called in the section on stimulants and narcotics, has con T 
vinced us that physicians generally are culpably reckless in the use of 
this powerful, fascinating drug. Opium is certainly a boon in cases in 
which it is absolutely required; but its use should be restricted as 
much as possible, and not resorted to when relief can be obtained by 
any other means. The suffering which patients generally undergo 
in their attempts to escape from the thralldom of this habit, are 
greater, in the majority of cases, than those for the relief of which 
the drug was originally taken. As a general rule, when the opium- 
taker begins to lessen the dose which has been gradually increased for 
a longer or shorter period, a great variety of morbid symptoms make 
their appearance. In many cases, obstinate vomiting or equally per¬ 
sistent diarrhea set in as soon as the daily dose is reduced. In other 
cases, the patient will be seized with violent sneezing. In still others, 
pains in the joints, or old neuralgic pains, to relieve which the opium 
was originally taken, render the patient almost distracted with suffer¬ 
ing. But that of which these unfortunates complain most bitterly is 
a peculiar indefinable sensation, which is described by the patient as 
much harder to bear than actual pain. 

Treatment. —The amount of opium which the system will tolerate 
after the habit has been continued for many years, is sometimes aston¬ 
ishing. We have had under treatment patients taking daily amounts 
varying from one or two grains of opium to forty-eight grains of sul¬ 
phate of morphia, equivalent J:o more than half an ounce of the drug. In 
treating these patients, especially those by whom the quantity consumed 
was very large, the physician’s skill and patience are often taxed to the 
utmost. In beginning the cure, it is of the first importance to convince 
the patient that much will depend upon his own efforts. His will¬ 
power and fortitude, which invariably become sadly demoralized by the 
long subjection to the habit, must be stimulated as much as possible. 
He must be taught the necessity of patiently bearing some pain, and en¬ 
during a considerable degree of suffering. This is often hard to do, as 
the fortitude to bear pain is, in most cases, almost wholly lost. In the' 


THE TOBACCO HABIT. 


1135 


farther carrying out of treatment, we have adopted several plans with 
success. In some cases, especially those in which the quantity of opium 
or morphia taken daily is not very large, we have obtained very excel¬ 
lent results by withholding the drug altogether for two or three days, or 
until the patient was entirely out from under its narcotic influence. 

By this time, the sufferings of the patient will become considerable, 
and a small dose is then administered. It is found that a very small 
dose indeed, after the patient has abstained for two or three days, will 
generally produce as much effect as was produced by the full dose at the 
beginning of the treatment. After a day or two, the same process is 
repeated, each time the quantity of opium administered being dimin¬ 
ished until finally it is left off’ altogether. When the patient has a great 
deal of will-power, and is willing to make the attempt, especially when 
the amount of opium taken is moderate, the drug may be wholly dis¬ 
continued from the first. In general, however, it is better to dimin¬ 
ish the amount of the drug by degrees, quite rapidly at first, and more 
slowly afterward. This should not be left to the patient, however, as 
very few have the moral courage to conduct the treatment successfully. 
The patient should be deprived of every particle of the drug, and of 
all means of access to it, and the daily amount should be administered 
at a regular hour each day in a gradually diminishing quantity. We 
have, in some cases, slowly diminished the quantity of the drug until it 
was finally left off entirely without the patient being aware of the 
change. In one case, the hypodermic injection of pure water was con¬ 
tinued for several weeks, producing precisely the same effects which had 
before been produced by the usual dose of the drug, illustrating the 
powerful effect of the imagination upon the body. We have found the 
employment of electricity in the form of galvanization of the spine, gen¬ 
eral faradization, electro-thermal baths, together with massage, warm 
baths, and other hygienic measures, of very great use in mitigating the 
sufferings of patients undergoing cure of the opium habit. 

TIIE TOBACCO IIABIT. 

This habit, when thoroughly fixed upon an individual, is scarcely less 
difficult of abandonment, in many cases, than the use of opium. Some 
persons are able to enounce their accustomed pipe or cigar at once, even 
after the habit has been indulged for many years, while others are only 
able to succeed after repeated attempts. We do not need to consider 
here the evil results of the tobacco habit, as the subject has been thor- 


1136 


DISEASES AND THEIR TREATMENT. 


oughly discussed under the head of “ Stimulants and Narcotics,” to which 
the reader is referred. 

Treatment. —The secret of success in the treatment of the tobacco 
habit, is in relieving the system entirely from the influence of the drug 
as quickly as possible. This is best done after the patient has discon¬ 
tinued the habit, by the use of hot-air, vapor, Turkish and Russian baths, 
or by the use of the wet-sheet pack. The last-named remedy is quite as 
effective as any of the others. The odor of nicotine can be distinguished 
in the perspiration of a patient long accustomed to the use of tobacco, 
for several days after the habit has been discontinued. Electricity, pref¬ 
erably in the form of galvanization of the spine, fomentations to the 
spine, leg baths, with cold applications to the head, fomentations over 
the stomach and liver, and frequent dry-hand rubbing are very effective 
measures of allaying the nervousness from which many patients suffer, 
after dispensing with their usual quid or cigar. We have treated hun¬ 
dreds of patients for the tobacco habit, and have rarely failed to obtain 
complete success by the above measures, well backed up by the co¬ 
operation of the patient, within a week or ten days. Substitutes for to¬ 
bacco are utterly worthless. As was remarked with reference to substi¬ 
tutes for alcoholic drinks, anything which would produce the same 
effect would be equally detrimental, and nothing else would be accepted 
by the tobacco-user as a substitute. The so-called substitutes which are 
now sold quite extensively, undoubtedly contain a considerable propor¬ 
tion of tobacco. At least, this has been the case with those we have 
examined 

Till; TEA AM) COFFEE IIA BIT. 

Individuals sometimes become as thoroughly enslaved to the use of 
strong tea and coffee as do other persons to the use of tobacco, liquor, 
or opium. An English physician has recently called attention to the 
fact that “tea-drunkards” are becoming quite common among ladies in 
that country. The effects of the tea-and-coffee habit have been fully 
described elsewhere. The treatment consists in their thorough abandon- 
ment, with the determined resolution never to resort to their use under 
any circumstances. Most persons can readily overcome the habit by 
gradually diminishing the strength of the beverage, and then substitut¬ 
ing wheat or bran coffee, crust coffee, clover tea, or some similar drink 
equally innocent. The severe headache, lassitude, and general depression, 
of which ladies sometimes complain when deprived of their accustomed 


DISORDERS OF SPEECH. H37 

<*>• ^ — 

cup of tea or coffee, affords the strongest evidence of tire injurious effect 
of these beverages. 

These symptoms may generally be relieved by the application of fo¬ 
mentations to the back of the neck or shoulders, with a hot foot bath, 
and fomentations over the stomach. The application of either form of 
electricity to the back of the head or spine will also generally give 
speedy relief to these symptoms. If nothing whatever is done, they will 
soon vanish, and the improvement in digestion, in nerve power, and in 
many other directions, will soon convince patients of the injury 
which they have suffered from these useless and harmful drinks and the 
benefit to be derived from their disuse. 

FATTY DECiEYERATIOY OF TIIE SERVES. 

This is a morbid process in which the proper nerve substance is 
gradually removed, fatty particles being deposited in its place. A nerve 4 
which has undergone fatty degeneration has lost its power to transmit 
nerve sensations or nerve force. Nerve cells undergo this process, as well 
as nerve fibers, thereby losing the power to generate nerve force. An 
organ, the nerves of which have undergone fatty degeneration, is para¬ 
lyzed. The same is true if fatty degeneration has taken place in the 
nerve centers from which the nerve supplying the organ originates. 
Softening of the brain is a form of fatty degeneration. A nerve which 
is cut off from its connection with the nerve centers generally undergoes 
this change in a short time. Nerves which are not used, in consequence 
of paralysis from inj ury to some part of the brain, often rapidly undergo 
degeneration. The causes of fatty degeneration of the nerves, are 
the use of alcoholic liquors, the use of tobacco, gluttony, habits of dissi¬ 
pation, deficient exercise, and various diseases. 

Treatment. —The treatment is chiefly preventive, since repair of the 
nerves is impossible when extensive changes have once taken place. The 
use of electricity, and systematic exercise of all the paralyzed parts, are 
the best means for preventing or checking the progress of this disease. 

DISORDERS OF SPEECH. 

We have already considered loss and impairment of the voice from 
disease of the vocal apparatus and from paralysis of the nerves which 
control the muscles of speech, under the head of “ Aphonia.” W e have 
now to consider other disturbances of speech which arise from disease of 

72 


1138 


DISEASES AND THEIR TREATMENT. 


some part of the nervous apparatus involved in speech production. Of 
the numerous disorders which have been described by systematic authors 
we will mention some of the most important. 

Aphasia. —This is a condition arising from a disease of the brain 
which occasions loss or impairment of the idea of language or its ex¬ 
pression. It differs from aphonia in that in the latter disease, speech 
is impaired or lost from disease of the vocal apparatus, although the 
memory of words and the power of expressing them by writing re¬ 
mains unimpaired, while in aphasia the vocal apparatus remains in¬ 
tact, but the memory of words and the power to use them is destroyed 
or impaired. 

The most common cause of aphasia is injury to the brain from ap¬ 
oplexy. The portion of the brain supposed to be injured in these 
cases is a part called the “ island of Reil ” of the left side of the brain. 
It is thought that the memory of words and control of the organs of 
‘speech reside chiefly in the left side of the brain, from the fact that 
in nearly all cases in which aphasia results from injury of the brain, 
examinations after death have shown the inj ury to be on the left side. 
This is not always found to be the case, however, and it is probably 
true that both sides of the brain possess this faculty, but that from 
force of habit, the left side is chiefly used, just as one eye, one hand, 
or one ear is generally employed in preference to the other. It has 
been claimed that in right-handed people aphasia is due to injury of 
the left side of the brain, while in left-handed people it is to be at¬ 
tributed to injury on the opposite side, owing to the well-known 
anatomical fact that the nerves of the right side of the body originate 
in the left side of the brain, and vice versa. 

A person suffering with aphasia may be unable to utter a syllable, 
or may simply be deprived of the power of using words correctly. 
Sometimes the power of speech will be lost, while the memory of 
words remains, so that an individual can write as well as ever. This 
is not generally the case, however. Patients are sometimes aware of 
their inability to use words correctly, and at other times seem to be 
wholly oblivious to the mistakes they are constantly making. We re¬ 
cently had under treatment a patient suffering with this difficulty as a 
result of apoplexy. If she wished to say door, she was much more 
likely to say chair, table, carpet, or window. Apparently aware of the 
mistakes made in speaking, she often repeated a long list of names, 
hoping to find the right word. If the desired word was suggested to 


DISORDERS OF SPEECH. 


1130 


her, she would at once recognize it, and would repeat it without diffi¬ 
culty. Aphasia sometimes results from epilepsy, hysteria, and various 
other functional disturbances of the brain. 

Treatment .—The treatment of aphasia consists chiefly in the treat¬ 
ment of the cause from which it arises. Unfortunately, this cannot 
always be removed, so that in many cases complete recovery is im¬ 
possible. However, much benefit may often be derived from a persever¬ 
ing effort to cultivate the speech organs of the opposite side of the brain, 
which may, in many cases, by long effort be developed to a considerable 
degree of utility. In order to accomplish this, it is often necessary to 
pursue a course of systematic instruction, beginning with the letters of 
the alphabet, the names and significance of which must be learned as in 
first learning to read. The application of electricity, both galvanic and 
faradic, to the tongue and muscles of the throat is a remedy of con¬ 
siderable value. Functional aphasia can be entirely cured by relief of 
the difficulty upon which it depends. 

Stammering. —This difficulty is an inability to pronounce letters 
properly. This is sometimes the result of defects in the organs of 
speech, such as cleft palate, paralysis of the soft palate, tongue-tie and 
other deformities of the tongue, hare-lip, deformity of the teeth, etc. 
Enlarged tonsils may also be included among the causes of stammering. 
The difficulty is also not infrequently acquired. It naturally exists in 
children, in whom, as well as in cases in which the difficulty is very con¬ 
siderable, it is termed “ lading.” A very frequent cause of the acquire¬ 
ment of this form of defective speech, is talking “ baby talk ” to chil¬ 
dren, and thus preventing them from forming correct habits of artic¬ 
ulation. The defects of articulation shown in the speech of children 
should never be imitated by their attendants. Great pains shoidd 
always be taken to speak to them in clear and distinct tones, 
so that they may be led to form correct habits of utterance. 
This is very important, since it is impossible for most adults to 
utter many sounds which are not learned during early life, even 
though they might have been acquired at that time. The learned 
Kussmaul remarks that “ no living man is able to pronounce the speech 
sounds of all the nations of the earth. A Lepsius may succeed in ex¬ 
pressing them in letters, and a Bruecke may unravel the mechanism 
of their articulation, but it is beyond the power of even such erudite 
philologists to articulate them all.” There is a great difference in the 
number of sounds possessed by different languages ; for instance, the 


1140 


DISEASES AND THEIR TREATMENT. 


number of consonant sounds in Hindostanee is forty-eight, more than 
double the number in the English language, which is but twenty. 
The Greek language contains but seventeen consonants, and some Aus- 
tralian languages are said to have but eight. Some languages are en- 

o O O o o 

tirely wanting in whole classes of sounds; for instance, the languages 
of the Mohawks, Senecas, Hurons, and of a number of other Indian 
tribes, do not contain the sounds p, b , f } v, w, and m, and consequently 
have not the words “ mamma ” and “ papa,” found in almost all other 
known languages. According to Tylor, when the attempt was made 
to teach the Mohawks to pronounce words containing these letters, 
they declared that they would not make themselves ridiculous by at¬ 
tempting to speak with their mouths closed. This peculiarity of dif¬ 
ferent languages is the occasion of the difficulty often met with by 
persons of different nations in attempting to learn the pronuncia¬ 
tion of other languages; for example, the Chinese, having no r, in the 
attempt to pronounce the word “ America,” substitute an l for the r, 
and render it “ Ja-ma-li-ka.” The German language abounds in gut- 
teral sounds, the French in nasal vowels, the Russian in hissing sounds, 
such as tsch and even schtsch. In Africa, tribes are found whose lan¬ 
guage abounds in clicking sounds, and certain tribes of Indians delight 
in the expression of grunting, gurgling, and chuckling sounds. 

Treatment .—The treatment for stammering consists in the perform¬ 
ance of a proper surgical operation, in cases in which the difficulty 
can be remedied in this way, and proper training when the difficulty 
is due to acquired habit. 

Stuttering. —Stuttering and stammering should not be con¬ 
founded, as they are distinct forms of speech disturbance. In stutter¬ 
ing, there is no lack of ability to pronounce sounds distinctly, but a 
want of power to combine sounds together in forming syllables and 
words. Single sounds can be articulated without difficulty, but when 
the patient attempts to speak, an impediment occurs. The impediment 
consists in spasmodic contraction of some of the muscles involved in the 
production of sounds. The impediment may show itself as soon as the 
patient begins to speak, or not until several words have been uttered. 
It is most likely to occur when the word which the individual at¬ 
tempts to pronounce begins with a consonant, especially with an ex¬ 
plosive sound. In very severe cases, the sufferer, in his attempts to 
utter an explosive sound, sometimes works himself into a state of 
great agitation, his heart palpitates, his face becomes red with conges- 


DISORDERS OF SPEECH. 


1141 


tion, profuse perspiration breaks out, and he presents an almost mani¬ 
acal appearance. The paroxysm often continues until it becomes nec¬ 
essary for the patient to take breath. \Y hen the attempt is renewed, 
or it may be just as the patient is almost exhausted, the refractory or¬ 
gans perform their function, and the required sound is produced. In 
mild forms of the affection, there is simply the repetition of particular 
letters or syllables. 

This affection presents many peculiarities, among which is the 
fact that stutterers can often sing or whisper without difficulty. Many 
persons affected in this way have no trouble in speaking when alone, 
in the dark, or when with persons with whom they are intimately ac-. 
quainted. 

Anything which increases nervous excitability, greatly exaggerates 
the difficulty. In one case, the patient w T as entirely unable to speak a 
word when exhausted by a night’s watching. Very frequently the stut¬ 
terer will speak with perfect distinctness when asked to stutter. Stut¬ 
tering is generally more marked in the morning than in the evening. 
In some countries the affection is quite common. Statistics show that 
in France there is one stutterer for every thousand persons, and in 
tojtt years nearly seven thousand persons were exempted from military 
service on account of stuttering. It is still more frequent in Ger¬ 
many. It is said that stuttering is wholly unknown in China, a fact 
wdiich is undoubtedly due to the rythmical character of the language. 
A curious fact is mentioned by Colombat, who states that a French¬ 
man who learned Chinese was able to speak the acquired language with 
fluency, although he stuttered badly in his native tongue. 

A tendency to stutter seems to be hereditary in families. The habit 
is often acquired by association with stutterers. It occurs about ten 
times as frequently in males as in females, and is most common in per- 
f sons of nervous and excitable disposition. 

Temporary stuttering is sometimes produced by dissipation, smok¬ 
ing, indigestion, loss of sleep, and other causes which produce great nerv¬ 
ous exhaustion. Stuttering and stammering may be combined in the 
same individual, although the two diseases are distinct. 

Treatment .—The treatment of this difficulty involves the removal 
of the causes, so far as possible, by the improvement of the general health, 
by tonic baths, nourishing diet, and exercise, especially lung gymnastics, 
Swedish movements, and tonic applications of electricity. The direct 
treatment of the disease itself begins with exercises in breathing. Some 


1142 


DISEASES AND THEIR TREATMENT. 


require the patient to spend a week in absolute silence before beginning 1 
exercises of any sort. The first thing to be learned by the stutterer is 
how to fill his lungs completely, and then to expire it slowly and steadily. 
After this power has been acquired, the patient should be practiced in 
the pronunciation of all the different vowels, both singly and in combi¬ 
nation. He must be made to speak them in loud tones, prolonged as 
much as possible, to speak them in a louder than ordinary voice, and in a 
whisper. He should also be taught to sing them, and to continue practice 
with each vowel in combination until he acquires perfect confidence in 
his ability to pronounce them all. This acquirement of confidence in 
. himself is one of the essentials of treatment. Without it, a cure can¬ 
not be effected. 

The next thing to be accomplished is the acquirement of power to 
combine consonants and vowels. This should be done by practice, 
first, in combinations in which the vowel comes before the consonant; 
and when this has been mastered, combinations in which the conso¬ 
nant comes first should be practiced upon. All the while the most 
careful attention must be given to the respiration. By degrees the 
patient will become able to pronounce words of one syllable, after¬ 
ward the ability will extend to the pronunciation of words of iftvo 
or more syllables, and then to combinations of words, and finally to 
sentences, periods, and paragraphs. Phrases and short combinations 
of words must first be spoken like words of many syllables. When 
the patient reaches this stage of improvement, he should be practiced 
in reading aloud, first poetry and then prose. After a time, he may 
be allowed to repeat short pieces of poetry or prose which have been 
committed to memory. After two or three months, a series of exer¬ 
cises should be given in which the pupil should be taught to keep 
time, speaking very slowly and giving to each syllable the same length, 
drawing breath whenever there is a grammatical pause. This regu¬ 
lated speech must be continued for months. 

During all this time, the patient must never allow himself to speak 
otherwise than he has been taught to do in the exercises. When he 
finds himself unable to speak without stuttering, he should keep 
silence. The employment of measured or rythmic speech should be 
resorted to whenever he finds himself getting excited in conversation. 
Relapses are very likely to occur, which necessitate a new course of 
treatment. 

Many mechanical devices have been adopted for the relief of stut- 


SEASICKNESS. 


1143 


teiing. It is said that Demosthenes spoke with stones under his 
tongue. Little wooden plates, shaped like the lower jaw T , “tongue 
forks, or “ tongue bridles,” and a great variety of other contrivances 
have been invented and used for this purpose. This plan of treat¬ 
ment is rarely successful and often does harm. It never effects a 
permanent cure. arious surgical operations have been performed for 
the relief of stuttering, but never with permanent benefit. 

A peculiar affection somewhat resembling stuttering, known as 
aphthongia, has been occasionally observed. It consists in a spasm of 
the tongue, mouth, and jaw, whenever the patient attempts to speak. 
This difficulty is fortunately very rare, for no special means of relief 
has yet been devised. 


SEASICKNESS. 

SYMPTOMS. — Headache; dizziness; nausea and vomiting, with severe retching; 
great prostration. 

This disease generally occurs in persons who are taking a voyage 
at sea, or on any large body of water. The symptoms exhibited are 
essentially the same in character and originate from the same cause as 
those which result from whirling, riding on the cars, or riding back¬ 
ward, being undoubtedly due to the disturbance of the brain, which 
results from the unusual and irregular impressions received from the 
senses of sight and touch. When occurring at sea, the disease is un¬ 
doubtedly aggravated by the foul odors frequently present in the close, 
unventilated apartments of the ship. Undoubtedly, the rich and un¬ 
wholesome food generally used on shipboard has much to do with 
the production of seasickness. Fortunately, the disease is very rarely 
fatal in itself, although the violent retching has, in some instances, 
produced hemorrhage from the stomach which has resulted in death. 

Treatment. —A person preparing to take a sea voyage should eat 
veiy sparingly of the simplest and most wholesome food for at least 
three or four days before going on shipboard. After going on board, 
he should retire to his berth before the peculiar motion of the ship 
becomes in any very great degree noticeable. He should remain in a 
horizontal position most of the time for the first twenty-four hours, 
eating chiefly dry and very simple food, as graham or oatmeal crack¬ 
ers, dry toast with a little fruit. Liquids, if taken, should be either 
cold or quite hot. Slight qualmishness, if it occurs, may be re¬ 
lieved by swallowing a few bits of ice or taking a few sips of hot 


1144 


DISEASES AND THEIR TREATMENT, 


lemonade. Nothing highly seasoned should be taken into the stom¬ 
ach during the voyage. Fried food, cake, pastry, lard biscuit, and all 
similar substances should be strictly prohibited. It is also best to ab¬ 
stain from the free use of meat. After the first day or two, it will be 
safe to venture upon deck. The precaution should be taken to pro¬ 
tect the body thoroughly from the cold, moist air by warm wraps. 
Many persons find themselves entirely free from seasickness while 
upon deck, only feeling sick when confined within the close, poorly- 
ventilated apartments below. Wearing a tight bandage about the 
abdomen is recommended by sailors as a preventive of seasickness. 
Some physicians recommend the use of pickled oysters, ham, and 
smoked herring, and the free use of cayenne pepper, spice, and mus¬ 
tard, which advice we would earnestly exhort our readers to ignore. 


RETENTION OF URINE. 


1145 


DISEASES OF THE URINARY ORGANS. 

SYMPTOMS RELATING TO DISEASE OF THE KIDNEYS AND BLADDER 

Retention of L rine. —This symptom occurs more often in males 
than in females, owing to the greater length of the urethra, or passage 
through which the urine escapes from the bladder. It frequently re¬ 
sults, especially in females who are somewhat hysterical, from nervous¬ 
ness. In males, it may be the result of enlargement of the prostate 
gland or irritability of the urethra, causing contraction of the mouth of 
the bladder. The worst forms of retention are due to paralysis of the 
bladder, stricture, or permanent contraction of the urethra. 

Treatment .—Mild cases of retention can generally be relieved by 
the prolonged warm sitz bath, and fomentations over the lower part of 
the back and abdomen. When retention is due to the spasmodic con¬ 
traction of the urethra or of the sphincter of the bladder, relief may be of¬ 
ten given by pouring a small stream of water into a vessel while the pa¬ 
tient is making the attempt to pass water. With females, relief may 
often be obtained by giving the patient a vaginal douche when the at¬ 
tempt to pass water is made. 

In case relief is not soon obtained by these measures, a physician 
should be called to relieve the bladder by means of a catheter, a small 
tube which is passed into the bladder through the urethra. 

It is important to recollect that the Gladder naturally requires to 
be relieved at least two or three times during the twenty-four hours, 
and more than a few hours should.never be allowed to elapse without 
relieving it, as it may become paralyzed by over-distention. In case 
of severe injury to the head or the spine, apoplexy, and all conditions 
in which the patient is unconscious, or partially paralyzed, careful at¬ 
tention should be given to relieve the bladder at proper intervals. 

Suppression of Urine. —This condition differs from the preceding 
in that it is a diminished production of the urine by the kidneys, in¬ 
stead of being a retention by the bladder. This is a very serious 
symptom, indicating inactivity of the kidneys from congestion, acute 
or chronic disease, or conditions present in such diseases as typhoid 
fever, cholera, and other diseases characterized by great debility. The 


1146 


. DISEASES AND THEIR TREATMENT. 


danger to be apprehended in this condition is the poisoning of the sys¬ 
tem from the retention of uvea, the principal poisonous element elim¬ 
inated from the blood by the kidneys. 

Careful attention should be given to the amount of urine passed 
by patients or removed by means of the catheter. The amount usually 
passed in health is from a pint and a half to three pints. A much 
smaller quantity than twenty-four ounces or a pint and a half should 
be considered as a serious symptom. 

Treatment .—If the attack is an acute one, relief may often be ob¬ 
tained by giving the patient a sweating bath of some sort, as a hot air 
or vapor bath, or a warm blanket pack. Fomentations across the small 
of the back applied continuously for an hour or two, or until relief is 
obtained, is also a very excellent measure. If fomentations are not suc¬ 
cessful, alternate cold and hot applications may be employed. In case 
the disease is chronic, the patient should be kept in a state of active 
perspiration for several hours so as to relieve the system of urea through 
the medium of the skin. 

Painful Urination. —This is a symptom which accompanies many 
diseases of the bladder and urethra. It is due to an irritable condition 
of the mucous membrane of the urethra or bladder. It may often be 
much relieved by the daily use of the sitz bath or the ascending- 
douche. In women, relief is frequently given by the prolonged vagi¬ 
nal douche. 

Frequent Urination. —A frequent desire to pass water is generally 
due to an irritable condition of the bladder in consequence of chronic 
catarrh of this organ. It may also be due to sympathy with irritation 
in the rectum, uterus, or other organs. Enlargement of the prostate 
gland is one of the most common causes of this symptom in old men. 

The difficulty can only be relieved by treatment of the disease 
upon which it depends. It is generally mitigated either by warm 
fomentations over the abdomen, prolonged sitz baths, or, in women, a 
vaginal douche. (See further under “Incontinence of Urine,” “ Acute 
and Chronic Cystitis,” and “ Irritability of the Bladder.”) 

Scanty Urination. —If the quantity of urine is much less than one 
and a half pints, or more than three pints, in twenty-four hours, there 
is occasion to suspect that some disease may be present. 

This is a very frequent symptom in fevers. The urine when scanty 
is also very high colored and often contains a sediment. The amount 


COLOR OF THE URINE. 


1147 


of urine is diminished when the skin is very active, as in the summer 
time in persons who perspire very freely. A sudden cold will not in¬ 
frequently produce a scanty and high colored urine. 

An excessive secretion of urine may be due to diabetes, or to 
chronic disease of the kidneys. It is also sometimes occasioned by less 
serious conditions, as by extreme nervousness, great mental anxiety, 
and various temporary conditions. 

Color of the Urine. —The natural color of the urine varies from a 
light straw color to a yellow brown. The color is derived from the col¬ 
oring matter of the blood. When urine is very abundant, its color is 
light; and when scanty, it is high colored. 

In disease and various morbid conditions, the urine may become 
entirely colorless, or it may be deep red, green, blue, or olive color. 
In some cases, it even has a blackish hue. The deep red color is often 
present in fever. Olive color occurs in jaundice, and is due to the 
presence of bile in the urine. 

When bile is present, the foam produced by shaking the urine in 
a bottle also has a deep yellow color. The presence of bile may be 
detected by placing a few drops of urine upon a piece of white porce¬ 
lain or in a saucer, and adding a few drops of nitric acid. Rings of 
color will be seen spreading out from the point where the drop of acid 
was added. Various changes occur. The play of colors begins with 
green, and passes through olive, violet, blue, and red or yellow. The 
arreen color is characteristic of bile. 

o 

A dark brown or black color present in urine when passed, is due 
to blood in the urine. A black color appearing after the urine has 
set for some time is not particularly significant. Blue and-green 
colors are very rarely seen. They are sometimes observed in cases of 
chronic inflammation of the kidneys. Peculiar coloration of urine is 
often induced by the use of medicines of various kinds. Black color is 
produced by carbolic acid and creosote. The urine is colored yellow 
by rhubarb and santonine. Senna gives to it a brown color, and tur¬ 
pentine, violet. t 

Odor of Urine. —The urine in health has a characteristic odor pe¬ 
culiar to itself. Peculiar odors are frequently produced by articles of 
food, as garlic. Turpentine, and other medicines also produce unnat¬ 
ural odors. The urine in dyspepsia often has a very offensive odor. 

Diabetic urine has a smell resembling that of apples. When urine 
is retained long in the bladder, allowing decomposition to take place, 


1148 


DISEASES AND THEIR TREATMENT. 


or when decomposition occurs in consequence of inflammation, the 
urine has a pungent odor, due to the formation of ammonia. 

Taste of Urine. —In health the urine has a peculiar salty taste. A 
bitter taste indicates the presence of bile, and a sweetish taste, that of 
sugar. This test is seldom applied to the urine, but enthusiastic in¬ 
vestigators of the diseases indicated by the urine, do not hesitate to 
resort to it. When either a bitter or sweet taste is observed, the 
chemical test for bile or sugar should be made. 

Reaction of Urine. —By reaction is meant the condition of urine 
as to acidity or alkalinity. This is determined by test paper for the 
purpose. Alkaline urine turns red paper blue. Acid urine changes blue 
paper to red. In health, the urine is naturally slightly acid, especially 
in persons who employ a flesh diet. It is noticeable that animals 
whose diet is made up wholly of vegetables have alkaline urine, while 
in carnivorous animals, whose diet is made up almost wholly of flesh, 
the urine is very strongty acid. 

Persons who eat much meat, have a very acid urine, while in those 
who subsist upon vegetables, the urine is only very faintly acid, is neu¬ 
tral, or distinctly alkaline. This fact should be remembered by per¬ 
sons who are subject to gout, rheumatism, neuralgia, and various nerv¬ 
ous diseases, which are known to arise from a superabundance of acid 
in the blood, or, at least, are associated with a very acid state of the 
urine. Very acid urine is also likely to produce gravel or stone in 
the bladder, catarrh of the bladder, irritation of the urethra, and 
various other diseases of the urinary organs. Great acidity of the 
urine generally gives rise to a brick dust deposit when the urine is al¬ 
lowed to stand a short time. The fine, reddish particles composing 
this deposit are crystals of uric acid. 

Great alkalinity of the urine sometimes occurs in consequence of 
decomposition taking place in the bladder. This occurs most fre¬ 
quently in chronic catarrh of the bladder, and in cases in which the 
bladder is not completely emptied as frequently as it should be. 
When this condition exists, the urine will have a very unpleasant and 
distinct ammoniacal odor, as though it had stood for a few hours in a 
warm room. 

Acidity of the urine is relieved by the treatment to be presently 
recommended for uric acid. An excessive degree of alkalinity will be 
relieved by the proper treatment of the disease to which it is due. 

Density of Urine. —By density is meant the specific gravity of 


URINARY DEPOSITS. 


1149 


the urine, which is determined by an instrument for the purpose, called 
a urinometer. As the density of urine varies considerably during the 
twenty-four hours, being particularly great an hour or two after meals, 
the test should be applied to the whole amount of urine secreted in 
the twenty-four hours. 

When this cannot be done, the first urine passed in the morning 
should be tested. The specific gravity of the urine in health is 1.015 
to 1.025 ; when the urine is very abundant in quantity and of light 
color, its specific gravity is usually low ; when scanty and high colored, 
the density is high. When the specific gravity is habitually as low as 
1.006 to 1.012, and the quantity of urine secreted is not excessively 
large, it is probable that the patient is suffering with Bright’s disease. 
In case the density is habitually 1.030 or more, and the quantity of 
urine is large, chronic diabetes may be suspected, and the urine should 
be examined for sugar. The specific gravity of the urine, of course, 
depends upon the amount of solid matter it contains. The more 
nearly it approaches to 1.000, the less excrementitious matter it con¬ 
tains. The approximate amount of solid matter in the urine can be 
ascertained by simply doubling the last two figures obtained in testing 
the specific gravity; for example, if the specific gravity is 1.025, the 
urine contains about fifty grainy of solid matter in one thousand of 
urine. 

Urinary Deposits. —Healthy urine is perfectly clear when it is 
first passed, although it may present, on standing for some time, a 
slightly clouded appearance. In various diseases, however, which are 
greater or lesser departures from health, the urine contains, after 
standing, a sediment which varies in color and character according to 
various circumstances which we will not now explain. On examina¬ 
tion by means of various chemical tests and the microscope, this sedi¬ 
ment is found to be composed, in the majority of cases, of one or more 
of the following substances : Uric acid, urates, phosphates, oxalate of 
lime, blood, mucus, pus, or matter, epithelium, and casts. 

Each one of these we will notice briefly. 

Uric Acid. —Fig. 324 and 325. A deposit resembling brick dust 
in color, or a fine, reddish sand, consists of uric acid. The test for 
uric acid is the following. Place a few crystals on a white plate ; add 
a drop of strong nitric acid; heat over a lamp or candle until the 
fluid is all evaporated; then add a few drops of hartshorn, or aqua 
ammonia. A bright violet color appearing after the addition o’f am¬ 
monia indicates uric acid. 


1150 


DISEASES AND THEIR TREATMENT . 


If the sediment is formed before the urine is passed, as is indicated 
by the presence of a deposit in the vessel immediately after the pas¬ 
sage of the urine, the presence of gravel or stone in the bladder may 
be strongly suspected. A brick-dust deposit in the urine is probably 
chiefly due to inactivity of the liver, as it is the proper duty of this or- 



jran to convert uric acid into urea, a form in which it is soluble and 
never appears as a deposit. 

Treatment .—A patient who has a brick-dust deposit in his urine 
should abstain from the use of a flesh diet, eating chiefly fruits and 
grains. Milk may be used in moderate quantities, and eggs and fish 
may be allowed occasionally; but the less the quantity of meat eaten, 
the better. 

Such treatment should be taken as has already been recommended 
for torpid liver, which is probably a principal cause of this condition, 
in addition to the excessive use of meat. 

Urates. —A deposit of urates in the urine produces a turbid appear¬ 
ance. The color varies with that of the urine; may be white, yellow, 
pink, or red. It is noticed only after the urine is cold, and may be dis¬ 
tinguished by the fact that it disappears when the urine is re-heated. 
Urates are sometimes deposited in the bladder, especially in young 
children, and may be a cause of stone in the bladder. When this is 
the cause, the urine may be turbid when it is passed. The principal 
causes of this deposit are, feverish condition of the system, dyspepsia, 
great exhaustion from overwork, or dissipation. Taking cold is the 
most common of all causes of urinary deposits. 

Treatment .—Avoidance of the causes is of course the first and 
most essential element of treatment. Beer, wine, tobacco, and all 
kinds of narcotics or stimulants should be wholly avoided. Little an¬ 
imal food should be used. The patient’s diet should consist chiefly of 
fruits and grains, and he should practice the free drinking of water. 



PUS IN THE URINE. 


1151 


taking one or two glasses before breakfast and an equal quantity be¬ 
fore going to bed at night. 

Phosphates, tig. 320. This is a white sediment which is found 
in alkaline urine. It is distinguished from urates by not being dis¬ 
solved when the urine is heated. It is, however, dissolved by acids. 

It is chiefly caused by smoking, by the use of alkaline medicines, 



Fig:. 326. Crystals of Triple 
Phosphates. 


excessive mental strain, nervous prostration, sexual excesses, especially 
self-abuse, and occasionally by excessive use 
of some articles of food, especially sweet fruits. 

When present in the urine when passed, it in¬ 
dicates decomposition of the urine in the blad¬ 
der. This is one of the common causes of stone 
in the bladder. When present continuously, 
it generally indicates nervous disorder of some 
form. 

Treatment .—The treatment of this con¬ 
dition consists chiefly in the avoidance of the causes and removal of 
the diseased conditions upon which it depends. 

Oxalate of Lime. —Fig. 327. This deposit is discovered only by 
means of the microscope. It is chiefly found in men, and generally 
occurs in patients suffering with indigestion, palpitation of the heart, 

irritable bladder, gloomy and irritable disposi¬ 
tion, also often accompanies impotence. When 
very abundant, it may be the cause of a variety 
of stone in the bladder, known as mulberry cal¬ 
culus. 

Treatment .—The treatment consists in im¬ 
proved hygiene and cure of the disease upon 
which it depends. The patient should carefully 
avoid overeating;, and the use of such articles of diet as are known to 

O 7 



CD' 

Fig:. 327. Crystals of 
Oxalate of Lime. 


produce oxalates in the urine, such as rhubarb, raw apples, and most 
sweet fruits. 

The use of hard water should also be avoided. Daily sponge baths, 
and the application of an inunction two or three times a week, to¬ 
gether with the use of electricity, when possible, and massage, con¬ 
stitute the best treatment. 


Pus ill the Urine. —Fig. 328. The occurrence of pus in the urine 
is indicated by a deposit which closely resembles that of phosphates, 
but which does not dissolve when heated with acids, as does the lat- 



1152 


DISEASES AND THEIR TREATMENT. 


ter deposit. It sometimes has a ropy or stringy appearance. It is 

due to decomposition in the bladder. It indicates 
the presence of inflammation or ulceration in the 
kidneys, bladder, or urinary passages. It is a very 
serious symptom, to which intelligent medical at¬ 
tention should be called at once. 

Bloody Urine, or Hematnrea. —Blood in the 
urine, or hematurea, is indicated by a deep brown, 
reddish, smoky, or even black appearance. It may be produced by 
hemorrhage from the kidneys, bladder, or urinary passages. It often 
occurs in Bright’s disease and catarrh of the bladder. 

Casts and Epithelium. —Figs. 329 to 331. When present in 
great abundance, casts and epithelial cells form a white, flocculent 
deposit after the urine has been allowed to stand for some time. They 
cannot be distinguished, however, without the use of the microscope. 





Fig-. 331. Hyaline 

Casts. 


Epithelium in great abundance indicates catarrh of the bladder. 
Casts of the small tubes of the kidneys indicate Bright’s disease. 

Chylous Urine. —A milky appearance of the urine sometimes oc¬ 
curs in consequence of the very abundant deposits of pus or phos¬ 
phates It is also caused, in some cases, by the presence in the urine 
of chyle, which is supposed to be occasioned by the filaria, a parasitic 
worm which infests the blood-vessels and lymphatics, causing rupture 
of the latter into the urinary passages, an affection which is almost 
wholly confined to tropical countries. 





CONGESTION OF THE KIDNEYS. 


11 53 


COXGESTIOS OF TIIF KIDNEYS. 

SYMPTOMS.—Urine very abundant, pale, or scanty and high-colored; if scanty, con¬ 
taining albumen, and often blood; examination with a microscope shows casts; denoting 
catarrh of the kidneys: no pain. 



Fig. 332. Congested Kidneys. 


Causes. —Due to either increased pressure in the arteries, as from 
hypertrophy of the heart, or to obstruction of the \enous ciidilation.. 
The first cause occasions an abundant secretion of urine; the second,, 
scanty, high-colored, urine. The disease is also caused by the y arious- 
causes mentioned as productive of congestion of the liver, especially 
73 




1154 


DISEASES AND THEIR TREATMENT. 


"by the free use of condiments, tobacco, tea and coffee, and alcoholic liq¬ 
uors, particularly raw whisky and beer. Lastly, as a common cause, 
may be mentioned the use of irritating diuretic remedies, and counter¬ 
irritation by means of blisters and irritating salves. 

Treatment. —As a general rule, when the urine is scanty and 
high-colored, the abundant use of M r ater as a drink should be pre¬ 
scribed. Two or three pints of water a day will be none too much for 
most patients. If the stomach is injured by this excess of cold fluid, 
the water may be taken quite hot, which will facilitate absorption. 
The wet-sheet pack, and vapor and hot-air baths, are indicated when the 
congestion is considerable, together with fomentations over the kid¬ 
neys, the abdominal bandage worn constantly, and the application of 
■electricity to the small of the back. The diet should consist chiefly 
of fruits and grains. The less animal food eaten, especially meat, the 
better. Coffee, tea, tobacco, condiments, and everything which will 
give the kidneys extra work must be most carefully avoided. The 
use of various powerful diuretics in these cases, a very common prac¬ 
tice, is in the highest degree detrimental. The use of barley-water, 
slippery-elm water, linseed tea, and various other demulcent drinks, 
is perfectly harmless, but no more beneficial than the use of pure water. 

HEMORRHAGE FROM TIIE KIDNEYS. 

SYMPTOMS.—Bloody urine, which coagulates when heated; bleeding excited by ex¬ 
ercise; clots in the urine. 

This disease cannot always be positively distinguished from hem¬ 
orrhage of the bladder and other parts of the urinary organs, un¬ 
less symptoms of suppression of the urine occur, such as nausea, 
vomiting, convulsions, or dropsy, as sometimes happens in consequence 
-of the blocking up of the tubes of the kidneys with clots. As a 
general rule, however, clots are more frequent and abundant in hem¬ 
orrhage from the bladder than in hemorrhage from the kidneys. 

Causes. —Hemorrhage from the kidneys may be the result of acci¬ 
dent, gravel in the pelvis of the kidneys, congestion, or renal apo¬ 
plexy. 

Treatment. —Apply cold over the region of the kidneys by means 
of ice compresses, or cloths wrung out of cold water. The cold sitz 
bath, and injections of cold water into the bladder, are also useful 
measures of treatment. In severe cases it may be necessary to inject 


ACUTE BRIGHT'S DISEASE. 


1155 


a mild solution of tannin. The patient should be kept very quiet. 
Heat should be applied to the extremities. The patient should receive 
tonic treatment and a very nourishing diet after the hemorrhage 
has ceased. 

ACUTE IAFLIMMATIOS OF TIIE KID^EYS-ACUTE 

BRIGnT'S DISEASE. 

SYMPTOMS. — Chill, followed by fever and sharp pain in the region of the kidneys; 
sometimes violent vomiting; frequent urination ; suppression of urine ; urine opaque, 
bloody, or of a dark, or dirty brown color. (Edema, or dropsy, which changes from one 
part of the body to another, as from the face to the feet and ankles, or the reverse. Symp¬ 
toms of suppression of urine, as convulsions, coma, etc.; examination with the microscope 
shows casts of the small tubes of the kidneys. 

Causes. —This disease is a croupous inflammation of the kidneys, 
involving chiefly the small urinary tubes, which become blocked up, 
causing suppression of the secretion of urine. It occurs very fre¬ 
quently as a complication of scarlet fever, measles, diphtheria, typhus 
fever, and cholera. It may also occur in malarial fever. 

When it occurs independently, it is commonly a result of exposure 
to cold, or the use of irritating diuretics or other irritating drugs, 
which affect principally the urinary organs, as balsam of copaiba, can- 
tharides, and oil of turpentine. 

There is every evidence to believe, also, that free indulgence in the 
use of alcohol, beer,—which is exceedingly stimulating to the kidneys, 
—and the excessive use of tobacco, are also causes of acute Bright’s 
disease. 

Treatment. —The essentials of treatment consist in fomentations 
to the small of the back; warm baths, followed by wrapping the 
patient in warm blankets, so as to continue the sweating; vapor baths, 
and hot-air baths. 

These measures are, according to Niemeyer, much more effective, 
and much less likely to be attended by bad results, than the use of 
drugs to produce activity of the skin. 

The Turkish and Russian baths, should, however, be avoided. The 
patient should practice drinking considerable quantities of water daily. 
Care should be taken that the water is pure and soft. When natural 
water answering these requirements cannot be obtained, well filtered 
water, or distilled water should be used. 

Condiments, tea, coffee, tobacco, and all spirituous liquors, should 
be scrupulously avoided. Animal food should be used only to a very 


] 156 


VIS-EASES AND THEIR TREATMENT. 


limited extent. Meat may be better avoided altogether. Milk may 
be used moderately, and fish and eggs occasionally. 

One of the most important of all hygienic requirements is careful 
attention to the maintenance of proper warmth of the body. The pa¬ 
tient should take care to avoid overheating of his apartments, secur¬ 
ing also a plentiful supply of fresh air. He should be extremely 
careful not to venture out of doors in cold damp weather, at least 
without being so thoroughly protected as to make chilling of the body 
or even coldness impossible. Warm woolen clothing should be worn 
next to the skin. , 

The use of medicines and mineral waters which excite excessive 
activity of the kidneys is regarded by experienced physicians as a per¬ 
nicious practice. The kidneys need rest, instead of overwork, and rest 
should be given them by compelling the skin to do as large an 
amount of their work as necessary, to relieve them as much as pos¬ 
sible. The use of opiates is also extremely objectionable, as it 
diminishes the activity of the kidneys, and hence increases the 
liability to poisoning from the retention of urea. 

CHROMIC BRIGHT’S DISEASE. 

SYMPTOMS.—Increasing debility; pallor; viscid urine; if the urine is shaken in a 
bottle, much froth, which lasts for a long time; urine coagulates with nitric acid, and 
when heated after adding acetic acid; whitish sediment containing casts; dropsical swell¬ 
ing of the face, feet, hands, and abdomen; bronchitis; watery diarrhea; pleurisy; peri¬ 
tonitis; oedema of the lungs; enlargement of the heart; valvular disease of the heart; 
frequently headache; when the disease is far advanced, nausea, vomiting, drowsiness, 
convulsions, coma; after attacks of coma, partial or complete blindness, due to rupture 
of a blood-vessel in the eye. 

This disease is much more common than is generally supposed. 
It usually exists some time before its presence is known, as it is rarely 
accompanied by pain in the region of the kidneys, more often or¬ 
iginating as a primary disease than following acute Bright’s disease. 
The nature of the disease is such that the kidney gradually loses its 
ability to perform its duty. It is usually divided into three stages, 
in the first of which the organ is enlarged and pale of color. In 
the second stage, after degeneration has begun, it becomes yellow. 
The third stage is the stage of degeneration and atrophy in 
which the organ becomes almost useless as an excretory organ al¬ 
though it may continue to excrete large quantities of water. 

Causes. —The principal causes thought to be productive of this dis- 


CHRONIC BRIGHTS DISEASE. 


1157 


ease are exposure to cold and dampness, long-continued use of alco¬ 
holic liquors, and employment of irritating diuretics, as cubebs, co¬ 
paiba, and excessive use of meat. It also frequently occurs in conse¬ 
quence of long-continued congestion, chronic gout, syphilis, scrofula, 
and malaria. 

Treatment. —The same precautions respecting diet, clothing, etc., 
should be followed as prescribed for acute Bright’s disease. Prof. Nie- 
meyer and others have claimed excellent results from the use of an ex¬ 
clusive milk diet in this disease, without the use of medicines or anv 
other remedy. The quantity taken is from two to three quarts daily. 
In many instances persons have greatly improved by this diet, dropsy 
and other symptoms being relieved in a remarkable degree. In one 
case, in which we used this remedy, the patient made very marked 
improvement, which has continued up to the present time, now nearly 
two years. Buttermilk has also been highly recommended as a diet 
remedy for this disease. The more closely the patient will confine 
himself to # fruits and grains, the better it will be for him. Meat 
should be discarded altogether, and also coarse vegetables, such as as¬ 
paragus, turnips, cabbage, and particularly beans and peas. Irish and 
sweet potatoes are, in fact, about the only vegetables which can be 
eaten without detriment. 

All possible measures should be employed to build up the patient’s 
health, such as gentle exercise in the open air, sun baths, and tonic 
applications of electricity. It is also well for him to wear a moist ab¬ 
dominal bandage to encourage the activity of the liver, as well as kid¬ 
neys. He should drink daily a considerable quantity of water, and care 
should be taken to keep the skin in as active a condition as possible. 
The best means for this pui-pose are the wet-sheet pack, hot-air bath, 
vapor bath, and inunction with vaseline, sweet oil or cocoanut oil, two 
or three times a week. 

When the dropsical accumulation becomes very great, the hot-air 
bath should be used daily. In extreme cases, the sweating should be 
prolonged after the bath by wrapping the patient with warm woolen 
blankets, surrounding him with hot bags and bottles of hot water, 
and giving him warm drinks in abundance. In case vapor or hot-air 
baths cannot be conveniently employed, acti\e sweating may be pro¬ 
duced by covering the patient warmly in bed, and surrounding him 
with bottles of hot water, over each of which has been drawn a stock¬ 
ing wrung out of warm water. This is an excellent means of producing 


1158 


DISEASES AND THEIR TREATMENT. 


vigorous sweating. It is known as Sir James Simpson’s bath, having 
been first suggested by that eminent physician. When the patient 
has severe vomiting, give lemon juice in small sips, ice-cold or hot 
water, or allow him to swallow small bits of ice. Hot fomentations 
or a mustard plaster over the stomach will sometimes give relief. Ap¬ 
plications of ice to the head, and alternate hot and cold rubbing of the 
spine by means of a sponge dipped in hot water and a small piece of 
ice, constitute the best means of combating the drowsiness and ten¬ 
dency to coma and convulsions. 

Great swelling of the limbs sometimes requires puncturing of the 
skin, to allow the effused fluid to escape, as the circulation may be 
interfered with so much that it cannot be relieved by sweating. 

ABSCESS OF TIIE KIDNEYS. 

SYMPTOMS.—Begins with chill, followed by fever; violent pain in the region of the 
kidneys, and increased by pressure, extending along the urethra to the bladder, and down 
the thigh; vomiting; urine scanty, high-colored, contains pus and blood; symptoms of 
suppression of the urine; when chronic, continued fever, and continued chills ; gradual 
emaciation and increasing debility. 

This is a somewhat obscure disease, and cannot, in many cases, be 
distinctly distinguished from some other affections of the kidney and 
its region. After existing for some time, a lump can usually be felt 
near the kidney. In a case which we now have under treatment, a 
tumor may be felt beneath the lower ribs, on the left side, as large as 
two fists. Recovery from this disease is very rare, the patient usually 
dying from gradual exhaustion. 

Causes. —Gravel; obstruction of the passage of the urine; extension 
of inflammation from the bladder; embolism, occurring in heart disease. 
In many cases the cause cannot be ascertained. 

Treatment. —Fomentations over the region of the kidneys and 
the seat of pain, with cold applied during intervals when there is much 
local inflammation and general fever. Hot baths to induce perspira¬ 
tion, and copious water-drinking to wash away the products of inflam¬ 
mation from the bladder and urinary passages. 

A vegetable and fruit diet. In severe cases, the exclusive milk diet 
may be tried. Washing out the bladder should be practiced daily, when 
there is much local irritation. For the relief of the fever, which is, in 
some cases, quite high, sponge baths should be frequently applied. In 
chronic cases, in which the skin is dry and inactive, inunction should 
be employed two or three times a week. 


. 1150 


FATTY DEGENERATION OF THE KIDNEYS. 

ABSCESS SEAR THE KIDSEl. 

SYMPTOMS.—Symptoms similar to those of the preceding disease, only the urine /S' 
not affected; great pain; tumor felt at the bach, just below the lower ribs ; in some cases 
sudden death. 

In these cases, the abscess forms in the mass of fat in which the 
kidney is embedded, instead of in the organ itself. The abscess may 
discharge internally or externally. When it discharges internally, it 
sometimes opens into the intestines and sometimes into the abdominal 
cavity. In the latter case, the result is speedy death. When it opens 
externally, or into the intestinal canal, there is a fair chance of recovery. 

Treatment. —When a tumor can be felt over the region of the 
kidney, at the back, which gives evidence of containing pus, it should 
be promptly opened, to prevent its discharging internally. Fomentations 
should be applied to the affected part, both before and after opening the- 
abscess. 


FATTY DEGEAERATIOA OF THE KIDYEYS. 

SYMPTOMS. — Debility, gradually increasing ; great pallor of face and skin, often ac¬ 
companied by puffiness ; frequent pulse ; frequent urination ; dyspepsia, with attacks of 
nausea and vomiting; tendency to inflammation of the heart-case, pleura, peritoneum, and 
the membranes of the brain, and also to inflammation of the retina, causing blindness ; 
general dropsy ; symptoms of uremic poison and convulsions ; coma, drowsiness, and fre¬ 
quently headache; albumen in the urine, as shown by coagulation after adding nitric acid, 
and heating; cloudy sediment in the urine, consisting of casts. 

Causes. —This disease is sometimes the result of acute inflammation 
of the kidneys. It most often occurs, however, in consequence of dissi¬ 
pated habits, the use of liquors, and severe and prolonged exposure to- 
wet and cold. It may also result from excessive use of fats, gluttony, 
and sedentary habits. After death, the kidney is found to be very large, 
pale, and soft. 

Treatment. —The patient must abstain from the use of butter, lard, 
fat meats, all kinds of fat foods, salt, sugar, and all sweet and starchy 
substances. The use of meat should be very limited indeed. Alcoholic 
liquors, tea, coffee, and tobacco must be wholly interdicted. Fish may 
be allowed occasionally; eggs and milk maybe used in moderation. The 
treatment is usually simply palliative, as complete recovery can hardly 
be expected when the kidney has become structurally diseased. 

For relief of the dropsical symptoms, vapor baths, packs, a bandage 
about the abdomen, the application of electricity to the abdominal walls. 


11G0 


DISEASES AND THEIR TREATMENT. 


and other measures recommended for a similar condition in other dis¬ 
eases, should be thoroughly employed. When the limbs are become 
very greatly swollen, the skin may be punctured, in many cases, with a 
needle, so as to allow the fluid to drain out. No harm will result from 
this measure, if the portion of the limb in which the punctures are 
made is covered with a cloth bandage which has been wet in a solution 
•of ten drops of carbolic acid or five drops of oil of cinnamon, with a 
teaspoonful of glycerine, to an ounce of water. The solution should be 
well shaken before being applied. After the limbs have been relieved of 
their fluid, a return of the swelling can be prevented to a considerable 
•degree, by the use of an elastic rubber bandage, which should be applied 
evenly to the limbs, beginning at the toes and extending upward to 
.•above the knees. 

WAXY DIIOEXT.RATIOX OF TIIF KIOXEYS. 

♦ 

SYMPTOMS.—Gradually increasing loss of strength ; lassitude; great thirst; un¬ 
usual quantity of urine; albumen in the urine; cloudy sediment, which is composed of 
lube casts; urine very dark colored and yellowish brown; enlargement of the liver and 
spleen; dropsy of the abdomen, or general dropsy; sometimes watery diarrhea; symp¬ 
toms of uremic poisoning, 

This disease is very similar in its course to the preceding. It occurs 
most often in persons who have long suffered from syphilis, consumption, 
or a prolonged discharge, as from chronic abscess or bone disease, which 
may be considered as the chief cause of this affection. On examination 
after death the kidney is found to be enlarged, hard, and heavy. When 
out, it has a waxy appearance, from which the disease has derived its 
.name. 

Treatment. —The treatment is the same as for fatty degeneration. 

CAXCER AXD (OXSOIPTIOX OF THE KIDXEY. 

These are rare diseases, and generally occur in connection with the 
same disea,ses of other parts. No special treatment is indicated, in con¬ 
sequence of the incurable character of these maladies. 

FLOATING KIDXEY. 

SYMPTOMS.—Movable tumor of the size and shape of the kidney, usually fait below 
Ihe ribs on the right side. 

This disease, although not very frequent, is occasionally met with, 
especially in large hospitals. We happen to have at the pi'esent time a 


ADDISOJU’S DISEASE. 


1161 


patient under treatment, who is afflicted with this difficulty on both 
sides, although it almost invariably occurs on the right side only. It is 
chiefly caused by frequent child-bearing, or by severe jarring, as from 
a fall. It is most common in women. As no particular harm arises 
from the movable condition of the kidney, the organ performing its 
functions as well as when it remains stationary in its proper place, no 
special treatment is required; in fact, there is no remedy of very great 
value for this peculiar affection. The wearing of the abdominal bandage 
is to be recommended, however, as it sometimes relieves the patient of 
the slight discomfort which is occasionally felt. 

ADDISOX'S DISEASE—BRONZE SKIN. 

SYMPTOMS.—Gradual darkening of the skin to bronze color, sometimes green or 
black ; most intense on exposed parts ; the roots of the nails and whites of the eyes re¬ 
main uncolored ; black spots on lips and mouth ; great and increasing debility, and great 
depression ; pain in the back and at the pit of the stomach ; dyspepsia and vomiting; di¬ 
arrhea ; convulsions ; rapid pulse, but no fever. 

This is a very peculiar disease, and is named after the man who 
first described it. The symptoms which characterize the disease are 
supposed to be due to chronic inflammation and degeneration of the 
supra-renal capsules. The cause of the disease is not known. 

Treatment.— The only treatment which is of any value whatever 
is the employment of such measures as will improve the patient’s general 
nutrition and enable him to tolerate the disease as long as possible, 
recovery rarely, if ever, taking place. 

PYEESTIS—INFEAAOIATION OF THE PELVIS OF TIIE 

KIDNEYS. 

SYMPTOMS. — Chills; fever; pain in region of the kidney, with tenderness ; vomit¬ 
ing; frequent and painful desire to pass urine; excessive quantity of urine, which al¬ 
ways contains pus and blood ; urine cloudy when passed; pain increased by jolting of the 
body. 

This disease cannot always be detected during life. It is often very 
obscure. Sometimes death occurs by perforation of the pelvis, the 
threatening of which is indicated by sharp pain in the back, pain in 
drawing up the limbs, and repeated chills. 

Causes. —The most common cause is gravel. Other causes are the 
use of irritating diuretics, such as cubebs, copaiba, turpentine. It may 
also arise from extension of inflammation of the bladder or urethra to 
the kidney. 


1162 


DISEASES AND THEIR TREATMENT. 


Treatment. —Apply cold compresses over the small of the hack 
continuously, changing for fomentations, for fifteen minutes at a time, 
once in two or three hours. Fomentations may be applied longer if 
necessary to relieve the pain. When there is much pain, the prolonged 
warm full bath is the best remedy that can be employed. If comfort¬ 
able, the patient may remain in the bath two or three hours at a time, 
without detriment. Dr. Oppolzer, a very eminent physician, recom¬ 
mends the use, in this disease, of milk and alum-water, as the principal 
diet. 


GRAVEL Of TIIE KIDIEV-REIAL COEIC. 

SYMPTOMS.—Small concretions and brick dust sediment passed in the urine; a sharp 
pain in the kidney, coming on after severe jolting, and acute pain darting from the kidney 
to the bladder and down the thigh ; great desire to pass urine, efforts ineffectual; vom¬ 
iting ; sudden cessation of pain after having lasted from two to thirty minutes, or longer. 

This disease occurs most often in adults, but not infrequently in 
children. It is an exceedingly painful affection, and may easily be 
mistaken for ordinary colic or the passage of gall-stones. The causes 
are the same as those which produce stone in the bladder. They are 
not fully understood at present. 

Treatment. —Hot baths, fomentations over the kidney and follow¬ 
ing the course of the pain, and large draughts of hot water, are the most 
useful measures of treatment. We will also suggest the use of copious hot 
enemas. This measure is often very efficacious in relieving severe 
abdominal pain, for which we have often employed it, though we have 
not had the opportunity of using it in this disease • but we have no 
doubt that it will be found a very useful means of relieving the terri¬ 
ble pain of gravel if efficiently employed. 

PARASITES OF TIIE ltIDAEYS. 

The kidney is subject to parasitic affections as well as other parts, 
although less liable to be thus affected than the liver. The most com¬ 
mon parasite of the kidney is the echinococcus. It is the undeveloped 
embryo of the tapeworm. The sac in which the parasite is contained fre¬ 
quently attains the size of a child’s head. Another parasite of the kid¬ 
ney is the strongylus gigas, a worm which somewhat resembles the 
round worm found in the intestines. It grows from six inches to three 
feet long. 

The symptoms of parasites in the kidneys and their causes are both 
very obscure. 


CATARRH OF TEE BLADDER. 


11G3 


CATARRH OF TIIE BLADDER-CYSTITIS. 

SYMPTOMS. —ACUTE : Chilliness; pain and tenderness in the region of the bladder, 
extending to the perinceum, and down the limbs ; burning pain in the urethra ; frequent 
scanty urination ; either slight or high fever, or none at all; nausea ; urine clouded with 
pus, stringy mucus and blood; clammy sweats. 

CHRONIC : Symptoms sometimes slight. Walls of bladder tender; frequent urina¬ 
tion ; scanty urine, containing pus, and sometimes blood and viscid, ropy mucus; thick¬ 
ening of the walls of the bladder; ulceration, dribbling of urine, dilatation or contraction 
of the bladder; loss of appetite; derangement of the digestion; debility. 

This is a disease which, while not fatal, often renders a person subject 
to it very wretched for many years. When long continued, the mucous 
membrane of the bladder becomes roughened, fissured, often ulcerated, 
and in some cases almost entirely destroyed. 

Causes. —Long retention of urine; decomposition of urine in the 
bladder when retained by temporary paralysis; use of cantharides, bal¬ 
sam of copaiba, and other irritating drugs; stricture of the urethra; 
enlargement of the prostate gland; irritation from stone and gravel; 
careless use of the catheter; especially use of a dirty catheter, causing 
decomposition of urine; exposure to cold; gonorrheal inflammation of 
the urethra, extending to the bladder; in females, inflammation of the 
womb. 

Treatment. —Acute catarrh of the bladder generally recovers of it¬ 
self in a short time, the patient having good care and proper nursing, and 
avoiding the causes by which the disease was produced. When it occurs in 
consequence of exposure to cold, the best remedy is thorough sweating 
by means of warm packs, or the full bath followed by dry packs. 
Thorough fomentations to the bowels and the use of large warm enemas 
in men, and prolonged hot vaginal douches in women, are also very 
essential measures of treatment. The patient should drink large quan¬ 
tities of water, and should abstain from the use of salt, spices, condiments, 
and should eat little meat. The latter suggestions also apply to chronic 
catarrh of the bladder. 

Fomentations and frequent warm baths to induce vigorous action of 
the skin are also useful in chronic cystitis. When there is much pus 
and blood, it is generally necessary to wash out the bladder thoroughly 
with tepid water, bran tea, or slippery-elm water, or a solution of golden 
seal, or some other mild astringent. When the bladder is dilated, the 
urine should be drawn with a good catheter two or three times a day, 
and the bladder should be well washed out with a weak solution of 


1164 


DISEASES AND THEIR TREATMENT. 


carbolic acid. Four or five drops of carbolic acid to the ounce of water 
or bran tea is about the right proportion. In case of dilatation of the 
bladder, the patient should learn to use the catheter himself, so that in 
case the services of a physician cannot readily be secured, he may not 
be left to suffer. When the bladder is contracted, the patient should 
retain the urine as long as possible, so as to dilate the contracted walls 
of the organ. In order to effect a cure, it is often also necessary to 
stretch the walls of the bladder by means of daily injections with a 
syphon syringe. 

IIE3IORRIIAGE OF TIIE BLADDER. 

SYMPTOMS.—Bloody urine ; many clots of considerable size. 

Hemorrhage from the bladder is sometimes difficult to distinguish 
from hemorrhage from the kidneys. When it occurs at intervals, it 
may generally be distinguished, however, by the presence of pus and 
mucus in the urine during the intervals, which indicates chronic catarrh 
of the bladder, and also by the greater abundance of clots. 

Causes. —Hemorrhage of the bladder may arise from ulceration of 
the bladder, from injury, or from the irritation of stone in the bladder. 
It also frequently occurs in cases of acute or chronic cystitis, and some¬ 
times from vascular tumors which grow from the diseased mucous 
membrane of the organ. 

Treatment. —The patient should be kept quiet in bed. Apply cold 
over the bladder, and hot to the extremities. In severe cases, it may be 
an advantage to tie a bandage tightly around one or both limbs, so as to 
retain a portion of the blood in the limbs, and thus encourage spon¬ 
taneous checking of the hemorrhage. 

The ligation of the limbs should not be continued too long, and they 
should be carefully watched. If they become purple or very cold, the 
bandage should be removed. In very bad cases, not otherwise con¬ 
trolled, cold water or a weak solution of alum should be injected into 
the bladder. 


IACOATIAEACE OF FROE-EATRESIS. 

This affection is often a troublesome one, unfitting the patients for 
their accustomed avocations, on account of the necessity of relieving the 
bladder so frequently, in some cases every fifteen or twenty minutes. 
We have had patients who declared that they had to get up as often as 
twenty times during the night to relieve the bladder. There are two forms 


INCONTINENCE OF URINE. 


1165 


of this disease. In the variety just described, the loss of power to 
retain the urine more than a short time is due to the sensitiveness in the 
bladder, which, in some cases, is the result of chronic inflammation; 
in others, of chronic inflammation, or enlargement, of the prostate 
gland. Another variety of the disease is that which gives rise to wetting 
the bed at night, which seems to be due to the opposite condition of the 
bladder, or diminished sensibility, so that the urine passes away without 
waking the patient. This form is most common in young children, 
rarely continuing after the age of twenty years. 

Causes. —Some of the causes of the first form of the disease have 
just been mentioned. Constant dribbling of urine also sometimes results 
from dilatation of the bladder and partial paralysis of its walls. The 
patient passes water frequently through the day, and never empties the 
bladder fully, so that it continues to overflow. The nocturnal incon¬ 
tinence of urine arises from causes not fully understood. It is not 
generally, as many people suppose, a simple habit. It is sometimes 
occasioned by sleeping on the back. 

Treatment. —For the first form of the disease, cold sitz baths, douches 
over the bladder, and daily washings bv injections of tepid water, are the 
proper remedies. If the urine is strongly acid, the patient should abstain 
from the use of meat. For “wetting the bed at night,” a great variety 
of remedies have been tried, most of which are of no value whatever. 
The most effective plan which can be pursued, is to restrain the patient 
from drinking for three or four hours before retiring. An eminent 
physician has also suggested that the use of meat by children encourages 
the habit. Whipping, scolding, and frightening children, unless there is 
good evidence that the child is lazy or vicious, will do no good; in fact, 
these measures are likely to do harm by exciting a nervous condition of 
the system which will encourage the very thing which is to be corrected. 
Wearing a wet bandage about the lower part of the bowels at night is 
a very useful measure. To prevent the patient from sleeping upon the 
back, a good remedy is to tie a knot in a towel and place it about the 
body in such a way that the knot will come at the center of the 
back. In cases in which the patient is bid enough, and sufficiently 
intelligent to appreciate moral influence, he should be encouraged, and 
should be given some simple prescription in which he should be taught 
to have perfect confidence as a certain cure, since faith will do much 
toward effecting a cure when other remedies are of no avail. 


11 GO 


DISEASES AND THEIR TREATMENT. 


SPASM OF THE BLADDER. 

SYMPTOMS. — Incontinence; retention of urine; desire to pass urine, but inability to 
do so; violent pain, with intervals of complete relief; spasm in the rectum; in some 
cases, general convulsions. 

Causes. —This disease is often a very troublesome one. It may 
arise from disease of the brain and nervous system, or, as is generally 
the case, it may be the reflex result of irritation of the womb or of the 
rectum, as from piles or fissure. It also occurs very frequently in 
hysterical and nervous women from pure nervousness. 

Treatment. —Removal of the cause, if possible, by cure of the dis¬ 
ease upon which the difficulty depends. The best palliative measures 
are warm baths, hot enemas in men, and prolonged vaginal douches in 
females. Passing the catheter will often relieve the spasm at once. 

PARALYSIS OF THE BLADDER. 

SYMPTOMS.—Retention of urine; when bladder is greatly distended, dribbling; 
urine bad smelling and loaded with mucus; often severe pain at neck of bladder. 

Causes. —The most frequent causes are general paralysis; paralysis 
of the lower part of the body; over-distention of the organ from 
stricture, or other obstruction to urination; sexual excesses. 

Treatment. —When the paralysis is complete, the bladder must be 
relieved by means of the catheter two or three times a day. The 
best curative remedies are cool sitz baths, cool compresses over the 
bowels, cool enemas in males, and tepid, gradually cooled douches in 
females; daily injection of the bladder with warm water gradually 
cooled down to 65° or 70°; application of electricity to the bladder, both 
through the abdominal walls and by means of the metallic sound, two 
or three times a week. 

IRRITABILITY OF THE BLADDER. 

SYMPTOMS.—Straining after urination, with desire to pass water when the bladder 
is empty; frequent urination; dribbling urine ; smarting in urination ; pain in back and 
at the fork of the thighs in males; relief of the symptoms at night. 

This is a very common difficulty. It frequently exists in consequence 
of slight catarrh of the bladder which has not been discovered, and con¬ 
tinues after recovery from chronic catarrh of the bladder. 

Causes. —The chief causes are neglect to relieve the bladder; acidity 
of urine from the excessive use of meat, use of alcoholic liquors and 


GRAVEL. 


1167 


tobacco; self-abuse; prolonged sexual excitement from lewd thoughts; 
excessive sexual indulgence. 

Treatment. —Avoidance of the causes ; a nutritious diet of fruits 
ami grains, and total abstinence from tea, coffee, tobacco, and alcoholic 
liquors, and the use of meat in very small quantities. Fried food, 
butter, ginger, mustard, pepper-sauce, and all other irritating condiments 
should be wholly discarded. As the patient suffering from this disease 
is often very gloomy and despondent, he should be supplied with cheerful 
surroundings. By way of treatment, the cold bath, the use of fomenta- 
t ons to the lower part of the spine, and the application of a belladonna 
plaster in very severe cases, is to be recommended. The patient should* 
also carefully avoid straining after passing urine. Passage of the sound 
is also useful. We have employed, with excellent success in some cases, a 
d >uble sound, so arranged as to allow the circulation of a current of 
water through it while in use. We regard this as a very excellent 
measure of treatment. 

GRAVEL. 

SYMPTOMS.—Irritation of the bladder; white or red sediment passed with the urine. 

Causes. —A red sediment occurs in persons whose urine is very acid. 
It is most frequent in persons suffering with gout and rheumatism, and 
often arises from the excessive use of meat. White deposit, generally 
composed of phosphates, is most common in persons suffering with 
chronic dyspepsia, neuralgia, and various nervous disorders; also, is often 
produced by overstudy, loss of sleep, overwork, dissipation, etc., etc. 

Unnecessary alarm is frequently excited by the discovery of whitish 
sediment in the urine, especially in persons who have been addicted to 
self-abuse, which is also a common cause of this affection, it being 
mistaken by these persons for seminal fluid. A microscopic examination 
is necessary in these cases to determine whether the patient’s fears are 
groundless or not. 

Trent nient.— The treatment consists in the avoidance of flesh diet, 
alcoholic liquors, tea, coffee, and tobacco; an abundant use of fruit and 
grains when the person is suffering with the red, or uric acid gravel. 
Fomentations over the liver, and the wet girdle worn about the body at 
night, together with a wet-sheet pack, or hot air or vapor bath, once or 
twice a week are excellent measures of treatment. If there is much 
irritability of the bladder, a cool sitz bath should be taken daily. For 
white deposit, the best remedies are such tonic measures as will improve 


1108 


DISEASES AND THEIR TREATMENT. 


the patient’s condition. Special attention should be given to improving 
the digestion. Abundant out-of-door exercise, sun baths, and frequent 
inunctions, are among the chief remedies indicated in this difficulty. 

STOWE IW THE BLADDER. 

The causes of this affection are similar to those of the preceding. 

Gravel probably originate in the kidneys, and finding their way to 
the bladder through the ureter, there become gradually enlarged until 
calculi are formed. More can be done for the relief of stone in the bladder 
by regulating the diet than by the use of any of the so-called “solvents” 
for calculi, which are of little, if any, value. Large calculi generally 
require a surgical operation for their removal. The cutting operation 
so long practiced is now being, in a considerable degree, superseded by 
the new operation of crushing, which can be performed by a skillful 
surgeon much more rapidly and safely than the old operation of lithotomy. 

TIMOUS OF TIIE BLADDER. 

Tumors of various sorts, principally vascular or villous in character, 
occasionally form in the bladder, in consequence of long-continued 
catarrh of its mucous membrane; warty excresences are also formed in 
profusion over the surface of the bladder. Cancer occasionally affects 
this organ as well as nearly every other in the body. 

The treatment of these affections also pertains to the domain of 
surgery, and need not be considered further here, especially as they are 
very rare; and no treatment can be applied to them on account of the 
difficulty in reaching the seat of the disease. 


ACUTE RHEUMATISM. 


1169 


DISEASES OF THE LOCOMOTIVE ORGANS. 


ACUTE RHEUMATISM. 

SYMPTOMS.—Slight chilliness for two or three days, followed by fever, or fever from 
the first; pain in one or more joints, most frequently in the knee, ankle, wrist, or shoul¬ 
der, which increases rapidly and becomes very severe; great tenderness of the affected 
joints; pain greatly increased by motion; joint swollen ; pulse ninety to one hundred a 
minute, sometimes more rapid; frequent respiration; sour saliva and perspiration; con¬ 
siderable thirst; scanty and high-colored urine, usually with reddish sediment; tongue 
coated. 

Acute rheumatism is a very common disease. It is rarely imme¬ 
diately fatal, but very often leaves the patient with difficulties which, 
sooner or later, terminate his life. This occurs whenever the heart 
becomes affected by the disease, which not infrequently happens. This 
does not occur by a metastasis or change of the seat of the malady 
from the joints to the heart, as is often supposed, but by an extension 
of the disease to the lining membrane of the heart. In consequence 
of inflammation, the valves of the heart become thickened and con¬ 
tracted so that valvular organic disease of the heart is the result. 
Rheumatism is the most common cause of this form of heart disease. 
The extension of the disease to the heart is indicated by the occur¬ 
rence of acute pain in the left side, in the region of the nipple, dis¬ 
turbance of the pulse, increase of fever, and increased frequency of 
respiration, in fact, all the symptoms elsewhere described as occurring 
in endocarditis. Only one, or all the joints in the body, may partici¬ 
pate in the inflammation. The joints are generally affected symmet¬ 
rically ; that is, the ankles, wrists, knees, elbows, or shoulders, will be af¬ 
fected on both sides at the same time. When this is not the case, anal¬ 
ogous joints upon the same side, are likely to be affected, as the ankle 
and wrist, the knee and elbow, the hip and shoulder, etc. Sometimes 
the disease appears to be very fickle, changing constantly from one 
joint to another without any apparent cause, the change taking place 
within a few hours. 

By a careful investigation of the subject nearly twenty years ago, 
our instructor in the practice of medicine and physical diagnosis, Dr. 
Austin Flint, of Bellevue hospital, New York, showed that rheumatism 
is a self-limited disease; that is, one which will recover of itself, without 
74 



1170 


DISEASES AND THEIR TREATMENT. 


any treatment whatever, and in from two to eight weeks, the average 
duration of the disease being about four weeks. Dr. Henry Sutton, 
of Guy’s hospital, England, in his investigations found the average du¬ 
ration, in forty-one cases, two weeks. In two subsequent series of 
cases, the duration was nine to ten days. 

Causes. —The causes of rheumatism are not thoroughly understood, 
but it is generally believed that exposure to cold and wet are the 
most common exciting causes, while free living, especially the large 
use of meat, and sedentary habits,—conditions which favor the produc¬ 
tion of an acid condition of the blood, particularly the accumulation 
of uric acid,—have much to do with producing a predisposition to this 
malady. Dr. Murchison holds that inactivity of the liver is a predis¬ 
posing cause of rheumatism. A tendency to the disease is undoubt¬ 
edly inherited in many cases. Rheumatism seems to be very closely al¬ 
lied to gout, a disease from which it cannot always be distinguished. 
Indeed, some very eminent observers, among whom may be classed the 
learned Dr. Fothergill, of England, hold that rheumatism and gout are 
one and the same disease. 

Treatment. —The preventive treatment of rheumatism consists 
in thoroughly clothing the body, wearing flannel next to the skin, pro¬ 
tection from exposure to cold and damp, especially sudden checking 
of the perspiration, and avoidance of too free use of animal food of all 
kinds. The excessive use of salt, and of the various condiments, together 
with the use of alcoholic liquors and tobacco, produce an undoubted 
tendency to this disease. As soon as possible after the attack begins, 
the patient should be placed in a hot blanket pack, in which he should 
be kept for several hours. As a general rule, the longer the pack is 
continued, the better the effect. The pack should be continued two to 
four hours at least, and may be repeated two or three times within 
the twenty-four hours with advantage. In the Mt. Sinai hospital, of 
New York, this plan of treatment has been adopted almost to the ex¬ 
clusion of other methods, and with marked benefit. In some cases, 
the patients were left in the pack all night. We have employed this 
plan of treating rheumatism for a number of years with most excel¬ 
lent success, patients having all made good recoveries without compli¬ 
cations. Hot air, vapor, Turkish and Russian baths are also valuable, 
as well as the hot pack, but less serviceable on account of the pain oc¬ 
casioned by moving the patient in the administration of the bath. 
Hot fomentations applied over the affected joints give great relief. 


A C UTE HHE UMA TISM. 


1171 


The joints should be kept constantly enveloped in warm applications. 
Moist heat may sometimes be exchanged for dry heat, in the form of 
bags filled with salt, sand, or corn-meal, or some similar substance, as 
hot as can be borne. Hot-water bags constitute the best method of 
applying dry heat in these cases. The patient should be allowed an 
abundance of drink. Lemonade, with a very little sugar, is one of the 
best drinks, as the juice of the lemon seems to have some influence 
upon the disease, in some cases. The sour perspiration should be fre¬ 
quently removed from the skin by rubbing with dry flannels. Warm 
sponge baths often add to the patient’s comfort. An eminent French 
physician has recommended the application of cold water to the sound 
part of the body, the water being injected into the tissues near the 
joint corresponding to the affected joint, by means of the hypodermic 
svringe. He claims to have obtained almost marvelous results from 
this mode of treatment. (See page 1006). When the fever rises very 
high, it is, in some cases, necessary to administer a prolonged cool 
bath. The patient should be put into a bath about the temperature of 
the body, the temperature of the water being gradually lowered to 
seventy-five or seventy degrees. The bath should not be prolonged 
sufficiently to produce marked chilliness on the part of the patient. 
We have never resorted to this measure, though it is highly recom¬ 
mended by some eminent authors. It is a somewhat severe one, and 
is attended by slight danger of occasioning rheumatism of the heart, 
and when employed should be used with very great care on this 
account. The employment of tepid sponge baths, repeated every hour 
or two, or more frequently, if necessary, is a safer means in these cases. 
When hot fomentations seem to increase the pain in the joints, cool 
or cold applications may be employed. 

The diet of the patient during the attack should consist wholly of 
simple preparations of fruits and grains. Meat, beef-tea, and all other 
animal food, excepting milk, should be wholly avoided. The use of 
meat after convalescence is begun, is a frequent cause of relapse, hence 
flesh should not be eaten for some weeks after recovery. 

If symptoms of inflammation of the heart arise, the patient should 
be kept upon a very low diet, or should take little or no food for a 
day or two. Hot fomentations and poultices should be constantly 
applied to the chest, covering the whole left side. The patient should 
have an abundance of fresh air, but should not be exposed to drafts. 

The number and variety of drugs which have been employed for 


1172 


DISEASES AND THEIR TREATMENT. 


rheumatism are almost endless. Scarcely a month passes which does 
not bring to light some new remedy, which is pronounced to be a 
panacea for this disease. The unreliable character of these remedies 
is shown, however, by their great number and variety, which is suffi¬ 
cient evidence that they do not accomplish what is claimed for them. 

Prof. Niemeyer expresses very little confidence in medication of 
any sort as a means of shortening the duration of this disease, and the 
investigations of Dr. Flint and Dr. Sutton, already referred to, show 
that good nursing, without any medication whatever, secures as 
speedy recovery as the use of any known remedies. If any remedy 
at all is to be taken, ordinary baking-powder, taken in doses of half a 
thimble-full, dissolved in water, once in three or four hours, answers 
as good a purpose as anything which can be used. It is well to al¬ 
low the patient to take lemon juice or eat lemons as freely as he de¬ 
sires. Several may be eaten every day with advantage. Salicylic 
acid, which has been recently recommended for rheumatism, does not 
sustain the reputation given to it, and sometimes serious symptoms 
have been produced by its free use. In severe cases of rheumatism, a 
physician should be called when one can be obtained. 

. Sub-acute Rheumatism is a form of the disease in which the 
symptoms are less acute, but continue a longer time, the patient be¬ 
ing subject to frequent relapses. It often follows the acute form of 
the disease. The treatment is essentially the same as that described 
for acute rheumatism. 

ciikosic aiua uATisa. 

SYMPTOMS.—Pain in the joints; slight tenderness on pressure; more or less swell¬ 
ing of the joints; either one or several joints may be affected; slight fever or none at all; 
pain increased at night, and by bad weather. 

Chronic rheumatism, sometimes the acute form of the disease, srener- 
ally runs an independent course, beginning insidiously. It generally 
produces more or less deformity, when long continued, from stiffness of 
the joints. In many cases the patient suffers with flatulent dyspepsia, 
and other forms of indigestion. The disease is very chronic in charac¬ 
ter, often continuing many years, frequently without affecting the gen¬ 
eral health as much as would be expected. 

Treatment. —Pain and stiffness of the joints is best relieved by hot- 
water bags, hot fomentations, and friction. The prolonged hot spray 
and hot pour we have also used to very great advantage. In his article 


CHRONIC RHEUMATISM. 


1173 


on this disease, Prof. Niemeyer remarks that the douche applied to the 
affected part is a much more effective derivative than the hot iron, 
which is often recommended, together with plasters and other irritants. 
^ hen the pain in the joint is very severe, and the inflammation great, 
some physicians recommend the employment of a freezing mixture of 
snow or pounded ice and salt. The joint should be pi’otected by thin 
muslin, and surrounded by the mixture. The application should not 
be continued more than five minutes, but may be repeated. It should 
not be employed more than twice a day. It almost always gives im¬ 
mediate relief. 

The various liniments which have been recommended are generally 
effective only by means of the rubbing by which they are applied. This 
view we have often confirmed by our own experience. The pains at 
night are generally relieved by wrapping the affected joints in moist 
flannels, which are covered with dry cloths, or oiled silk. We have 
often recommended patients, in whom the disease was chiefly confined 
to the hands, to wear upon the hands at night large cloth mittens, filled 
with oatmeal or corn-meal mush and tied about the wrist. We have 
often seen excellent results from this simple plan of treatment. It acts 
upon the same principle as the warm packing of the joints, a remedy 
which has in our hands proved more effective than any other in reliev¬ 
ing the pain and tenderness, and removing stiffness. The general con¬ 
dition of the system, on which the disease of the joints depends, will be 
best relieved by the employment of the wet-sheet pack, the vapor, hot 
air, Turkish or Russian baths, and other eliminative measures. Some 
one of those modes of treatment may be employed daily to advantage, 
when the patient is strong enough to bear severe treatment, and in some 
cases will need to be continued for months. We have frequently been 
taught the importance of persevering, even in apparently hopeless cases, 
by seeing patients recover under this treatment, after the employment 
of a great variety of remedies for years without any apparent benefit, 
indeed, without even checking the progress of the disease. The great 
reputation enjoyed by some mineral springs in the treatment of rheu¬ 
matism, particularly by the hot springs of Arkansas, and other thermal 
springs, is due to the active elimination which is induced by the hot baths. 
We have, however, successfully treated cases which have remained under 
treatment at these celebrated resorts for months without benefit, and 
had almost totally despaired of recovery. 

We have found, in some cases, great advantage from the use of local 


1174 


DISEASES AND THEIR TREATMENT . 


applications of electricity to the affected joints while the patient was in 
a warm bath, as in a Turkish, hot-air, or vapor bath ; and a combina¬ 
tion of electricity, particularly of faradic electricity, with the warm 
water bath, is also a very effective means of relieving pain in the joints. 
The application of a strong galvanic current to the affected joints, daily, 
or every other day, has proved very successful in some cases. We con¬ 
sider inunction a very important adjunct to the treatment, especially in 
cold weather, as it in some degree protects the patient from the results 
of exposure to alternations of temperature. Such exposure should be 
avoided, however, as much as possible, as it is very important that the 
temperature to which the body is subjected should be kept as uniform 
as possible. The body should be clothed in flannel, and the affected 
joints should be protected with extra covering. The tendency to stiff¬ 
ness of the joints should be counteracted by daily manipulations to as 
great an extent as possible without exciting too great increase of pain. 
The patient should resist as much as possible the tendency to bend up 
the limbs and joints which are affected. In case the knee joints are 
affected, the tendency to stiffening in a flexed condition may be prevented 
by elevating the foot when sitting. 

The diet of the patient should be nutritious, but as free as possible 
from meat and all highly nitrogenous food. Tea, coffee, tobacco, and 
alcoholic liquors and stimulating condiments should be carefully avoided. 
Salt should be used as little as possible. Some authors warn patients 
against the use of raw fruits, particularly apples, pie-plant and asparagus. 
As a general rule, the coarse vegetables should be avoided. A patient 
suffering with flatulent dyspepsia, or other forms of indigestion, should 
follow the rules which have been laid down elsewhere. 

DEFORMING RHEUMATISM, OR RHEUMATIC GOUT. 

SYMPTOMS.—Pain in joints, usually slight, sometimes severe; pain increased by 
pressure and by motion of the joint; motion of the joint accompanied by slight crackling ; 
deformity of joints; fingers drawn toward the little finger side of the hand. 

This disease in some respects resembles rheumatism, while in others 
it is more like gout. It is not accompanied by the fever and inflam¬ 
mation usually present in rheumatism. It differs from gout in that it 
affects the large as well as the smaller joints. 

Gout is generally confined to the fingers and toes. Rheumatic gout 
may affect every joint in the body, and in some cases produces the 
most surprising deformity. The peculiar deformity of the hand shown 


MUSCULAR RHEUMATISM. 


1175 


in Fig. 333 is characteristic of this disease. In the case of a young 
lady whom we had under treatment a year or two ago, all the fingers 
and toes, both elbows and both knees, were dislocated by the structural 
changes which had taken place. 

Treatment. —Although this dis- 
ease is a very obstinate one, and 
generally considered almost incurable, 
it has been repeatedly demonstrated 
that the thorough and persevering 
use of the same remedies recom¬ 
mended for chronic rheumatism will 
often result in very great benefit to 
the patient. 

MUSCULAR RHEUMATISM. 

SYMPTOMS.—Dull pain in the affected part, resembling that from a bruise ; pain in¬ 
creased by motion, often of a cramp-like character, and sometimes excruciating; tender¬ 
ness on slight pressure ; pain relieved by firm pressure. 

I 

It is probable that this disease is often neuralgic in character, 
though it is likely that in many cases it is a manifestation in the mus¬ 
cles of the same disease which more often shows itself in the joints. 
It may affect any part of the muscular system, as the muscle of the 
scalp, muscles of the face and jaw, muscles of the eye and all other 
external, as well as internal, muscles. What is termed pleurisy of the 
diaphragm is probably in the majority of cases really rheumatism or 
neuralgia of that muscle. The most common forms of muscular rheu- 
matism are pleurodynia, in which the disease affects the muscles of the 
chest, and lumbago, in which it is confined to the muscles of the back. 
Pleurodynia is often mistaken for pleurisy and intercostal neuralgia, 
as it occasions pain upon drawing a long breath as well as from cough¬ 
ing or sneezing. Persons suffering with it often imagine themselves 
to have some serious lung disease. When it affects the back, produc¬ 
ing “ crick in the back,” the patient can neither bend over nor 
straighten up, but is obliged to hold the trunk in a stooping position. 

The causes of muscular rheumatism are the same as those of other 
forms of rheumatism. Patients suffering with it generally have dark 
colored urine which contains large quantities of urates, or uric acid, 
indicating an inactive condition of the liver. It most frequently 
occurs in persons who make free use of meat, condiments, salt, and 





1176 


DISEASES AND THEIR TREATMENT. 


alcoholic drinks. It is, perhaps, frequently excited by taking cold 
through exposure to drafts. 

The pains of muscular rheumatism are undoubtedly simulated, in 
many cases, by infection of the muscles with trichinae. As the capsules 
in which the parasites are inclosed become chalky from age, they are 
sources of irritation, as foreign bodies. 

Treatment. —The best treatment for muscular rheumatism is the 
employment of moist heat, the application of hot bags, gentle rubbing, 
rest, and improvement of the general health. Galvanism, and, in 
most cases, faradization, give very prompt relief. The same general 
directions, with regard to treatment, diet, clothing, etc., as have been 
given for acute and chronic rheumatism, should be followed in this af¬ 
fection as well. 

It is especially important that the whole body should be clothed in 
flannel. The pain in the back may often be greatly relieved by wear¬ 
ing a tight flannel bandage about the body. When severe, a warm 
poultice may be worn over the seat of the pain. The old-fashioned 
pitch-plaster, which is so often used for these cases, undoubtedly does 
some good by retaining the natural warmth of the part and giving 
the muscles rest. 

OOITT. 

SYMPTOMS.—Acute pain in great toe, heel, or instep, occurring suddenly; chill, fol¬ 
lowed by heat; tenderness and swelling of the affected part; fever and restlessness ; 
irritability of temper; constipation ; coated tongue ; urine dark, with heavy deposit; in 
chronic cases, enlargement about the joints. 

Causes. —The chief causes of gout are the excessive use of meat, 
the use of stimulating condiments, beer, wine, alcoholic liquors, and 
high living in general. 

Dr. Joseph Drew of Breckingham, England, in an article in the 
British Medical Journal a year or two ago, called attention to the fact 
that the use of salt is a frequent cause of gout. He had suffered from 
the disease for over twenty years, until his joints became greatly en¬ 
larged. By discontinuing the use of alcoholic beverages, he was very 
much improved, but the enlargement and stiffness of the joints still re¬ 
mained. It occurred to him that, as the disease was greatly aggravated 
by the use of cakes, biscuit, or anything which contained soda, as his 
experience had abundantly proven, it was quite possible that chloride 
of sodium, or common salt, might also be a cause of aggravation of 


GOUT. 


1177 


the difficulty. The remainder of the account we will give in his 
own words. 

“ The idea once started, it was, of course, immediately carried into 
practice, and chloride of sodium was placed in the index expurgatorius. 
Salt was omitted as an article of diet, not only as a condiment, but 
avoided in salted meat or any other accepted comestible. The result 
in four or five weeks has been astonishing. Most of the stiffness has 
passed away. Finger rings that had been laid aside can be worn, and 
the phalangeal finger bones have almost returned to their primitive 
size and shape.” 

Dr. Drew further remarks that on every occasion on which he had 
taken any article of food containing soda in any form, he had suffered 
a relapse, or an increase of his pain and symptoms, even when used in 
small quantity, and in several instances when he was entirely unaware 
of the digression. 

Treatment. —In a majority of cases, the pain of gout is only a 
proper punishment for dietetic and other transgi'essions committed by 
the sufferer. Complete and permanent cure can only be effected by 
the adoption of a vegetable diet, and the disuse of all forms of alco¬ 
holic beverages. All the habits of the patient must be regulated in 
accordance with the laws of hygiene. Excess in the quantity as well 
as in the quality of food should be avoided. He should practice free 
water-drinking, taking anywhere from four to ten glasses of pure 
water per day. Abundant exercise in the open air should be daily 
taken. The affected parts should be carefully protected from the 
cold. The patient should take daily fomentations over the region of 
the liver and kidneys, as well as over the affected parts. Either dry 
or moist heat may be used for the relief of local pain. 

In bad cases it may be necessary to employ heat continually. Hot¬ 
air, vapor, Turkish, and Russian baths are excellent means of eliminat¬ 
ing from the system the waste and excrementitious material which 
lies at the foundation of this disease. A wet-sheet pack is equally 
valuable for the same purpose. Wearing of a moist abdominal band¬ 
age night and day for several weeks is also a useful measure. Dur¬ 
ing the attack, the affected limb should be elevated above the level of 
the body, carefully covered with cotton or wool, and the patient 
should abstain from food almost entirely, for two or three days, taking 
only a little gruel or toast once or twice a day. A celebrated French 
author recommends the drinking of six ounces of hot water every fif- 


1178 


DISEASES AND THEIR TREATMENT. 


teen minutes during the attack. The active sweating which will be 
produced by this measure will certainly be conducive to recovery. 


SOFTESOG OF TIIE BO^ES-MOLLITIES OSSIUM-OSTEOc 

MAEACHIA. 

SYMPTOMS. — Boring, tearing pain in the bones, relieved by quiet, increased by mo¬ 
tion ; pain at first thought to be rheumatic ; slight fever; much sediment in urine ; gait 
tottering and uncertain * distortion of body and limbs; general health often not impaired 
for some time. 

This is a disease in which the bones unciergo a process of softening 

by the removal of the phosphates and various other earthy matters 

which give them solidity. Fatty 

degeneration of the bones takes 
© 

place, so that they become weak 
and fragile. The distortion of 
the body sometimes becomes very 
great, affecting the whole skele¬ 
ton. This disease most fre¬ 
quently occurs in women, begin¬ 
ning a short time after confine¬ 
ment, especially in cases in which 
there has been injury to the 
pelvic bones, which constitutes a 
starting point of the disease. 

T r e a t m e 11 1.—Fortunately, 
this disease is very rare, as it is 
incurable. The most that can 
be done is to prevent distortion of the body by proper support of 
the parts most likely to become deformed. 



Fig-. 334.—Healthy 
Muscular Fibres. 


' 3 ? : . 


Fig-. 335.—Fatty 
Muscular Fibres. 


FATTY DEGENERATION OF TBIE MISCLES. 

This is a morbid process in which the proper muscular tissue is re¬ 
placed by little particles of fat. The change in appearance is easily seen 
by reference to Figs. 334 and 335, in which are shown the healthy mus¬ 
cular fibres and fibres which have undergone fatty degeneration. It oc¬ 
curs in muscles which have long been paralyzed, being the result of their 
non-use. The occurrence of fatty degeneration in the muscles is one of 
the results to be guarded against in cases of paralysis. It may be pre¬ 
vented by the daily employment of massage and the use of electricity. 






FEVERS. 


1179 


INFECTIOUS DISEASES. 


Under this heading will be considered all diseases of a contagious 
character, together with those which arise from miasma. A contagious 
disease is one which is communicated by actual contact of an individual 
with palpable substances, originating in individuals suffering with the 
disease. Infectious diseases are those which are propagated by means of 
impalpable substances carried in the air. Nearly all contagious diseases 
are also infectious. In most infectious diseases, the morbid parts which 
give rise to the disease proceed from individuals suffering with contag¬ 
ious maladies. In some cases, however, as in the so-called malarial dis¬ 
eases, such a connection cannot be traced. 

The Germ Theory of Disease. —The supposed nature of germs 
has already been considered. (See page 548). In the case of quite a 
number of the diseases included under this heading, it may be claimed 
that absolute proof of the existence of microscopical organisms as specific 
causes of the affections referred to has been obtained through extensive 
and searching investigations which have been made respecting this sub¬ 
ject. In the case of several, while proof is not absolute, the evidence is 
such as to leave little room for doubt. Recent investigations of the 
nature and cause of malarial poisoning seem to have shown beyond 
reasonable doubt that this class of affections depend upon certain low 
vegetable organisms which are produced in great abundance under con¬ 
ditions known to be favorable to the development of malarial diseases. 

Infectious diseases are divided into two classes, acute and chronic. We 
shall consider both classes together without any other distinction than 
that of sequence. 

FEVER. 

Symptoms.—Usually begins with chill; dry, hot skin; full, quick pulse; elevation of 
temperature^ thirst; coated tongue: headache; little or no appetite; nausea; pain in 
back and limbs. 

The above are the symptoms characteristic of fever, a condition 
which is present in nearly all the diseases included in this section. In 
the various febrile diseases, numerous other symptoms arise in addition 
to those which pertain to fever itself, varying according to the particu- 



1180 


DISEASES AND THEIR TREATMENT. 


lar affection or the local complications which may arise. Fever is gen¬ 
erally understood to be a general disease of the blood. In the majority 
of cases, its cause is the introduction into the system of poisonous or 
morbid elements of some sort. When the poison thus received into the 
system is of an animal or vegetable nature, reproduction usually takes 
place, occasioning a great increase in the quantity of the morbid ele¬ 
ment. This explains the fact that a certain period, varying from a few 
hours or days to several months, almost always elapses after the morbid 
elements are received into the system before the chief symptoms of the 
disease make their appearance. This is called the period of incubation. 

The Temperature. —The natural temperature of the 
body, when taken under the tongue or in the arm-pit, is 
98 b°. Only very slight variations occur in health. When 
the temperature rises to 100° or more, the pulse will al¬ 
most invariably be found to be increased in frequency. The 
frequency of respiration will also be increased, and other 
symptoms of fever will generally be found. It may hap¬ 
pen, however, that the increased temperature, as detected 
by the thermometer, will be the only febrile symptom which 
can be readily detected at the very beginning of febrile dis¬ 
ease, since this is by far the most delicate and reliable means 
for determining the degree or intensity of febrile action. 
Fig. 336 shows one of the latest forms of fever thermometer 
which has been devised. Every family should possess a re¬ 
liable instrument of this kind, as, by its aid, the first begin¬ 
nings of disease may sometimes be detected. In using the 
thermometer, care is necessarv to secure correct results. If 
the instrument be placed in the arm-pit, the arm should 
be drawn close to the body, with the fore-arm drawn across 
the chest, so as to cover the instrument as completely as pos¬ 
sible. It should be retained in position eight or ten min¬ 
utes. It is often more convenient to take the temperature 
in the mouth, the bulb of the thermometer being placed 
under the tongue, the lips of the patient being kept tightly closed for 
five or ten minutes. In young infants, the thermometer may be intro¬ 
duced into the rectum. In this location, the temperature is found to be 
about a degree higher than in the mouth or arm-pit. Before placing 
the thermometer in position, if it is a self-registering instrument, and 
no other should be employed, care should be taken to shake the 



Fig-. 336. 

Fever Ther¬ 
mometer. 













FEVERS. 


1181 


index down to 90° or 95°, reading from the upper end of the index, 
which consists of a short column of mercury detached from the main 
column. 

A very accurate idea of the temperature of the body may generally 
be obtained by means of the hand, if proper precautions are taken to 
avoid error. In order to judge correctly of the temperature, the hand 
should be perfectly clean, smooth, and dry, and should be properly 
warmed before applying to the body ; as, if the hand happens to be 
cold, the body may feel unnaturally hot, although of normal temper- 
ture. First, one or two fingers, and then the whole flat surface of the 
hand should be laid upon the body. 

The variations of temperature from that of health differ in various 
febrile diseases, in some running very high, while in others only a very 
moderate degree of elevation is noticed. As a general rule, the temper¬ 
ature does not rise above 103° to 105°. A temperature over 107° is 
very likely to prove fatal, although cases have been known to recover in 
which the temperature has risen two or three degrees higher. In de¬ 
pression, the condition opposite that of fever, the temperature is lower 
than normal, sinking even as low as 94° or 95°, or even lower. A very 
low temperature is as grave a symptom as a very high one ; but occurs 
much less frequently. 

The general supposition that a chill is the opposite of fever, is an 
error. The thermometer shows that the temperature is elevated during 
a chill as well as during a fever. The temperature may not rise as high, 
but is considerably above the normal standard. In most of these cases, 
the thermometer is of course the onlv reliable means of determining the 
temperature, as the skin is, not infrequently, cold and the patient shiver¬ 
ing, while the internal temperature of the body ls much higher than in 
health. 

Classification of Fevers. —We shall not here attempt to give a 
scientific and elaborate classification of the affections to which the term 
fevers is attached. Fevers in which the high temperature is con¬ 
tinuous from the outset without any very great remission or interrup¬ 
tion, are termed continued fevers. To this class belong febricula, 
typhoid, and typhus fevers, erysipelas and relapsing fever. Periodical 
fevers are those in which the disease is subject to regular periodical 
intermissions or remissions. Intermittent, remittent, typho-malaria, 
yellow fever, and a fever to which the term dengue is applied, belong 
to this class. Fevers in which the nervous system is very greatly dis- 


1182 


DISEASES AND TIIEIR TREATMENT. 


turbed are said to be ataxic. Those which are very fatal are called 
malignant. Putrid fevers are those in which there is supposed to be 
tendency to putrefactive changes in the fluids of the body. The terms 
gastric and mucous fevers are sometimes applied to fevers in which 
the stomach and intestinal canal are particularly affected. The terms 
high and low, as applied to fevers, relate to the degree of temperature. 
A slow fever is one in which the intensity of the fever is not great, 
but the duration prolonged. Congestive fevers are those in which 
there is supposed to be a marked tendency to congestion of the in¬ 
ternal organs. 

General Treatment. —In a majority of the infectious diseases of 
which fever is a prominent symptom, the great danger to life is oc¬ 
casioned by the great increase of temperature. This is also the prin¬ 
cipal cause of the rapid loss of weight and strength by a patient suf¬ 
fering with fever. There is an unusually rapid destruction of the tis¬ 
sues of the body, while, at the same time, there is a loss of assimilative 
power, so that the wasted tissues are not readily replaced. The nerv¬ 
ous system, and especially the heart, also suffers directly from the de¬ 
pressing influence of a high temperature. In consequence of this fact, 
the treatment of fevers comprises the most essential measures to be 
employed in the treatment of the whole class of diseases included in 
this section; and the directions given should, with few exceptions, be 
followed in all cases in which fever is a prominent symptom, other 
measures being employed as may be indicated by their special symp¬ 
toms. As the high temperature is the greatest source of danger in fe¬ 
ver, the greatest importance attaches to remedies which will have an in¬ 
fluence to lower the temperature. Those which are most effective for 
this purpose may be briefly enumerated as follows: Sponging with 
cold, cool, or tepid water (page 638); the application of the cold com¬ 
press to the abdomen, chest or head, or to all at the same time (page 
664); ice to the spine (page 667); wet-sheet pack (page 641); cool 
shower bath (page 644); affusion (page 648); cool or cold enemas 
(page 663); drinking ice-water, or swallowing bits of ice; the gradu¬ 
ated full bath (page 645); the cool-air bath. 

Any or all of these measures may be employed, according to the 
particular indications of each individual case. When the fever is slight, 
tepid and cool sponging, and the application of tepid compresses over 
the abdomen, are usually sufficient. When fever rises very high, as 
indicated by very full and rapid pulse, severe headache or delirium, 


FEVERS. 


1183 


throbbing temples, and a temperature of 102 to 105° or upward, ice to 
the head and spine, cold compresses over the bowels, frequent cool 
sponging, and the use of the cool or cold enema once in two or four- 
hours, are the remedies upon which we chiefly depend. By the com¬ 
bined use of these measures, the temperature can almost always be 
readily controlled. The cold enema is a very useful measure indeed, 
and is especially serviceable in cases in which the patient complains 
of chilliness upon being sponged with cold water. 

We also value very highly as a means of reducing the tempera¬ 
ture, the application of the ice compress to the spine and back. If 
the patient complains of chilliness, a bag of hot water may be placed 
at the pit of the stomach. The compress may be continued for from 
fifteen minutes to two or three hours, care being taken that the skin 
is not injured by the direct contact of the ice, or the patient annoyed 
by the cold water from the melting of the ice running down about the 
body. In extreme cases, the shower pack, or the graduated bath may 
be employed. We believe, however, that these measures can be dis¬ 
pensed with, even in the most severe cases, if the other measures men¬ 
tioned, especially the cold enema, are thoroughly employed. 

When the fever is high, the patient may be allowed to drink freely 
of cold water, as by this means an appreciable effect upon the tem¬ 
perature may often be obtained. If at any time, unpleasant sensa¬ 
tions are pi'oduced in the stomach by taking too much cold or iced 
water, it may usually be quite promptly relieved by applying a hot 
fomentation over the stomach. When the patient complains of a bad 
taste in the mouth and a dislike for water, weak lemonade, slightly 
sweetened, may be used to very great advantage. Juices of various 
other fruits, as of apples, raspberries, currents, etc., may be used in the 
same way as lemon juice. In cases in which the stomach is very ir¬ 
ritable and rejects drinks of all kinds, the thirst will often be re¬ 
lieved by giving the patient an enema, as a considerable quantity of 
fluid may be absorbed by the mucous membrane of the lower bowel. 
When given for this purpose, as when administered to reduce the tem¬ 
perature, quite a large quantity of water should be employed. It 
should be introduced very slowly and should be retained as long as 
possible, half an hour at least. When the disposition to expel the 
water cannot be readily controlled, a sponge or napkin should be 
held against the anus for some ten or fifteen minutes. The severe 
headache which most fever patients suffer, is best relieved by a con- 
tinous application of cold to the head (page G79). 


1184 


DISEASES AND THEIR TREATMENT. 


The diet of a fever patient shoud be very simple, consisting almost 
wholly of fluid food, as oatmeal gruel, graham gruel, milk, and, oc¬ 
casionally, chicken or mutton broth, or beef tea. We are not much in 
favor of animal broths, however, on account of their stimulating 
character. The same objection is valid against the use of beef tea, 
and especially against the various extracts of beef which are sold at 
the drug stores, which are almost entirely devoid of nutriment, being of 
a very stimulating character. No meat nor solid food of any kind, 
with the exception of toast, should be allowed. Baked sweet apples, 
ripe grapes, oranges and lemons are about the only fruits which may 
be safely employed under nearly all circumstances when the stomach 
does not reject food. When grapes are taken, the skins and seeds 
should be rejected. Vegetables should be discarded as deficient in 
nourishment, and hard of digestion. Jellies, rich sauces, preserves, 
pastries, and other delicacies, should be strictly prohibited. These arti¬ 
cles are not only very difficult of digestion, but contain very little 
nourishment. Milk is an article of food more generally acceptable 
than any other. It has the advantage of being easy of digestion, and 
containing all the elements of nutrition. When it can not be taken 
alone, it may be combined with barley-water or oatmeal gruel, 
in varying proportions to suit the wish of the patient. When neces¬ 
sary, lime-water may be combined with the milk, in the proportion of 
one part lime-water to three or four parts milk. 

In cases in which the patient is too feeble to take nourishment, or 
is unconscious and refuses to swallow food when it is placed in the 
mouth, nutritive enemata should be employed. It is a mistake to sup¬ 
pose that a patient suffering from fever requires no nourishment at all 
until the appetite returns. The opposite extreme of excessive feeding 
should also be avoided. If the patient takes no nourishment at all, 
the depression and weakness resulting from the disease will be very 
much increased, and death may result from the great weakness oc¬ 
casioned by want of nourishment. Excessive feeding will increase 
the fever. We have observed cases in which the violence of fever was 
very greatly increased by the use of large quantities of stimulating 
food, as beef tea, e^cf-no^, brandy and milk, etc. The directions some- 
times given to feed a patient every few minutes, or every half hour, 
is pernicious advice, unless the patient is so weak that only one or two 
teaspoonfuls of food can be taken at a time. Two or three hours is 
as short an interval as is admissible. As a general rule, it is better 


FEVERS. 


1185 


that the patient should take food not more frequently than three or 
four times a day, the quantity being made large enough to afford the 
required amount of nourishment. 

The supply of an abundance of fresh air by proper ventilation is by 
no means the least important measure necessary in the successful treat¬ 
ment of fevers, as, in many cases, the morbid action is a result of in¬ 
flammation excited by poisonous germs. Thorough ventilation is nec¬ 
essary to remove the infectious particles with which the air of the 
patient’s room may become impregnated, so that the infection will not 
become intensified by breathing over and over the poisoned atmosphere. 

Ventilation is also necessary for the safety of nurses and attendants. 
Practical experience has shown a very great difference in fatality be¬ 
tween cases treated in close and unventilated hospitals, and those in 
which an abundant supply of fresh air was furnished. At a Sanitary 
Convention held in Detroit, in January, 1880, under the auspices of the 
Michigan State Board of Health, an old army surgeon related a very 
interesting experience illustrating the importance of securing to the 
sick, and especially persons suffering with fever, an abundance of pure 
air. He stated that during the war he had charge of a large hospital in 
■which at one time in the winter season he had under treatment three 
hundred and twenty cases of measles. Just at this time the hospital 
took fire and burned to the ground. The patients were placed in tents, 
and all but one or two recovered. He had no doubt that the number of 
deaths would have been thirty or forty at least, had the patients re¬ 
mained in the hospital. He afterward sent one hundred men, who were 
only slightly ill, to the general hospital at Nashville, and seventy-five of 
them died. Upon visiting the hospital, he found it so poorly ventilated* 
that the air was exceedingly foul, producing a sickening sensation when 
he had been in it only a few minutes. The Doctor concluded by re¬ 
marking that he regarded pure air and water as most important agents, 
and believed them to be capable of controlling the ravages of raging- 
disease. 

Dr. John H. Griscom read a paper before the New York Academy 
of Medicine, many years ago, in which he gave an account of eighty-two 
cases of typhoid fever which occurred on an American ship at Perth 
Amboy, New Jersey. The ship had brought over about four hundred 
passengers, of whom a number had died on the passage. On its arrival, 
eighty-two fever patients, twelve of whom were insensible, were re¬ 
moved to the shore, and for want of other accommodations, were placed 

75 


118G 


DISEASES AND THEIR TREATMENT. 


in two open shanties, the roofs of which were composed of old sails. 
The first night after the removal, a violent thunder-storm occurred, 
•which was accompanied by torrents of rain. The next morning it was 
found that the clothing of all the patients was saturated with water. 
The principal measures of treatment employed, were enemas of lemon 
juice and eold water. The food was chiefly buttermilk. Four sailors, 
.sick of the same disease, were cared for in a dwelling-house. Two of 
them died. Every one of the eighty-two emigrants recovered. 

The danger of fever patients taking cold by exposure to cool air is 
much less than is generally supposed. An eminent German physician 
advocates the use of the cold-air bath, when the cold-water bath cannot 
be conveniently employed. His plan is to open the doors and windows of 
the sick-room, and after removing the patient’s clothing, place him in 
such a position that he will be fully exposed to the draft of cold air. 
We have frequently employed a modification of this plan by stripping 
the patient, and after moistening the surface with a wet sponge, or the 
hand dipped in water, allowing evaporation to take place. A marked 
■cooling effect can be produced in this way. If proper care is taken to 
keep the feet and hands warm, little fear need be felt that the patient 
will take cold when suffering from a general fever. The temperature of 
the room should be kept as low as possible without inconveniencing the 
patient. As a general rule, sixty to sixty-five degrees is a proper tem¬ 
perature. Seventy degrees should rarely be exceeded. 

In many cases the discharges of the patient are the most efficient 
means for communicating the disease. They should be promptly and 
thoroughly destroyed by the use of disinfectants. The night-vessel should 
* constantly contain a solution of copperas, or a strong solution of chloride 
•of zinc or permanganate of potash. This will secure disinfection of 
the discharges as soon as passed. Immediately after it has been used, 
the vessel should be removed from the room, and its contents buried in 
the earth, at a safe distance from any well or cistern. (See pages 441 
and 442). The discharges of a patient suffering with any contagious 
or communicable disease, should not be placed in a common privy or 
water-closet. A neglect to observe this precaution has often resulted in 
the wide dissemination of infectious maladies. For the majority of 
fever-patients, careful nursing is more indispensable than the most 
skillful medical treatment. With careful nursing alone, the majority of 
patients will recover. 


TYPHOID FEVER. 


1187 


FEBRICULA. 

SYMPTOMS.—Attacks generally abrupt; weakness; loss of appetite; chilliness; 
skin very hot; pulse rapid; severe pain in forehead; pain in back and limbs; constipa¬ 
tion ; urine scanty and dark. 

This disease is also known by the names ephemeral, irritative, or 
inflammatory fever. It is the mildest form of fever, and generally lasts 
from one to three days, though it sometimes continues a week or ten days. 
It is not accompanied by delirium, and is distinguished from typhoid 
fever by the absence of the characteristic symptoms of that disease. 

Causes. —The principal causes of febricula are overwork, overeating, 
loss of sleep, sexual excesses, and exposure to the heat of the sun. It is 
probable that many cases supposed to be febricula are really cases of 
typhoid fever in which the disease is checked before its characteristic 
symptoms are manifested. 

Treatment. —Rest in bed, fasting for a day or two, and the use of 
■cool or tepid sponge baths, compresses, and enemas. Patients always 
get well. 


TYPIIOID FETER. 

SYMPTOMS. — Lassitude; irregular chills, sometimes followed by perspiration; fre¬ 
quently headache; confusion of mind; irritability of disposition; no appetite; nausea or 
vomiting; nosebleed; pain in back and limbs; looseness of the bowels; as the disease 
advances, countenance becomes dull and stupid; cheeks, hands, and arms red, or of a 
dusky hue; wakefulness; more or less delirium in severe cases; patient talks in his 
sleep, tries to get out of bed, picks at the bedclothes, etc.; jerking movement of the 
tendons at the wrist; tongue coated whitish, yellowish, or brownish, usually smooth and 
glassy, or dry and hard—tremulous; a brownish accumulation on teeth and lips; bleed¬ 
ing of lungs; bowels distended with gas ; tenderness low down on the right side; gur¬ 
gling on pressure; hemorrhage from the anus or bowels, or both ; a few slightly elevated 
rose-colored spots on the abdomen; fever less in the morning; increased in the evening ; 
pulse ninety to one hundred and twenty. 

This is a general febrile disease, attended by local affection of the 
glands of the small intestines. For several days preceding the attack, 
the patient feels weak, debilitated, and a general indisposition. What is 
termed the forming period of the disease lasts about four days. The 
severity of the attack is indicated by the temperature. W hen the ther¬ 
mometer shows a temperature of 100° or 107°, the case may be con¬ 
sidered a very grave one. The severity of the disease itself is often 
greatly increased by complications, the most serious of which are pneu¬ 
monia, inflammation of the parotid glands as in mumps, peritonitis. 


1188 


DISEASES AND THEIR TREATMENT. 


hemorrhage. The duration of the disease is generally from two to four 
weeks. The popular belief in critical days does not seem to have a very 
solid foundation. In some cases, the brain symptoms do not disappear 
with the occurrence of convalescence. In occasional instances, the 
illusions or delusions incident to the delirious stage of the disease continue 
for a short time after all other symptoms have disappeared. Recovery 
from this condition generally takes place, however, in from one to three 
weeks. In a case of this kind which occurred in our practice a few 
years ago, the patient was subject to marked religious delusions, which 
disappeared, however, in a very short time, as his strength returned. 
Cases frequently occur in which the symptoms of disease are not suf¬ 
ficiently severe to confine the patient to bed. These are termed “walk¬ 
ing cases” of typhoid. As a general rule, patients gain flesh very rapidly 
after recovery begins, often acquiring a greater weight than at any 
previous time. 

Causes. —Typhoid fever is, by many physicians, supposed to be 
produced by a specific germ, which is communicated chiefly by means 
of the bowel discharges. It is believed that when the discharges are 
mingled with other human excreta, as in privy vaults, sewers, etc., the 
germs will affect the whole mass. Others believe that the germs may 
originate outside of the body, under certain conditions. This theory 
does not necessitate belief in spontaneous generation, as it is held that 
germs which, under ordinary circumstances, may not give rise to 
disease, or, under certain other peculiar circumstances, may give rise 
to other diseases, may, under circumstances not fully understood, but 
the existence of which is entirely possible, give rise to the disease 
known as typhoid fever. These germs, however they may originate, 
are generally received into the system by means of drinking-water. 
Wells and cisterns often become contaminated by means illustrated 
and described on plates XY and XVI. Milk has also been known to 
be a carrier of typhoid-fever germs, becoming infected through the use 
of water containing germs either in diluting the milk, or in washing 
the milk cans or other vessels in which it was placed. It has also been 
• claimed that milk may be contaminated through the drinking of in¬ 
fected water by cows. Recently an epidemic of typhoid fever in 
which a large number of persons were affected by the disease, occurred 
in Germany, the cause of which was traced to the use of soup made 
from the flesh of a calf which, as was afterward proven, had died of 
typhoid fever. 


TYPHOID FEVER. 


1189 


It is thought by some that the inhalation of sewer gas, and of the 
foul odors from neglected privies, cesspools, etc., may occasion typhoid 
fever; but it is probable that, in these cases, the disease is somewhat 
different in character, although allied to this affection. Fever originat- 
ing in this way has been termed cesspool fever. 

Treatment. —Typhoid fever is clearly a preventable disease, which 
may also be said of all other infectious and contagious diseases. Since 
its communicability has been established beyond question, it is of the 
greatest importance that proper measures should be taken to prevent 
the contraction of the disease by others, as well as for the relief and 
recovery of the persons suffering. The proper preventive measures 
to be adopted are careful examination of drinking water, and all other 
possible sources of contamination, thorough ventilation of the sick¬ 
room of patients suffering with the disease, destruction of the 
germs in the discharges of the patient by disinfection and burying 
at a safe distance from any well, cistern, or other sources of water 
supply. 

The general management of the disease should be precisely as 
has been described for fever. (See page 1182.) In many cases, by the 
adoption of vigorous measures, especially by the employment of the 
wet-sheet pack, hot-air bath, Turkish bath, and other means for excit¬ 
ing vigorous perspiration at the outset of the disease, its career can be 
cut short. We have succeeded in a number of instances, in breaking 
up the disease when it had advanced sufficiently far to leave little 
doubt as to its real character. The fever should be controlled by 
means of sponge baths, cold compresses to the bowels, ice packs, and 
cold enemas. The delirium and sleeplessness are best relieved by ice 
compresses, or the ice pack applied to the head. When discomfort is 
occasioned by pain or gas in the bowels, fomentations should be ap¬ 
plied once or twice a day, or every three or four hours, according to 
the requirements of the case. The use of stimulants is seldom called 
for. We occasionally employ them, when the patient seems to be 
sinking with exhaustion from the long continuance of the disease, but 
do not feel at all certain that we have ever obtained any marked ben¬ 
efit from their use. 

In the treatment of a large number of cases of this disease, we 
have had no occasion for the employment of such large doses of 
quinine as have lately been recommended by some eminent German 
physicians. In a few cases in which we have given this remedy a 


1190 


DISEASES AND THEIR TREATMENT. 


trial, the benefits derived from its use, as shown by the decrease in- 
bodily temperature, were so insignificant when compared with the ef¬ 
fects which could be obtained by the employment of other measures 
already described under the treatment of fever, that we had no de¬ 
sire whatever to resort to it again. The cold enema produces‘far more 
decided and permanent results than the largest doses of quinine which 
can be safely given, and is quite free from the unpleasant after effects 
of this drug. If the patient is very greatly troubled with inability to 
sleep, mild doses of gelsemium may be employed when other means 
fail; but if the head is kept cool by cold compresses changed every 
few minutes, or the ice pack or cold-water bag, very little difficulty 
will generally be experienced. 

It is frequently the case that the patient is not out of danger 
when convalescence begins, as hemorrhage from the bowels may occur 
even after the disappearance of most of the other symptoms of the 
disease. . The only typhoid fever patient we ever lost, v r as one in 
whom hemorrhage from the bowels occurred after convalescence- 
seemed to be fully established. The patient gave marked symptoms 
of turberculosis when attacked by the fever, and although the disease 
ran a very mild course, seeming to be very easily controlled by treat¬ 
ment, the patient finally died in consequence of the unfortunate acci¬ 
dent referred to, which was probably due to the relaxed condition of 
the blood-vessels, and the generally debilitated condition of the system. 

Perforation of the intestines by ulceration may also occur at a 
very late period, giving rise to inflammation of the peritoneum, and 
thus occasioning death. The patient should be very careful not to 
take solid food of any kind, especially meat, for some little time after 
convalescence is fully established, as the stomach becomes very greatly 
weakened in this as in most other febrile diseases, the secretion of 
gastric juice being almost suspended, and not being fully established 
for some time after recovery begins, making the digestion of meat 
more difficult that that of other foods. The directions given under 
treatment for fevers, respecting diet, ventilation, nursing, etc., should 
be carefully followed. 

The proportion of deaths in typhoid fever under ordinary methods 
of treatment are stated by Dr. Flint to be about eighteen to twenty- 
five in a hundred. Very often the fatality has reached a much higher 
per cent than this. According to M. France Glenard, between six 
and eight thousand cases of typhoid fever have been treated by a 


TYPHUS FEVER. 


1191 


method essentially the same as we have described, with an average- 
mortality of only about six per cent. Stieler treated a large number 
of cases at Munich, losing less than six per cent. Jurgenson reports 
a mortality of only three and one-tenth per cent. Brandt claims to- 
have lost only two and one-tenth per cent. Glenard treated fifty-two- 
cases at Lyons without a single death. We might mention many 
others who have been equally successful, but will only add our own 
experience in the treatment of sixty cases, by the aid of an assistant 
physician and a medical student, without losing a single patient, al¬ 
though in many cases the disease appeared in its worst form. When 
the plan of treatment pointed out can be pursued thoroughly and 
systematically from the outset, death will result in only a very small, 
proportion of cases. 

TIPIII'S FEVER—SHIP FEVER. 

SYMPTOMS.—Before the attack, slight chills; headache; disturbed sleep; no appe¬ 
tite; cough; coryza. The attack generally begins with severe chill, followed by con¬ 
tinued fever; patient confined to bed; heaviness and numbness in head; dizziness - 
flashes of light before the eyes; noises in the ears; deafness; pain in the limbs; tremb¬ 
ling; stupor; delirium; pulse one hundred or more; temperature high; urine scanty; 
eruption, resembling that of measles, but not appearing on the face; thick, brown coating; 
on the tongue. 

The common name for this affection is ship-fever, which is derived 
from the fact that the majority of cases occurring in this country may 
be traced to importation through immigrants, particularly those com¬ 
ing from Ireland, where the disease occurs much more frequently than 
in this country. The symptoms of this disease are very similar to those 
of typhoid fever,—stupor and delirium being still more characteristic of 
typhus than of typhoid fever. It occurs most frequently in years of 
famine, when people are badly fed, and seems liable to attack persons- 
in military camps, prisons, crowded barracks, tenement houses, and on 
shipboard where, a large number of persons are crowded into poorly 
ventilated cabins. The active symptoms of the disease generally term¬ 
inate quite suddenly with a profuse perspiration, after which the patient 
slowly recovers. The disease is very contagious. 

Treatment. —With reference to the treatment of this condition, the 
eminent Lebert remarks, “ Drugs, as such, are unnecessary. I give them 
chiefly to satisfy the patients and their friends.” The same plan of 
treatment may be followed which has been recommended for typhoid 
fever. Especial attention should be given to the application of cold or 


1192 


DISEASES AND THEIR TREATMENT. 


ice compresses to the head, as by this means the stupor and delirium will 
be greatly relieved. The frozen compress applied as elsewhere directed, 
may be usefully employed. 

If the patient bears cold treatment well, compresses and sponge baths 
at a temperature of sixty or seventy degrees should be employed as far 
as possible to keep the fever subdued. The cold enema should be resorted 
to whenever other measures fail to give prompt relief. If the patient is 
very restless, a warm bath or warm blanket pack may be employed, the 
head being kept cool during the application by the ice-cap or rub¬ 
bing with ice. The same care respecting diet, ventilation, disinfection, 
etc., should be observed as directed for typhoid fever. After the pa¬ 
tient’s recovery, the clothing, and everything used about the patient, 
should be thoroughly disinfected by exposure, in a tight compartment, 
as, for instance, a bleaching box, to the fumes of burning sulphur. The 
room in which the patient has been sick, should be disinfected in the 
most thorough manner. The paper should be removed from the walls, 
carpet from the door, and after thorough disinfection with sulphur (see 
index), should be thoroughly scrubbed and newly whitewashed. These 
measures should be attended to with very great thoroughness as the dis¬ 
ease is a very communicable one. 


RELAPSING FEVER. 

SYMPTOMS.—Begins with a chill, followed with high fever; great weakness; head¬ 
ache ; dizziness ; ringing in the ears ; pain in back of neck, small of the back, and in the 
limbs ; general muscular pains throughout the body, increased by pressure or movement; 
unnatural sensitiveness of the skin ; tongue white, with red tip ; pulse from one hundrea 
and ten to one hundred and twenty; temperature rises rapidly from one hundred and 
seven to one hundred and nine degrees; catarrh of the pharynx; usually constipation, 
but occasionally diarrhea; liver inactive, generally enlarged; spleen greatly enlarged; 
urine scanty, containing bile; at the end of one or two weeks, crisis, with sudden disap¬ 
pearance of fever and pain ; after six or eight days, return of previous symptoms ; three 
or four relapses may occur. 

Causes. —According to Lebert, the cause of relapsing fever is a pe¬ 
culiar microscopical organism which appears in the blood of the patient 
suffering with this disease, in the form of delicate spiral filaments, which 
are about -jtfot of an inch in diameter, and of an inch in length. 
They are coiled in a spiral form, and have a lively, twisting motion. 
The disease is clearly contagious, being communicated by the convey¬ 
ance of these parasites from one person to another. It is probable that 
drinking-water is one of the most common measures of communication. 



BILIOUS TYPHOID FEVER. 


1193 


Bad food, unsanitary conditions, and crowding of many people together 
are the principal predisposing causes. Some observers believe that the 
disease may be communicated by contact of one patient with another. 
Various epidemics of this disease have occurred, particularly in England, 
Ireland, Scotland, and Russia. The Irish epidemic extended over a large 
portion of that country, lasting four years. In 1847, the disease was 
imported into this country from Ireland. A. few years ago an epidemic 
of the disease occurred in Berlin. 

Treatment.. —Fortunately, this disease is not a very fatal one. 
With reference to its treatment, Lebert says, “ My recent, as well as my 
former, experience, has demonstrated the fact that there is no drug which 
may be said to exercise any direct influence upon the course of the dis¬ 
ease. The expectant plan of treatment, therefore, is the only proper one. 
Rest in bed, fresh air, cleanliness, fever diet, milk, soups, meat broths 
and cooling drinks, are the principal things to be attended to.” “ Clear, 
pure water, and carbonic acid water, are, as a general thing, the bever¬ 
ages best borne.” The general treatment recommended for fever should 
be pursued. Ice should be applied to the head to relieve the headache, 
cool sponging, compresses, and cool enemas, should be used to reduce the 
temperature. When the pain is severe, it may be relieved by the hot 
blanket pack, applied once or’ twice a day for half an hour. The major¬ 
ity of patients have a craving for acid, and may take lemon juice as 
freely as desired. For the soreness and pain at the pit of the stomach, 
apply hot fomentations three or four times a day, fifteen or twenty min¬ 
utes each time. As this is a contagious and infectious disease, the same 
precautions should be taken respecting disinfection during and after the 
attack as has been recommended for typhoid and typhus fevers. 

ItlT.lOl S TYI»lIOIff>. 

SYMPTOMS.—Pain in the head; dizziness and faintness; chills; pain in the limbs, 
especially the muscles and joints of the legs; continuous fever; restlessness; coated 
tongue; vomiting watery or bilious matter; soreness at pit of stomach; after a few 
days, temperature rises very high ; sic in dry and hot, or red and sweating, the headache 
intense; eyes red; roaring in the ears ; obtuseness of the mind; diarrhea; pain in the 
region of the spleen and liver from enlargement af those organs; jaundice; disease 
lasts from ten to fourteen days. 

This disease, in some respects, resembles the first attack of relapsing 
fever with which it is often combined. 

Causes. —Although the disease has not been very thoroughly studied 


1194 


DISEASES AND THEIR TREATMENT. 


as yet, having been recognized but a short time, it is believed to be in¬ 
fectious in character, although probably not contagious. 

Treatment. —The treatment is the same as that previously recom¬ 
mended for relapsing fever. When the diarrhea is troublesome, apply 
cold compresses over the bowels, and administer cool enemas three or 
four times a day. 

YELLOW FEVER. 

SYMPTOMS.—Disease usually preceded for two or three days by lassitude, headache „ 
no appetite, pain in the head, chilliness. 

FIRST STAGE: Begins with chill, followed by fever; severe headache; pain in 
back, and lower limbs; tenderness at stomach ; nausea and vomiting ; eyes red and 
watery. 

SECOND STAGE: After one to three days, fever and other symptoms abate or 
cease ; patient may improve until recovery takes place. 

THIRD STAGE: Severity of symptoms reappear, greatly aggravated; jaundice; 
black vomit; nosebleed; at last, stupor. 

This disease has attracted much attention within the last two or 
three years on account of the terrible epidemics which have almost de¬ 
populated some portions of the South. The symptoms above given pre¬ 
sent but an imperfect picture of the disease, as every case is more or less 
modified by individual peculiarities, and various other circumstances. 
The disease seems to vary in different epidemics, in some cases running a 
mild course, in others, raging with a violence and intensity which sweeps 
all before it. In addition to the black vomit, due to hemorrhage from 
the stomach, albumen in the urine, from acute inflammation of the- 
kidneys, is a very grave symptom which is present in the great major¬ 
ity of cases. 

Causes. —Careful investigations of this subject recently made un¬ 
der the auspices of the American Public Health Association, the Yel¬ 
low ’ Fever Commission, the National Board of Health, and various 
local sanitary organizations, have resulted in throwing great light upon 
the nature of this grave malady, although there are many questions of 
importance which cannot be said to be perfectly settled. There is little 
room left for doubt, however, as to the contagious nature of the disease, 
while its infectious character is fully established. It is generally con¬ 
sidered as proven that the disease is directly due to infection of the sys¬ 
tem by a specific germ, although there is still considerable discussion as 
to whether this germ necessarily originates with the yellow fever pa- 


YELLOW FEVER. 


1195 


tient, or may be developed independently under certain unsanitary 
conditions. 

Treatment. —The first and most important measure of treatment 
to be considered in the management of an epidemic of this disease is 
prevention. The ravages of the malady cannot be checked in any 
way but by the enforcement of the most rigid quarantine, and the em¬ 
ployment of vigorous disinfection. The most scrupulous attention to 
sanitary measures of all kinds is absolutely necessary. A patient suf¬ 
fering with the disease should be isolated from those who are well. 
Depopulation of the infected cities was found to be one of the most ef¬ 
ficient measures for checking the progress of the epidemic during the 
prevalence of the disease in the South, in 1878-79. The measures 
employed in the active treatment of this disease have been as diversi¬ 
fied as the theories of its origin. Some physicians have employed 
mercury, quinine, whisky, and other drugs, in large quantities, and 
others have declared with emphasis that no benefit is derived from the 
use of drugs. In analyzing the course of treatment prescribed by a 
large number of physicians who have had experience in the treatment 
of this disease, we have observed that there is a decided tendency on 
the part of those who have had the most experience, especially in se¬ 
vere epidemics, to rely more and more upon hygienic measures. 

Col. J. M. Keating, of Memphis, Tenn., Editor of the Memphis Daily 
Appeal, has prepared a very complete history of yellow fever, and the 
yellow fever epidemic of 1878 in Memphis, which contains, among 
much other valuable matter, a full description of the various plans of 
treatment pursued by the most eminent physicians of Memphis, Louis¬ 
ville, New Orleans, and other cities subject to this disease. The treat¬ 
ment pursued by Dr. R. W. Mitchell, who was medical director of the 
Howard Association of Memphis, and is now a member of the National 
Board of Health, seems to be a very rational method, and, as Dr. 
Mitchell says, is “the plan of treatment which observation and ex¬ 
perience have proven to be the best.’’ Dr. Mitchell remarks further, 
respecting the treatment of the disease, “ Being self-limited and one of 
very short duration, what could possibly be the aim of rational treat¬ 
ment beyond warding off complications, and sustaining nature ? ” In 
accomplishing this, Dr. Mitchell prescribes little or no medicine. He 
directs the patient to be put to bed as soon as the attack occurs, and 
kept there until convalescence is fully established. As the disease 
begins with a chill, measures should be promptly taken to bring about 


119G 


DISEASES AND THEIR TREATMENT. 


a reaction. This may be best accomplished by covering the patient 
with woolen blankets, putting the feet into a tub of hot water, in¬ 
troduced under the bedclothes, and surrounding him with hot bags, 
bricks, bottles filled with hot water, etc. When the bowels are con¬ 
stipated, the patient should take a thorough enema. The pain in the 
head is best relieved by cold applications ; the pain in the back may 
be relieved by fomentations. Gentle perspiration should be kept up 
for fifteen to twenty hours by keeping the patient covered with warm 
blankets, or giving him warm drinks. If the fever rises very high, 
cool or tepid sponging with water, or equal parts of water and alcohol, 
should be applied every hour or two. The cold enema may also be 
employed with advantage. If suppression of the urine occurs, the 
fever being very high, ice compresses, or compresses of ice and salt, 
should be applied over the small of the back for fifteen or twenty 
minutes at a time and repeated every thirty to sixty minutes. To 
relieve the soreness of the stomach, apply hot fomentations. To re¬ 
lieve vomiting, let the patient swallow small bits of ice. 

No food should be taken for two or three days, and then should 
consist of barley-water or thin oatmeal gruel, milk and lime-water 
in the proportion of three parts milk to one of lime-water, chicken 
broth, or some equally simple and nutritious food. When convales¬ 
cence is established, the quantity of nourishment may be gradually 
increased, but no solid food should be taken for two or three weeks. 
When a patient suffers with a great degree of muscular soreness, a warm 
pack may be given occasionally. The vapor bath is recommended by 
many physicians, and others have employed cold baths with advan¬ 
tage. Dr. Mitchell declares that when his plan of treatment is scru¬ 
pulously followed, a large majority of cases recover. 


TIIE PLAGUE. 

SYMPTOMS. — Chill, followed by fever; dizziness; thickened speech ; high fever; 
tongue coated, becoming dry and cracked, and covered with black crusts; delirium, fol¬ 
lowed by stupor; swelling of the glands in the groins, armpits, and around the neck; 
black and blue spots on the skin. 

This is a disease which, fortunately, seldom, if ever, visits this part 
of the world, although it prevails more or less at intervals in Turkey, 
Prussia and Russia. Its severest ravages are confined to the region of 
the Black Sea. The disease is both infectious and contagious. It is 
usually developed in from two to seven days after exposure. It is 


THE PLAGUE. 


1197 


very fatal, running its course in from three to five days. Eighty to 
ninety per cent of all who are attacked, die. When recovery occurs, 
improvement begins the latter part of the first, or by the middle of 
the second week. Patients who survive the first week, generally 
recover. 

In the Middle Ages, this malady frequently prevailed to such an 
extent in some of the European countries as to almost depopulate 
them. Terrible epidemics of the disease occurred in Egypt and As¬ 
syria before the Christian era. Several times this malady has seemed 
to die out, but has broken out anew, and it is probable that it con¬ 
tinues to exist in a mild form in some of the countries which appear to 
be its native home. It is undoubtedly the most fatal of all infectious 
diseases. 

Treatment.^In respect to no disease have the advantages of 
thorough quarantine been so thoroughly illustrated as in this. The 
necessity for isolation of infected indivuals was w T ell understood many 
years ago. When the plague broke out in a little town in lower Italy, 
an army was sent to prevent any individual from escaping into the 
surrounding country, and in order to make the quarantine more com¬ 
plete, the village was surrounded by three deep ditches, which were 
kept by soldiers under strict orders to shoot any individuals who at¬ 
tempted to escape. Almost equally vigorous measures were taken by 
the Russian government during the recent epidemic in that country. 
The good results were shown in both instances in the staying of the 
progress of the disease. There is no special plan of treatment which 
seems to have any particular influence upon this terrible malady. 
The best that can be done is to treat patients upon general principles. 
At the beginning of the disease, when the fever is high, cold should be 
applied. Fomentations and poultices should be applied to the suppu¬ 
rating; glands. 

o o 

The Black Death. —This is a malady which very closely resem¬ 
bles the plague, and is, by some authors supposed to be identical with 
it. In the fourteenth century, an epidemic of this disease spread over 
the whole known world, destroying a great proportion of the human 
race. It is probably still perpetuated in some provinces of East 
India, particularly in the vicinity of the Himalayas. 


1198 


DISEASES AND THEIR TREATMENT. 


SWEATING SICOESS-MILIARY FEVER. 

SYMPTOMS.—Attack preceded for two or three days by irritation of the skin, dryness 
of the mouth, thirst, headache, general weakness, bad feeling in the stomach, with 
peculiar sensation; ringing in the ears; dizziness. The disease generally begins 
in the night with a chill, or chilliness, followed by very profuse sweating, which is 
accompanied by prickling and stinging of the skin; skin hot; pulse exceedingly rapid; ex¬ 
treme headache; palpitation and pulsation at the pit of the stomach; stomach sensitive, pain¬ 
ful on pressure; occasional spasms in limbs ; rash appears on the third to the seventh day, 
other symptoms being aggravated; eruption consists of small, round, irregular spots, 
which vesicate and burst in two or three days; rash first appears on side of the neck 
and chest, extending downward upon the back and lower extremities; great restlessness, 
often delirium. 


Causes.— Very little is known concerning the cause of this mal¬ 
ady, although it is believed to be a germ disease. It is sometimes a 
very fatal malady, though in its epidemics, few fatel cases have oc¬ 
curred. 

Treatment. —The treatment consists in allaying the fever in the 
first stages of the disease by means of cold compresses, sponge baths, 
cool enemas, ice to the spine, etc. Especial attention should be given 
to thorough ventilation, and also to such other measures as have been 
recommended for the treatment of other infectious diseases. Bathing 
the skin with warm solutions of alum or vinegar is a useful meas¬ 
ure, much employed in Germany. The pain at the stomach is best 
relieved by cold applications. 

ERYSIPELATOrs FEVER— BLACK TOAGIJE. 

SYMPTOMS. — Fever, erysipelatous swelling of various parts of the body, most often 
the head; in severe cases, delirium ; neuralgic and rheumatic pains. 

Erysipelatous fever is distinguished from the local disease known 
as erysipelas, which is generally accompanied by fever, by the fact 
that in this disease the fever makes its appearance first, and the local 
disease afterward, while with the local affection the opposite is the 
case. The disease sometimes occurs in epidemics, some of which are 
very fatal. This was especially true of an epidemic which occurred 
thirty or forty years ago in different parts of the United States, which 
was characterized by peculiar blackness of the tongue, from which it 
obtained the name black tongue. 

This disease, like others of this class, is in all probability produced by 
the reception into the system of certain germs. Different observers have 


CATARRHAL FEVER. 


1199 


traced a similar connection between this and other infectious diseases, 
but nothing very positive has been established. 

Treatment. —The general fever should be treated by the same meas¬ 
ures which have before been recommended for the treatment of fever, 
page 1182. The local manifestations of the disease should be treated by 
means of cold applications at first, followed by warm applications or 
poultices; when the heat and redness gives place to a blue, purple, or scar¬ 
let hue, with cold ones. 

DENGUE-BREAK-BOKE PETER. 

SYMPTOMS.—Loss of appetite; chilliness; lassitude; after one to four days, fever, 
lasting from nine hours to four days, attended by pain in the head, eyes, muscles of the 
head, back and limbs ; then fever and other symptoms diminish ; after three or four days, 
symptoms return ; general eruption occurs which may resemble scarlet fever, measles, 
nettle-rash, or chicken-pox ; in some cases, the patient suffers with nosebleed or bloody 
diarrhea. 

This is not a very common disease, but several quite extensive epi¬ 
demics have occurred in Charleston and other cities in the South. In one 
epidemic, all the inhabitants of a town of moderate size suffered from 
the disease with the exception of half a dozen who had had it before. 

Fortunately, the disease is not very fatal, although recovery is usu¬ 
ally very slow. It is thought by those who have observed it, to be both 
infectious and contagious. 

Treatment. —The fever should be subdued by cool or tepid spong¬ 
ing, cool compresses, and cool enemas. Pains in the back and limbs are 
best relieved by warm baths, hot blanket packs, and hot sponging ; cold 
should be applied to the head to relieve the headache. The diet should 
be very spare. 

IMFLUEXZA-CATARRHAL PE1TR. 

SYMPTOMS.—Chilly sensations and flashes of heat; cold in the head, with copious, 
irritating discharge; eyes red and tearful; tickling in the throat; hoarseness; soreness 
of the throat; dry, irritating cough; pain and difficulty in breathing; great weakness; 
high fever; sleeplessness, or unnatural drowsiness; duration of disease three to ten days. 

This a disease which often affects whole cities or States at the same 
time, often making its appearance with great suddenness. Not infre¬ 
quently lower animals are affected at the same time with human be¬ 
ings. The disease is undoubtedly infectious, though not contagious. 
It is rarely fatal, recovery usually occurring within a very few days, 


1200 


DISEASES AND THEIR TREATMENT . 


although local irritation of the air-passages and general weakness 
may continue for some time. 

Treatment. —Warm blanket packs, vapor baths, hot-air baths, fo¬ 
mentations to the lungs, and cool or tepid sponging, with cool com¬ 
presses when there is considerable fever, are the most important meas¬ 
ures of treatment. The inhalation of hot steam should be tried when 
there is much bronchial irritation. When the nasal passages are ob¬ 
structed, much relief will often be obtained by rubbing the nose with 
sweet oil or vaseline. Lard or fresh butter will answer the same pur¬ 
pose. 

MOIPS, OR PAROTITIS. 

% 

SYMPTOMS.—Slight fever; headache; loss of appetite; swelling near the lobe of 
the ear, accompanied by heat and pain ; motion of jaws painful and difficult. 

This common disease of childhood usually runs a very mild course. 
The patient has first a chill, or slight shivering, followed by slight fever 
for two or three days, in most cases, when the parotid gland begins to 
swell, usually upon one side at first, the swelling being behind the angle 
of the jaw near the lobe of the ear. In some cases pain*on motion of 
the jaws is the first symptom. After a little, the swelling extends to the 
other side. The swelling also extends to the throat, sometimes embarrass¬ 
ing respiration. The patient does not usually suffer much pain when 
quiet, but eats and talks with difficulty on account of the pain caused 
by motion of the jaws. After five or six days the fever ceases, and in 
the course of eight or ten days the patient is well again. It sometimes 
happens, however, that instead of so prompt and favorable a termina¬ 
tion, suppuration takes place. The swelling becomes very painful, hard 
and dark red, and matter forms, which is discharged through an open¬ 
ing in the cheek or through the external canal of the ear. Another 
complication, known as metastasis, also sometimes occurs. In these cases 
the disease seems to subside in the parotid gland and makes its appear¬ 
ance somewhere else. In males the testicle and scrotum are the parts 
affected; in females, the breasts, vulva, or ovaries may be affected. In 
some instances the membranes of the brain become the seat of the in¬ 
flammation. The disease occasionally runs its course in the original 
place and the new seat at the same time. In most of these cases, as well 
as in the simpler form of the disease, the inflammation subsides in a few 
days and complete recovery takes place. Suppuration may occur, how- 


MUMPS—PAROTITIS. 


1201 


ever, in any of the parts affected, and hence tire danger is increased by 

these complications. 

* 

Cause. —This is an epidemic disease, and is generally believed to be 
contagious. The period of incubation, that is, the length of time which 
elapses after exposure before the symptoms of the disease appear, is six 
to fourteen days. The disease affects males more frequently than fe¬ 
males, and children more often than adults. 

Treatment. —Prof. Vogel, an eminent German physician, asserts 
that mumps ordinarily require no medicinal treatment, and that “ avoid¬ 
ance of injurious influences, rest, anti-febrile [vegetable] diet, and equable 
warmth, suffice, as a rule, for the restoration of normal health.” In¬ 
stead of “ heating herb-bags or cataplasms,” he recommends simple inunc¬ 
tions of the affected parts, and the use of ice-compresses. He explicitly 
states what many people will undoubtedly learn with surprise, that 
“ the use of cold is never dangerous ” in this disease. Irritating lini- 
ments, mustard plasters, and even blisters and other means of counter¬ 
irritation, have been employed as local remedies to prevent metastasis, a 
change of the seat of the disease. We believe these substances to all be 
injurious and prejudicial to recovery ; and we are glad to find our view 
supported by so eminent an authority as the renowned Dr. Niemeyer, 
who well remarks that “ experience has shown such treatment can only 
prove injurious.” Our plan of treatment is the following :— 

The patient is directed to abstain entirely from the use of all animal 
food but milk, which may be taken if it does not disagree with diges¬ 
tion. The diet is made to consist chiefly of cooked fruits, and grains in 
the form of gruels, as oatmeal and barley gruel, with softened graham 
toast. This the patient can eat easily. Cool, acid drinks are allowed to 
be taken freely. One or two warm, not hot, baths, or two or three 
tepid sponge baths, should be taken daily if there is much fever. Warm 
sitz baths are especially useful as derivative means of treatment, relieving 
the pain and congestion when it is severe. They may be employed once 
or twice a day in severe cases. When given at a temperature of 95°, 
the bath may be continued for ten minutes; at 90°, nine minutes; at 
85°, one minute. Apply to the neck cool or cold compresses, according 
to the intensity of the inflammation. When the cold becomes unpleas¬ 
ant, as it frequently does, apply mild fomentations for fifteen or twenty 
minutes, when the cool compresses may be renewed for an hour or two, 
or until they become unpleasant again, then being exchanged for the 
7G 


1202 


DISEAMS AND THEIR TREATMENT. 


fomentations for a short time. By this means, constant applications may 
he kept up and the severity of the disease much mitigated and its dura¬ 
tion shortened. If evidences of suppuration appear, exchange the cool 
compresses for fomentations or a poultice, so as to hasten the process, and 
have the abscess opened with a lancet as soon as the evidences of the 
presence of matter are distinct. A safe rule is to continue the applica¬ 
tion of cold so long as the swelling is hard and acutely painful to pres¬ 
sure; when a softened place is to be felt in the middle, fomentations 
should be applied. If the bowels are constipated, they should be relieved 
by means of the enema, and by the employment of manipulation and 
fomentations of the abdomen. 

Metastatic parotitis is a form of inflammation of the parotid gland 
which occurs in connection with other diseases. Itf is not contagious- 
The principles of treatment are the same as those given for mumps. 
(Suppuration is much more common in this form. 

CHOLERA. 

SYMPTOMS .— Three Stages. 1. Vomiting and purging; fluid stools resembling 
rice-water. 2. Contracted pupils; spasms; cramps in abdomen and lower limbs; skin 
cool; pulse intermittent. 3. Suppression of the urine;' great thirst; feeble pulse; 
difficult breathing; tongue and breath very cold; lips and skin blue; voice husky and 
unnatural; features pinched and shrunken; headache; drowsiness; coma. 

The symptoms are not very greatly different from those of bad 
cases of cholera morbus. In fact, when cholera is prevailing, it is gen¬ 
erally considered impossible to distinguish between the two diseases. 
The disease may vary in intensity from simple cholerine to the gravest 
form of the disease. When an epidemic is prevailing, all cases should be 
subjected to vigorous measures of treatment. 

Causes. —True, or Asiatic, cholera is one of those much-dreaded dis¬ 
eases which occur in epidemics, frequently almost depopulating the in¬ 
fected districts, often half of those attacked by it dying within a few 
days. The disease is undoubtedly a contagious one, being communicable 
from one to another, though not exactly in the same sense that small¬ 
pox, scarlatina, and similar diseases are contagious. Experiments have 
shown that the disease is not communicated by the direct or indirect 
contact of the body of the person affected, by the products of respira¬ 
tion, or by exhalations from the skin, but by discharges from the 
bowels. They are supposed to contain a specific germ peculiar to this 
disease, and the real cause of the affection. Facts seern also to support 
the idea that the germs of the cholera disease are less active in the 


CHOLERA. 


1203 


bowel discharges when they are fresh than after decomposition has 
progressed for a few days. The circumstances which favor the de¬ 
composition of organic matter seem very clearly to favor the extension 
of cholera after it has once been introduced. Careful investigations 

O 

have clearly shown that the most common means by which cholera 
poison reaches the system is through drinking-water, and perhaps, in 
some instances, food. Wells become contaminated from cesspools, 
sewers, etc., which have received the discharges from a cholera patient, 
and thus the disease is sown broadcast. The native home of chol¬ 
era seems to be in India, where in certain districts it constantly exists, 
being disseminated to neighboring countries, even to the most distant 
parts of the globe, through various means of human intercourse. A 
singular periodicity in the occurrence of cholera has led some visionary 
theorists to very strange conclusions respecting its cause. Observing 
that the great epidemics of the disease occurred about every twelve 
years, a certain Dr. Knapp of Mexico originated a few years ago the 
idea of‘planetary pestilence, his theory being that the disease is caused 
by the increased planetary attraction “ incident to the perihelion of 
Jupiter, which also occurs once in twelve years.” Dr. Knapp based his 
theory wholly upon the fact that the perihelion of Jupiter and the oc¬ 
currence of great cholera epidemics take place in the same year. Tak¬ 
ing this for a starting-point he proceeded to predict the occurrence of 
cholera and other epidemics with unexampled severity in the next 
decade,—1880-1890,—during which time the perihelion of Jupiter 
and that of several other large planets occur in conjunction. All that 
is required to show the fallacy of this theory is to find a sufficient ex¬ 
planation for the periodicity of cholera epidemic. This explanation is 
found in the following facts: The natives of India make periodical 
pilgrimages to Hurdwar, at the head of the Ganges. “ Hundreds make 
the Juggernaut pilgrimage every year. Much larger numbers make 
the journey every third year. Every sixth and ninth years the num¬ 
ber is still greater ; and once in twelve years an immense throng, num¬ 
bering more than three million people, make this long pilgrimage. 

“ Poor food, impure water, together with depressing meteorological 
conditions and the entire absence of any sanitary precautions, result 
in the production of the disease well characterized as Asiatic cholera. 
There is more or less of the disease every year; but once in twelve 
years, at the great pilgrimages, it assumes such proportions that it ex¬ 
tends beyond the limits of its original habitat and carries devastation 


1204 


DISEASES AND THEIR TREATMENT. 


to thousands of households in the larger cities of Europe and even of 
this country. 

“ Once in sixty years there gathers at Hurdwar a throng of pil¬ 
grims still greater than is collected at the twelve-year pilgrimages. 
The consequence is the production of a still more formidable cholera 
scourge, of sufficient malignancy and strength to sweep over the greater 
portion of the Western as well as the Eastern continent before it is 
checked by the approach of the cold season.” 

The above statements ai’e fully sustained by the eminent Dr. 
Peters, who has written a work in which he claims that since 1826 the 
cholera has regularly occurred as an epidemic at intervals of twelve 
years. He attributes the origin of each epidemic to the annual pil¬ 
grimages. He traces the course of two of these epidemics as follows :— 

“ In 1826 it became epidemic in Hindostan, its native home, and grad¬ 
ually spread until, in 1829, it was distributed throughout Russia, reach¬ 
ing England in 1830-’31. 

“ In the spring of 1832 it was brought to Quebec, whence it was 
carried up the St. Lawrence and across the lakes to Detroit, where it 
met the United States troops going to the Black Hawk war. It was 
distributed to all the national posts and forts in the then extreme West, 
being specially severe at Fort Dearborn, Chicago, Fort Crawford, near 
Prairie Du Chien, and Fort Armstrong, at Rock Island. From the latter 
place it was carried down the Mississippi River, striking New Orleans 
in October of the same year. 

“Twelve years thereafter, or in 1841, this contagion started in 
another tour around the world. It was found at Hurdwar in 1843 ; at 
Afghanistan, in Persia, in 1845; at Teheran in 1846; and Astrakhan 
in 1847. In 1848 it reached Havre, and was carried to New Orleans in 
some German emigrant ships the same year. From New Orleans it fol¬ 
lowed the travel up the Mississippi and along the Ohio. From St. Louis 
it was carried over the emigrant route to San Francisco, and eventual^ 
was distributed over nearly the whole country. Thus it will be seen 
that within the space of fourteen years the country suffered two visita¬ 
tions from the terrible' plague. The first time, being introduced at 
Quebec and following the rivers and lakes, it reaches New Orleans by 
going down the Mississippi; the second time, it starts at New Orleans and 
goes up the river, and is thus distributed.” • 

The Times of India clearly traces the origin of the last epidemic to 
the same source. The epidemic began in 1867. “ In that year three 


CHOLERA. 


1205 


millions of pilgrims, of whom a handful had come from a cholera dis¬ 
trict, assembled at Hurdwar, a few miles from the spot where the Ganges 
escapes from the Himalayas. On the 12th of April the three millions 
resolved to bathe and drink. The bathing-place of the pilgrims was a 
space 650 feet long by 30 feet wide, shut off* from the rest of the Ganges 
by rails. Into this long, narrow inclosure, pilgrims from all parts of the 
country crowded as closely as possible from early morn to sunset; the 
water within this space during the whole time was thick and dirty,— 
partly from the ashes of the dead, brought by surviving relatives to be 
deposited in the water of their river god, and partly from the washing 
of the clothes and bodies of the bathers. Now, pilgrims at the bathing- 
ghant, after entering the stream, dip themselves under the water three 
times or more, and then drink of the holy water, while saying their 
prayer. The drinking of the water is never omitted ; and when two or 
more members of a family bathe together, each from his own hand gives 
to the other water to drink. On the evening of the next day, the 13th 
of April, eight cases of cholera were admitted into one of the hospitals at 
Hurdwar. By the 15th, the whole of this vast concourse of pilgrims had 
dispersed, carrying the cholera in every direction over India; it attacked 
the British troops along the various routes, it passed the northern fron¬ 
tier, got into Persia, and so on into Europe, where it will work its wicked 
will for some time to come.” 

These facts expose the fallacy of planetary-pestilence theories so thor¬ 
oughly that we do not need to adduce any further arguments. We 
should have considered the subject almost unworthy of notice were it 
not for the fact that considerable attention has recently been given to it 
by several popular newspapers which have published sensational articles 
tending to propagate the theory, without attempting any exposure of 
the fallacy. 

Among the predisposing causes of cholera may be mentioned dissi¬ 
pated habits, the use of alcoholic drinks, unwholesome measures of diet, 
and anything which has a tendency to lower the vitality of the system. 
The use of cathartics is also to be deprecated when a cholera epidemic is 
prevailing. Mental depression is also a predisposing cause. It has been 
asserted that in cholera times thousands of persons die from simple fear 
of the disease, without having received into their system a single cholera 
germ; and it cannot be doubted that many who might otherwise escape 
harm are made unusually susceptible to the disease by excessive fear 
and dread. 


120G 


DISEASES AND THEIR TREATMENT. 


Treatment. —The most important measures of treatment are of a 
preventive character, since it is generally acknowledged that severe 
cases are not likely to recover under any form of treatment. Preventive 
measures consist, first, in careful avoidance of all predisposing causes of 
the disease; second, in careful avoidance of all specific causes. The lat¬ 
ter measure can be carried out only by the most rigorous quarantine, all 
communication being cut off by unaffected localities with those in which 
the disease is prevailing. The bowel discharges from patients suffering 
with the epidemic, instead of being emptied into cesspools or sewers, should 
be at onm rendered harmless by disinfection. The best plan is to place 
in the vessel which is to receive the discharges a tea-cupful of disinfecting 
solution, consisting of one-half ounce of permanganate of potash or soda, 
and an ounce of copperas, to each pint of water. No water should be 
employed for drinking purposes that has not been boiled and filtered. 
Upon the appearance of the first symptom, looseness of the bowels, warm 
baths, hot enemata, and fomentations to the bowels should be admin¬ 
istered. The food should be little in amount, and of the most simple 
character. It should consist chiefly of fruits and grains. Meat should 
be avoided. If the symptoms increase, fomentations should be used 
more assiduously. The patient should be allowed to drink all the cold 
water he desires, but it should be given in small quantities at a time. 
Ice pellets of the size of a large bean or filbert are swallowed by patients 
with great aviditv. 

In extreme cases, where the skin becomes very cold, it should be 
rubbed vigorously with dry, warm flannels, and when necessary, with 
mustard water. Hot bricks should be applied, and the fomentations 
should be continued with increased vigor. If the patient comes to con¬ 
valescence, great care should be exercised to prevent relapse from im¬ 
proper diet. The food must be of the simplest character for several 
weeks. No meat should be allowed until the activity of the stomach is 
fully restored. There have been hundreds of remedies advertised for 
this disease, but experience has shown the value of those mentioned. 
The hygienic treatment of cholera is undoubtedly the best of any which 
can be adopted. Everything depends upon the application of energetic 
measures of treatment at the very first appearance of the disease. 


1 


WHOOPING - CO UGH. 1207 

MTIOOPI1SG-COI GH-enn COKill-PERTI SSIS. 

SYMPTOMS.—Slight fever for eight or ten days, followed, sometimes accompanied, 
by violent paroxysms of coughing; coryza; hot, dry skin; restlessness; as fever sub¬ 
sides, cough acquires a peculiar shrill sound or whoop; expectoration of tough, viscid 
mucus; paroxysms of coughing often accompanied by vomiting; from three or four to 
six or eight times as many severe paroxysms occur each day. 

This disease is contagious, remaining latent about six days. The 
same person is rarely affected more than once. At its beginning, it is 
generally mistaken for an ordinary cold; the mistake is discovered, 
however, when the cough assumes its peculiar character. The cough 
is often preceded by a sensation of tickling in the throat. After a 
paroxysm, the patient is much exhausted, but in mild cases soon goes 
about as lively as ever. The cough is provoked by inhalation of cold 
air, laughing, crying, swallowing, and various other causes. The great 
cause of the cough, however, is the accumulation of tough, tenacious 
mucus in the throat. This stage of the disease may last only three 
or four weeks, or as many months. Finally, the tenacious mucus 
gives place to that which is thinner, less tenacious, and more easily ex¬ 
pectorated. The cough is less severe and frequent, and the patient is 
beginning to recover, but the tendency to relapse is very great. 
With good care and proper treatment, the disease should not last more 
than four or six weeks. The results of the disease are sometimes quite 
serious. The violent coughing may give rise to hernia or rupture. 
Collapse of some portions of the lungs, and also emphysema or dilata¬ 
tion of the air-cells is another not infrequent result. This is the cause 
of the permanent shortness of breath in some cases. Whooping-cough 
may also lead to consumption. In many cases, an irritability of the 
mucous membrane is left, which occasions a cough much resembling 
the peculiar cough characteristic of the disease whenever the person 
takes a little cold. The disease rarely affects adults, and is seldom 
fatal. 

Treatment. —Avoid exposure to the exciting cause. Give special 
attention even to the slightest cold when the disease prevails, as a cold 
predisposes to the disease as does a diarrhea to cholera in cholera 
times. The testimony of the most eminent physicians is that there is 
no specific for whooping-cough. The eminent Niemeyer declares that 
“ we cannot ever ascribe any special curative influence to belladonna, 

a drug which has acquired great reputation.On the other 

hand, we attach great value to well-managed treatment by sweating.’ 


1208 


DISEASES AND THEIR TREATMENT. 


The disease must be treated like any other severe catarrh. The pa¬ 
tient must be taken away from the source of infection with the dis¬ 
ease when possible, as continued exposure to the cause will aggravate 
it very greatly. He should also be kept at as uniform* a temperature 
as possible; and the temperature should be sufficiently warm to keep 
the skin in an active condition. Care should be taken to give the 
patient abundance of fresh air, but without exposure to drafts. In 
summer he may be out of doors during the middle of the day, but must 
not be exposed to the coolness of the morning and the evening. He 
should wear warm woolen clothing, particularly about the chest, and 
should have the neck protected by a thick flannel bandage. Once a 
day, if the patient is strong, he may take, with advantage, a warm 
blanket pack. The vapor bath, and vapor inhalations are also reme¬ 
dies of great value in this malady. Fomentations and compresses to 
the chest are of great value in children old enough to take them read- 
ily. The child must be taught to restrain the cough as much as possi¬ 
ble. After the mucus is expelled from the throat by coughing, there is 
no more occasion for cough, and it may be controlled by an effort of the 
will. An eminent German lady, who had had much experience with 
the disease, declared that “ whooping cough was only curable by the 
rod.” The child must be told to stop coughing, and if necessaiy, com¬ 
pelled to resist the cough, as this is one of the most effectual means of 
cutting short the disease. The cough itself aggravates it, and the more 
it is restrained the less will be the disposition to cough. Very little, if 
any, medicine is needed. Simple soda water is one of the most useful 
relnedies. It should be taken just before the paroxysm. The following 
is equally good used in the same way: Saleratus, half a teaspoonful; 
water, a large teacupful; sweeten with sugar, and flavor with cinna¬ 
mon or winter-green if necessary. This will shorten the attacks of 
coughing by facilitating the expectoration of the tough mucus; “it 
loosens the cough.” The common use of narcotics in this disease, 
especially in children, is to be condemned, since they are “ apt to cause 
hypersemia of the brain.” If used at all, their employment should be 
restricted, to use the words of an eminent German author, “to those 
cases in which danger from the disease outweighs danger from the 

o o o 

remedy.” When the amount of mucus is so great as to threaten 
death by obstruction, it may be necessary to cause vomiting for the 
purpose of relieving the lungs of the accumulated mucus. This should 
be avoided until absolutely necessary, and the mildest means possible 
should be used for the purpose. 


DIPHTHERIA. 


1209 


DIPHTHERIA. 

SYMPTOMS. —CATARRHAL FORM: Slight fever; malaise; dryness in throat, with 
slight pain on swallowing ; glands of throat swollen ; mucous membrane red; small gray¬ 
ish-white or whitish-yellow spots ; frequent nausea and vomiting. 

CROUPOUS FORM: Symptoms of catarrhal form intensified; more fever; head 
hot, mind confused; much pain m throat; one or more whitish patches in throat, pe¬ 
culiar offensive odor of breath ; tongue coated. 

MALIGNANT FORM: Foregoing symptoms, with extreme prostration; pulse weak 
and slow ; face sodden ; neck swollen and shiny; breath very offensive ; false membrane 
very extensive. 


This disease is of so great 
practical interest on account of 
its great and increasing preva¬ 
lence at the present time that 
we shall be justified in devoting 
more space to it than to most 
of the other affections consid¬ 
ered in this volume. In the 
following account of the dis¬ 
ease, its history, causes, and 
treatment, we have drawn lib¬ 
erally from our popular mono¬ 
graph on the subject, written in 
1878 * :— 

The disease is by no means 
a modern one, as is generally 
supposed. Homer and Hippoc¬ 
rates, who wrote several centu¬ 
ries before the Christian era, 
were each familiar with this dis¬ 
ease under the name of Malum 
vEgyptiacum. As the ancient 
name indicates, the disease was 
by early writers supposed to 
originate in Egypt and Syria. 
An epidemic of diphtheria oc¬ 
curred in Rome A. D. 380. Hol¬ 
land was visited by the disease ii 



Fig-. 337. 

1557. Many other parts of Europe 


* Diphtheria : Its Nature, Cause, Prevention, and Treatment.” Good Health Pub. Co., 
Battle Creek, Mich. 





















1210 


DISEASES AND THEIR TREATMENT. 


suffered from its ravages in the two last centuries. The first recorded 
occurrence of this affection on the American continent was in 1771, 
described by Samuel Bard in 178G. In 1856 another very severe 
epidemic visited this country, since which time it has been very 
common, seemingly increasing in virulence from year to year, some¬ 
times abating its ravages for a single season, then breaking out with 
redoubled fury and fatality the next. 

The characteristic feature of the disease when fully developed is a 
peculiar membranous formation which makes its appearance usually 
upon the fauces or tonsils, and is called diphtheritic membrane, from 
its resemblance to skin, which is the signification of the Greek word 
from which the name is derived. 

This membrane, or rather false membrane, when first formed, is of 
a grayish-white color; very tough, of leathery consistency, and ad¬ 
heres to the mucous membrane beneath it with great tenacity, it be¬ 
ing very difficult to tear away except in shreds, and then only by 
laceration of the mucous membrane, leaving a bleeding surface. The 
false membrane, in fact, is not formed upon the mucous membrane or 
other tissue where it may occur, but in it. At least it sends down 
numerous rootlets which are imbedded between the cells of the tis¬ 
sue beneath. In this respect the membrane is very different from 
that formed in croup, which often separates from the mucous mem¬ 
brane upon which it is formed, leaving the tissues entirely uninjured. 

The membrane is not confined to the fauces. It may occur on 
any portion of the structures of the mouth, the inside of the cheeks, 
the gums, the tongue, the edges of the lips, as well as on the tonsils,. 
the uvula, the soft palate, and the pharynx generally. It may also 
occur in the nasal cavity, either primarily or secondarily, extending 
upward from the fauces. 

We recently treated a case in which the whole back portion of 
the mouth was covered with the diphtheritic membrane, which also 
extended throughout the nasal cavity, and even appeared at the edges 
of the nostrils. The exudation may also occur at any other parts of 
the body where there is a union between skin and mucous membrane. 
Even the stomach and intestines sometimes become the seat of a diph¬ 
theritic membrane. 

The exact nature of this membrane has been the subject of much 
experimental inquiry. Besides being subjected to a most careful mi¬ 
croscopical inquiry by hundreds of skilled microscopists in the Old 


DIPHTHERIA. 


1211 


World as well as the New, eager pathologists have submitted it to the 
test of physiological analysis by applying it in various ways to lower 
animals. The results of these inquiries have seemed to establish the 
following facts:— 

1. The active cause of the characteristic features of diphtheria are 
vegetable organisms. 

o o 

2. The false membrane is formed by the growth of these vegeta¬ 
ble parasites in and upon the infected mucous membrane, and the 
vital resistance of the tissues to the depredations of the organisms. 

These conclusions are disputed by physicians of eminence, while 
warmly defended by Oertel, and others, and cannot be said to be ab¬ 
solutely proven; but since the most successful mode of ti’eating the 
disease is that which is based upon this theory of its nature, it is a 
perfectly safe and practical one for us to adopt. 


^ <S 

0 ^ «08 

a Vw 

o 1 


o* % 


0 


Exciting Causes. —The minute organisms peculiar to this disease 
act as the immediate exciting cause in all cases. These germs find 
ready access to the throat and nasal cavity, the parts most readily af¬ 
fected by the disease, being taken in by the act of respiration. The 
particular germs which are thought to be characteristic of this dis¬ 
ease are more or less common in the air, espe¬ 
cially in proximity to decomposing matter. It 
is their enormous numbers and extraordinary 
activity which give to diphtheria its dan¬ 
gerous character. In Fig. 338 may be seen 
a representation of the microscopical appear¬ 
ance of the Bacterium Termo and the Micro¬ 
coccus, the two varieties of germs thought to 
have most to do with the production of diph¬ 
theria. 

Since the disease is probably caused by germs, and since these 
very germs are produced in great abundance in the body of a person 
suffering with the disease, and thrown off with the breath and other 
excretions, it is evident that it may be communicated from one per¬ 
son to another. Clinical experience has verified this fact innumerable 
times. Experiments upon animals have also shown that the disease 
is communicable by inoculation. The affection is very appropriately 
called by one author a “miasmatic, contagious disease.” On no other 
hypothesis can observed facts be reconciled. The disease is now gen- 




Fig:. 338. Parasitic Fungi 
of Diphtheria. A, Micrococcus; 
B, Bacteria Termo. 



1212 


DISEASES AND THEIR TREATMENT. 


erally recognized as contagious, and is treated as such by all enlight¬ 
ened physicians. The certain knowledge of this fact is sufficiently 
useful to well repay all the labor and time which have been devoted 
to the investigation of this malady. The period of incubation is usu¬ 
ally two to eight days. 

We believe that diphtheria may very appropriately be included in 
the class of diseases latterly known as filth diseases, since the parasitic 
organisms by which it is probably caused are apparently identical 
with those which flourish in organic filth. There can be no doubt 
that in decomposing, putrefying organic matter the germs of this dis¬ 
ease are produced. One great source of such poisonous matters may 
load the air of a whole village with the poisonous germs, and thus 
expose to its ravages a whole community at once. 

Neglected cesspools, foul vaults, leaky sewers, damp, unventilated 
cellars, moldy walls, all these and every other source of organic decay 
are the favorite haunts of these destructive organisms ; and the only 
wonder is that cases of profound poisoning by these parasitic pests 
are not more common than they are. It is a mystery that so many 
escape. 

What are termed spontaneous cases of the disease, that is, those 
which originated without previous exposure to contagion from a per¬ 
son suffering from this affection, are not uncommon. These cases un¬ 
doubtedly originate from the production of germs by the usual sources 
of disease germs, which have already been indicated with sufficient 
definiteness. There are some who maintain that the spontaneous ori¬ 
gin of the disease is impossible; but so many cases have appeared in 
which no connection could be traced to a preceding case that it seems 
to us to be pretty clearly established that it is possible for the disease 
to arise otherwise than by contagion. A few months since, a lady 
from an Eastern State came under our care for treatment of the ef¬ 
fects of diphtheria, a very severe attack of which she had suffered. 
Upon inquiring into the history of the case we found it impossible to 
trace the disease to any other cause than exposure to the germs and 
spores of lower vegetable organisms. The house in which she was 
stopping was exceedingly damp, the walls, and even the door and 
window-casings being stained with green and brown mold. In per¬ 
sonal conversation with Dr. Snow, of Providence, Dr. E. L. Griffin, 
President of the State Board of Health of Wisconsin, Dr. Ezra M. 


DIPHTHERIA. 


1213 


Hunt, of New Jersey, Dr. R. C. Kedzie, President of the State Board 
of Health of Michigan, and various other distinguished sanitarians, 
we have learned of a large number of isolated cases of diphtheria 
which can be explained in no way satisfactorily but by the supposi¬ 
tion that the disease originated where it occurred. 

It is an observed fact that these germs, as well as those of other sorts, 
are remarkably tenacious of life. It is almost impossible to destroy 
them, either by boiling or by freezing, as they will endure both 
extremes for hours without losing their vitality. The germs will even 
retain their virulent properties for months. A house in which a 
family had suffered with diphtheria was vacated for several months, 
and on being again occupied, communicated the disease to its new 
inmates. 

Drinking water, milk, and even beer, have been proven to be the 
vehicles of typhoid poison in many instances. There is good reason to 
believe that diphtheria may be communicated in this manner also, the 
liquids named being contaminated by absorption of the emanations of 
prolific sources of germ poisons, or by direct contamination with the 
excretions of a diphtheritic patient. 

The common custom, most prevalent among the gentler sex, of 
rather indiscriminate kissing, bestowing especially frequent favors of 
this sort upon small children, cannot but be deprecated, at least during 
the prevalence of a diphtheria epidemic. There are on record numer¬ 
ous instances of the communication of most loathsome diseases through 

O 

the seemingly harmless medium of a kiss ; and there is a special 
danger respecting this disease which is well worthy of consideration. 
When an epidemic of diphtheria is prevalent, there are numerous cases, 
especially among adults, which are so very trivial in their general 
symptoms that the individual considers the difficulty nothing more 
than a cold, when he is really suffering with diphtheria, having distinct 
patches in his throat, and is, unconsciously, sowing broadcast the 
seeds of disease wherever he goes. Such a person calls to see a neigh¬ 
bor, and, as usual, smothers the baby with kisses, and, perhaps, also 
kisses the larger children. What is the result ? Very likely a week 
has not passed before the little one has diphtheria in a very severe 
form, and, possibly, dies. Thus an act intended as one of affection, 
becomes, literally, the embrace of death. This hint is worth thinking 
of. Life is too valuable to be sacrificed by a kiss. 


1214 


DISEASES AND THEIR TREATMENT. 


A few other means of contagion which we do not remember having 
seen mentioned are perhaps worthy of attention in a practical treatise 
like this. The disease may unquestionably be spread very rapidly by 
the use of a common drinking-cup at school or elsewhere. One of the 
worst cases of diphtheria we ever saw was in a little child who had 
taken the disease from a workman employed on the premises, by 
sipping water from the man’s drinking-cup. The man suffered but 
slightly; but the little boy narrowly escaped without serious injury 
after a very severe illness, with extensive production of the false 
membrane. Toys and even books may also become the medium for 
communicating the disease, as well as articles of clothing, and any¬ 
thing that may become infected by the breath or expectorations of 
the patient. 

Predisposing Causes. —Anything which impairs the vital func¬ 
tions will predispose to an attack of any febrile or other disease. We 
do not purpose to mention here all the numerous causes of impaired 
vitality, but only some of those especially active in rendering the 
system liable to the disease under consideration. 

, “ Taking cold ” is a process very difficult to describe exactly, but 
is so common an occurrence that the phrase is significant to every one. 
In general, when a person has taken a cold there is more or less con¬ 
gestion and irritation, if not actual inflammation, of the mucous 
membrane of the pharynx, and often of the nasal cavity also. 
•There is also usually present an increased secretion of these parts, 
and a tumid condition of the mucous membrane. This condition is 
particularly favorable, not only to the lodgment and development 
of the diphtheria germs, but to the development of the accompanying 
inflammation. 

Chronic inflammation, or catarrh of the pharynx, as well as nasal 
catarrh, is also a powerfully predisposing cause of diphtheritic inflam¬ 
mation of those parts. When the mucous membrane is already affected 
by an inflammatory process, the presence of the diphtheria organisms 
is all that is required to convert the morbid process into a diphtheritic 
inflammation. Consequently, those who are thus suffering should be 
exceedingly careful to avoid any sort of exposure to infection from 
the disease. Persons who have been subject to pharyngeal catarrh 
find the difficulty increased after an attack of diphtheria. 

Insanitary conditions, by impairing the vital forces, and thus 
diminishing the vital resistance of the tissues, will produce a strong 


DIPHTHERIA. 


1215 


predisposition to diphtheria. As already shown, all sources of decay 
may be sources of diphtheria poisoning, so that insanitary conditions 
are both directly and indirectly productive of this dangerous malady. 
This fact is well worthy of repeated emphasis when the larynx 
becomes affected, while adults may suffer the same amount of infec¬ 
tion and invasion of the throat and larynx without any serious inter¬ 
ruption of respiration. This is one cause for the greater fatality of 
the disease in children. 

The disease is often more prevalent in the cooler seasons of the 
year than in the summer, but probably this fact is wholly due to the 
increase of predisposing influences of other sorts at those times, as 
increased frequency of colds and nasal and pharyngeal catarrhs; less 
free circulation of air in dwelling-houses greatly increasing the viru¬ 
lence of the poison wherever it may chance to be at work, and simi¬ 
lar incidental causes. The disease has been known, in many instances, 
to extend its ravages in certain localities as widely and as fatally 
during the heat of summer as at any other season of the year. 

The observations compiled by Dr. H. B. Baker, Secretary of the 
State Board of Health of Michigan, show an increase in the frequency 
of the disease during July and August. This may be due to the fact 
that the great heat of those months encourages decomposition and the 
generation of germs in unusual abundance. 

Certain diseases, as whooping-cough, typhoid fever, and scarlatina, 
are liable to be followed by diphtheria, which is then known as second¬ 
ary diphtheria. Children under ten years of age show a marked suscep¬ 
tibility to this disease. Between the ages of two and four years the 
susceptibility is greatest. Children under one year of age are not 
likely to have the disease. Very young children seem to be almost 
wholly protected against it by their infancy. Children are not only 
the most liable to take the disease, but they are likely to suffer the 
most severely. Adults, except in cases of extreme old age, suffer 
much less from the most serious results of the disease on account of 
greater size of the larynx. In children the larynx is so small that 
suffocation is imminent. 

A mild or catarrhal form of the disease is very likely to be over¬ 
looked, or regarded as only an ordinary sore throat, even by physi¬ 
cians. Some physicians contend that the catarrhal form of diphtheria 
does not exist. We would call especial attention to the fact that epi¬ 
demics of diphtheria are always accompanied and followed by numerous 


1210 


DISEASES AND THEIR TREATMENT. 


cases of sore throat, tonsilitis, etc. Dr. Arthur Downs, in an able article 
in the American Medical Bi-Weekly, takes the position that these affec¬ 
tions at such times are “ essentially identical with undoubted diph¬ 
theria.” The reasons he gives for thus thinking are as follows:— 

“ 1. These sore throats prevail correlatively with the unquestioned 
cases of diphtheria. 2. Under favorable conditions they may commu¬ 
nicate the typical form of the disease. 3. The latter, also, in its turn, 
gives rise to these apparently trivial sore throats.” Dr. Downs adds: 
“ I can only repeat my conviction that, if the public generally, and 
medical men in particular, dropping the misleading name derived 
from a variable pathological appearance, would regard these concomi¬ 
tant ‘ sore throats ’ as essentially ‘ diphtheritic,’ a great point would he 
gained toward the isolation so necessary, but at present so difficult to 
obtain. It is to this end that Dr. Thursfield, whose experience is 
second to none, strenuously urges the disuse of the modern term ‘ diph¬ 
theria,’ and the resumption of the old name ‘ contagious cynanche.’ ” 

Paralysis and Other After Results .—Secondary affections of vari¬ 
ous sorts may follow any form of diphtheritic disease. The most com¬ 
mon of these is paralysis. Paralysis of the soft palate and pharynx 
is the most frequent; but the disease may involve any part or the 
whole of the muscular system. This affection usually comes on after 
the local disease is cured, even as late as the fifth or sixth week. It 
usually appears in the second or third week, beginning so insidiously 
as to be scarcely noticeable, and gradually increasing until fully de¬ 
veloped. The soft palate is first affected. The uvula hangs down, 
making it impossible to give the open sound of the vowel a. If the 
paralysis is of one side only, the uvula will be drawn over toward the 
healthy side. The patient finds difficulty in articulat on, in swallow¬ 
ing, and in expectoration. The speech is thin and nasal. The sounds 
of syllables run into each other, being sometimes almost unintelligible. 
The patient will sometimes complain of liquids getting into the nasal 
cavity in drinking. 

Paralysis of the muscles of the upper and lower extremities, of the 
larynx, of the face, the eye, the neck, trunk, and diaphragm, and of 
other parts also, occurs in many instances, especially in the more 
severe cases, appearing a week or two after convalescence begins. 

An important fact to be recollected is that one attack of diphtheria 
is no protection against subsequent attacks. Indeed, a person who 


DIPHTHERIA. 


1217 


has had diphtheria is often more susceptible to the poison, and more 
liable to infection than if he had not suffered from the disease, on 
account of the chronic inflammation of the throat which frequently 
follows the disease. 

Treatment. —The treatment of this disease has not usually been 
very satisfactory. The history of the various epidemics recorded shows 
a mortality of one in every two and one-half cases, or forty per cent in 
severe cases. In some epidemics, a rate of mortality as high as sixty 
and even seventy-five per cent has been reached. This makes the 
disease even more to be dreaded than small-pox or cholera. Even 
yellow fever scarcely exceeds it in fatality. 

Notwithstanding the discouraging outlook for the treatment of this 
disease, there is reason to hope that the adoption of improved methods 
of treatment may greatly lessen its present fatality. Constant im¬ 
provements are being made in the treatment of this as well as other 
diseases ; and it is to be hoped that in the near future its terrible rav¬ 
ages will be stayed by a better application of remedies in its manage¬ 
ment. The plan of treatment which we shall recommend is based on 
practical experience in a large number of cases. To our personal 
knowledge it has been employed in a very large number of cases with 
remarkable success, no death occurring when the treatment was ap¬ 
plied soon after the onset of the disease, and perseveringly employed. 
We have ourselves observed its efficiency in the treatment of fully 
one hundred cases, and have never seen a patient lost which was thus 
treated. Yet it is not claimed that this or any other plan is a specific. 
We expect sometime to meet with a fatal case, since no method of 
treatment can be infallible; but we are thoroughly convinced that a 
great improvement can be made on the ordinary mode of treating 
this disease. 

Local Treatment .—As already observed, diphtheria is primarily a 
local disease. This being the case, its local treatment becomes a mat¬ 
ter of the greatest consequence. Indeed, this portion of the treatment 
should receive first attention. This fact has been long recognized by 
one class of physicians, those who have believed the disease to be es¬ 
sentially local in character; and a great variety of remedies have 
been employed. Prominent among these has been the application of 
caustics of various sorts to the throat. Nitrate of silver, nitric acid, 
hydrochloric acid, iodine, caustic potash, pure carbolic acid, and va- 

77 


1218 


DISEASES AND THEIR TREATMENT. 


rious other caustics have been thus employed, but none so frequently 
or so extensively as the first named. 

After dwelling at some length upon the evil results of cauteriza¬ 
tion, Oertel remarks as follows :— 

“ There can be no doubt, then, that the unfavorable results which 
have been obtained on all sides by cauterizations, more or less energet¬ 
ically practiced, must put a stop to this procedure, even if, in its stead, 
we should be obliged to resort to its opposite, the purely expectant 
and symptomatic treatment.” * 

Another author, eminent both as a teacher and as a practitioner of 
medicine, says:— 

“ A large proportion, if not the great majority, of the practitioners 
of this country have been led to discontinue the causterizing and ir¬ 
ritating topical applications which have been heretofore in vogue.” j* 

“The use of a solution of nitrate of silver, and even of the solid 
stick, at one time met with considerable support, . . . but it is 
being gradually abandoned by those who have had experience of re¬ 
cent epidemics. ... In fact, the profession has given up the use 
of caustics altogether, being convinced that they rather aggravate than 
check the local process.” j 

Numerous other equally eminent names might be cited as opposed 
to the use of caustics in this malady, among whom are Profs. Jane way 
and Lusk, of Bellevue Hospital Medical College, New York. We have 
dwelt thus lengthily upon the subject of caustic treatment because 
this obsolete practice is still held to by physicians who have not had 
a large experience in the treatment of this disease, or who have be¬ 
come too thoroughly fossilized to be able to modify their ideas in ac¬ 
cordance with the most advanced information on this subject. 

Disinfectants .—All agents which are destructive to germs when 
used in a form which will not destroy the living tissues, are useful as 
local applications; but the best preparations are solutions of chlorine, or 
of some ot' its compounds, permanganate of potash, and carbolic acid. 
Strong alcohol lias proven very effective in many cases. These solu¬ 
tions must be used thoroughly and often as gargles. At least twice 
an hour the throat and mouth must be well rinsed. If the patient is 
too young to gargle well, or if the posterior part of the pharynx is 

* “ Ziemssen’s Cyclopedia of Medicine,” vol. i. p. 673. 

•f “ Practice of Medicine,” by Austin Flint. 

X “Diphtheria ; Its Nature and Treatment.”—Mackenzie. 





DIPHTHERIA. 


1219 


affected, the disinfecting lotion must be applied with a swab, syringe, 
or an atomizer. A swab can' be easily made by tying a small soft 
sponge or a strip of muslin to the end of a small stick or a lead pen¬ 
cil. In case the nasal cavity is invaded, the solution must be 
passed through the nose by a syringe. The following directions for 
the preparation of solutions which we have found to give exceedingly 
satisfactory results, may be useful to the unprofessional reader:— 

Chlorine Solutions, (a) One part of a freshly prepared solution of 
chlorine gas, or chlorinated soda, in three to five parts of pure water, 
according to the strength of the solution and the sensibility of the af¬ 
fected parts. Keep tightly corked, and wrap the bottle with a dark 
cloth or paper. 

(b) In a pint bottle place a teaspoonful of chlorate of potash. 
Drop in a half-teaspoonful of muriatic acid, cork the bottle quickly, 
and shake it gently in such a way as to bring the acid well in contact 
with the crystals. A greenish-yellow gas will appear in the bottle. 
After allowing the bottle to remain closed for ten or fifteen minutes, 
remove the stopper and pour in quickly half a teacupful of water. 
Stopper the bottle again immediately, and shake four or five minutes. 
Repeat the process until the bottle is two-thirds full. Use as strong 
as patient can bear without causing irritation of the mucous mem¬ 
brane. 

(c) Dissolve in a half pint of equal quantities of vinegar and water 
two heaping teaspoonfuls of common salt. Use very freely. 

Permanganate of Potash, one of the most useful of all disinfect¬ 
ants, is a good remedy in this disease. Dissolve in a pint of pure 
water, in a glass vessel, one-half dram of permanganate of potash or 
soda. Use of full strength or with an equal quantity of water. This 
solution will stain clothing upon which it happens to fall, as well as 
the skin. The stains are easily removed, however, by a weak solution 
of oxalic acid. 

Carbolic Acid. In a solution of one part of glycerine to three of 
water, dissolve pure carbolic acid in proportion of three to five drops 
to the ounce. We sometimes employ equal quantities of water and 
wine instead of the glycerine solution. To some patients the odor of 
carbolic acid is very disagreeable. For such, a solution containing 
double the quantity of the oil of thyme may be tried. 

If these solutions are carefully prepared and faithfully used from 
the outset of the disease, the results will be exceedingly satisfactory. 


1220 


DISEASES AND THEIR TREATMENT. 


They can be obtained of any druggist, and most of them can be 
readily prepared at home if the materials are at hand. It is impor¬ 
tant that every family should have the materials for at least one or two 
of the preparations constantly on hand in readiness for use without 
delay when occasion may require. 

There is no known means by which the growth and development 
of germs may be more efficiently checked than by the use of cold ap¬ 
plications which should be made to the throat externally, and the 
patient should be allowed to hold small bits of ice in the mouth and 
to swallow them occasionally. The cold applications must be made 
thoroughly enough to reduce the temperature of the throat as near 
the freezing point as the patient can endure without suffering, as 
otherwise it will do almost nothing toward modifying the morbid proc¬ 
ess. The best mode of accomplishing this is to apply to the throat 
compresses composed of several folds of linen or cotton—flannel may 
be used when necessary—between the folds of which are placed nu¬ 
merous small bits of ice, or small quantities of snow. The intensity of 
the cold may be regulated by the quantity of ice or snow used. When 
the patient cannot bear so great a degree of cold, compresses may be 
applied wrung out of cold or iced water. The compress must be large 
enough to cover the throat and extend well around the sides of the 
neck. 

To guard against too prolonged lowering of the temperature and 
circulation of the part affected, and to relieve pain, once an hour or 
two the cold compress should be removed and the throat fomented for 
ten or fifteen minutes. 

To alleviate the suffering, and the difficulty in breathing and swal¬ 
lowing, and to facilitate the removal of the false membrane, no single 
remedy is so efficient as the inhalation of hot vapor. It is not neces¬ 
sary that the vapor should be medicated, although chlorine, carbolic 
acid, or vinegar may be added with benefit. The important thing is 
that the vapor should be as hot as can be borne by the patient with¬ 
out discomfort. A temperature of 110° to 120° will be borne without 
difficulty by most patients. This remedy soon affords the patient so 
much relief that even little children manifest a very great apprecia¬ 
tion of it. The inhalation should be practiced once or twice an hour 
at first, and ten to fifteen minutes at a time. The warm vapor acts 
like a poultice in relieving the swelling, soreness, and spasm, and in 
facilitating the separation of the false membrane. In cases of croup- 


DIPHTHERIA. 


1221 


ous diphtheria, especially when the larynx is involved, this remedy is 
almost the sole reliance for saving the patient’s life. 

Different modes of applying this remedy have been suggested. It 
is of the greatest importance that it be done thoroughly. A very 
good plan is to attach a rubber tube to the nose of the tea-kettle. A 
tin tube can be readily made by a tinner if rubber cannot be obtained. 
As the steam is generating, let the patient hold one end of the tube to 
his mouth and inhale the warm vapor as freely as he can. 

Another very good plan is this: Place in an ordinary tea-pot a 
few good sized pieces of freshly burned lime. Pour on the lime a 
boiling hot mixture of vinegar and water. Close down the cover, and 
let the patient breathe the vapor through the nose. The lime and so- 
lu ion can be renewed as the cpiantity of vapor diminishes. This is a 
very good plan, if well carried out. The best of all arrangements for 
this object is an apparatus constructed for the purpose, a representa¬ 
tion of which may be seen in Fig. 274. Every family ought to have 
an apparatus of this sort ready for use. 

Iso attempts should ever be made at the forcible removal of the 
membrane. If it is torn off, the mucous membrane is left sore and 
often raw, or bare. When removed thus, another membrane is sure to 
form. 

The removal of the membranes may be effected by the inhalation 
of solutions of substances which have the power to dissolve them 
chemically. A moderately strong solution of lime-water, or of vine¬ 
gar, answers well for the purpose. An atomizing apparatus is re¬ 
quired. In cases of diphtheria of the larynx, this is a very important 
measure indeed, and must be used very thoroughly. 

When the membrane has ceased to form, hot fomentations should 
be assiduously applied to the throat in addition to the inhalation of 
warm vapor, which should be continuous at least fifteen minutes in 
each half hour. 

The administration of a light emetic is often advantageous in ef¬ 
fecting the dislodgment and expectoration of the membranes in cases 
in which the larynx is affected. A copious draught of lukewarm 
water is usually sufficient for the purpose; but if emesis does not fol¬ 
low its .repeated use, a small dose of sirup of ipecac or a teaspoonful 
of powdered alum or ground mustard, or some other simple emetic, 
followed by warm-water drinking, will be sure to induce vomiting. 


1222 


DISEASES AND THEIR TREATMENT. 


When the nasal cavity is obstructed by false membranes, thorough 
syringing should be resorted to, the solution consisting either of equal 
parts of good vinegar and warm water, or a solution of lime, five 
grains of freshly burned lime to the ounce of water. The syringing 
should be continued fifteen or twenty minutes at a time, and renewed 
at brief intervals until the membrane is softened and comes away in 
pieces. The face of the patient can be protected during the syring¬ 
ing so that the skin will be in no way unpleasantly affected. Usually 
very great relief may be given the patient by this measure. 

Deodorants, such as ozone, and other non-offensive agents, may be 
employed to great advantage with appropriate apparatus, for the pur¬ 
pose of purifying the air of the sick-room. Chloride of lime, carbolic 
acid, and sulphuric acid are too offensive and annoying to the patient 
to be used in this way with benefit. Probably no agent is so useful 
for this purpose as ozone, one of the most powerful disinfectants 
known. Ozone may be generated by any one of the means described 
on page, 803. 

General Treatment .—For subduing the fever no remedy equals 
water in antiphlogistic effects. In general, the febrile action accom¬ 
panying diphtheria does not rise so high as in most other febrile dis¬ 
eases ; yet this symptom is one of no small importance. The same 
means should be employed as elsewhere directed for fever, page 1182. 

Care must be taken continually in the use of water in this disease, 
that the patient has no tendency toward collapse. If the pulse begins 
to flag, is slow and feeble, while the skin is cool, no cooling applica¬ 
tions are necessary. Warm applications are needed. 

Care should be exercised that the limbs are kept warm. Cool 
compresses may be applied to the head, even the ice-cap when 
necessary. 

At the outset of the disease, when the patient often complains of 
chilly sensations, a warm blanket pack, given by wringing a woolen 
sheet out of water a little above blood heat, and wrapping it snugly 
about the patient, will be found a very excellent remedy, not only for 
the chilliness, but also for the muscular soreness, which is also a fre¬ 
quent symptom of the onset of the disease. 

Diarrhea, vomiting, and the other minor symptoms which often 
accompany this disease, are to be met by the usual remedies. For 
troublesome nosebleed, which not infrequently occurs when the nasal 


DIPHTHERIA . 


122:i 

cavity is affected, the nasal douche, employing a hot solution of chlo¬ 
rate of potash is the best remedy. 

For sustaining the patient, too great reliance is put by many upon 
the large use of iron and frequent feeding. We have never seen suf¬ 
ficient evidence of the utility of these methods to convince us of their 
efficiency. Others use stimulants in great quantities, which we be¬ 
lieve to be productive of more harm than good. What the patient- 
needs is nutrition, not stimulation. If overcrowded with food, and 
plied with aliment at too frequent intervals, the nutritive apparatus 
will have no time for the elaboration of food, and no time for rest. 
It will be always engaged in the preliminary work of digestion. The 
overworked stomach will be sure to fail up with indigestion, and the 
patient will really receive a much smaller amount of available nutri¬ 
tion than if food is taken in projDer quantities at intervals sufficiently 
far apart to allow time for digestion. 

Give the patient three meals a day at regular hours. Let the diet 
consist principally of oatmeal or barley gruel, with fruit and milk 
toast. If there is difficulty in swallowing solid food, let the patient 
have plenty of milk, beef soup or broth, at intervals of three to five 
hours. 

If the patient falls into a state of collapse, the pulse being slow 
and weak, the skin cool, the respirations rapid, with the other usual 
symptoms of that condition, the temporary use of stimulants may be 
useful. We have used electricity, both the galvanic and the faradic, 
in such conditions with excellent results. Dry heat is also a useful 
stimulant in such cases. All may be used in conjunction. 

Paralysis, and the other secondary affections which often follow 
this disease, should be treated on the general principles governing the 
treatment of those affections from whatever cause. In the case of 
paralysis, after the disease is fully developed, electricity should be em¬ 
ployed. This, with out-of-door exercise and time, will effect a cure in 
most cases. Tracheotomy is a surgical operation sometimes performed 
when the symptoms indicate imminent clanger of suffocation; but be¬ 
fore it is resorted to, the condition of the patient is already so hope¬ 
less that recovery rarely occurs. 


I 


1224 


DISEASES AND THEIR TREATMENT. 


GLANDERS-FARCY. 

SYMPTOMS.—High fever; chilliness; severe headache; pain in the muscles and 
joints; dark colored urine; profuse sweating ; discharge from the nose, at first watery, 
then profuse, viscid, and finally greenish ; eruption of the face, known as “ farcy-buds,” 
which become ulcers. 

This disease is generally contracted from horses. Both the mucous 
membrane and the skin are affected. The term glanders is applied to 
the disease when it affects the mucous membrane, and farcy when it 
affects chiefly the skin. Red, warty growths affect the skin when it 
makes its appearance, which are known as farcy-buds. In horses the 
disease frequently affects the lungs, when it very closely imitates what 
is termed “ heav v es,” the horse having a short, smothered cough, and be¬ 
ing' troubled with shortness of breath. Great care should be exercised 
to avoid exposure and contamination with the discharge from the nos¬ 
trils of horses, whether they are known to have glanders or not. Horses 
that are discovered to be subject to the disease should be at once de¬ 
stroyed, and everything which has been used about them should be thor¬ 
oughly disinfected by the burning of sulphur. The stalls, manger, har¬ 
ness, blanket, and everything employed about them should be thus treated. 

After the system has once become thoroughly infected with this dis¬ 
ease there is no known means by which a cure can be effected, though 
much can be done to palliate the patient’s condition and prolong his life. 
Great care should of course be taken to prevent communication of the 
disease to others. 

When a person in handling a horse suffering with glanders gets any 
of the matter into a crack of the skin or upon the raw surface, the same 
measures should be taken as have been recommended for the bite of a 
mad dog; that is, the parts should be cut out or cauterized, or 
measures should be employed. 

When the disease first makes its appearance in the nose, the nasal 
cavity should be washed but twice a day by means of the nasal douche, 
with a solution of chlorate of zinc in the proportion of two to six grains 
to the ounce of water. 

VARICELLA-CHICREN-POX-WIND-FOX. 

SYMPTOMS. — Eruption; slight fever; restlessness; some itching of the skin. 

This is a very mild disease. It generally occurs in epidemics, and 
is believed to be slightly contagious, being communicated, as is thought, 


MEASLES. 


1225 


by the breath. The first symptoms of the disease generally make 
their appearance about two weeks after exposure. 

The first symptom, and indeed the most prominent symptom of 
the disease, is the eruption, which consists first of roundish or 
irregular and slightly raised spots, being in size from that of a pin¬ 
head to a pea. In the center of these spots are little vesicles which 
are filled with a colored, watery fluid. The vesicles are generally very 
few in number, and never have the center depressed as in small-pox. 
When scratched, the eruption appeal's in successive crops during the 
first two or three days. By the sixth day, the vesicles become dry 
and covered with small brownish scabs. The disease is distinguished 
from both measles and small-pox, for which it may be mistaken, by 
the fact that the eruption either precedes or occurs at the same time 
with the beginning of the fever. 

Treatment. —As the disease is never fatal, the most that is re¬ 
quired is to keep the patient quiet, and if the fever is quite high, to 
cool the body by tepid sponging, or compresses applied to the bowels, 
changed as frequently as necessary. The patient should take a very 
light diet for a few days. 


MEAST.ES. 

SYMPTOMS .—FIRST STAGE : Chilliness, followed by symptoms of catarrh of the 
upper air-passages ; eyes red and tearful; hoarse and dry cough ; pain in the heac and 
limbs; disturbance of digestion; nausea, and sometimes vomiting; eyes sensitive to 
light; sometimes violent sneezing. 

SECOND STAGE: Increase of fever; in small children, sometimes convulsions; 
appearance of eruption about the mouth and eyes, which soon extends to the neck, chest, 
and over the lower part of the body ; itching and tingling of the skin. 

THIRD STAGE: Fever and eruption nearly disappear; spots covered with bran¬ 
like scales. 

Measles is an eruptive, contagious disease which may occur at any 
age, although children are most likely to be affected by it. It gener¬ 
ally occurs in epidemics, and is infectious as well as contagious. It 
begins much like a severe cold or influenza. After two to four days, 
the eruption appears, and consists of small, slightly elevated, reddish 
spots. When pressed with the finger, the red coloring disappears, and 
the spots soon run together, forming irregular clusters which often 
have a quarter-moon shape. The eruption feels rough to the finger. 
Occasionally little vesicles or blister-like spots are seen. The disease 


1220 


DISEASES AND THEIR TREATMENT. 


reaches its height upon the third day of the eruption. At the end of 
the fifth or sixth day, the spots become of a yellowish tinge, and there 
is a marked amelioration in all the symptoms. The catarrh gradu¬ 
ally subsides, and by the end of two weeks the patient is generally 
well. The period of incubation, or time which elapses after exposure 
before the symptoms of the disease make their appearance, is about 
one week. 

A form of the disease in which the spots are unusually dark, is 
known as black measles. The disease sometimes assumes a very ma¬ 
lignant form. Complications sometimes occur, the most dangerous of 
which are pneumonia and bronchitis. Inflammation of the eyes is 
also very common, the eyes sometimes remaining sore for a long time 
after the patient has recovered from the disease itself. Croup is an 
occasional and very fatal complication. Inflammation of the bowels 
sometimes occurs. 

Treatment. —When an epidemic of measles is prevailing, great 
care should be taken to prevent exposure to the disease. This cannot 
always-be done, as the popular dread of the disease is not sufficiently 
great to induce the entire isolation of persons who are suffering with 
it. Various experiments have been made which seem to indicate that 
a degree of protection may be afforded by inoculation with the virus 
of the disease, as was practiced as a means of protection from small¬ 
pox before the discovery of vaccination. Inoculation has never been 
extensively practiced, however, and is of doubtful propriety. 

In mild cases, very little treatment is required except such as is 
necessary to make the patient comfortable. Good nursing is much 
more important than medical treatment. If the eruption is slow in 
making its appearance, or is repelled after having once appeared, the 
patient should be given a warm blanket pack. The cold pack is most 
commonly used in Germany, but we have obtained equally good 
effects from the warm pack, and it is much more comfortable for the 
patient. 

When the fever rises high, it shovdd be subdued by tepid sponging, 
cool compresses to the abdomen, renewed as frequently as they become 
warm, and the cold enema. Cold packs and affusions, although in no 
degree dangerous, and highly recommended by many eminent physi¬ 
cians, are rarely required. Thomas, the eminent author of the article 
on measles in Ziemssen’s Encyclopedia, says in reference to the treat- 


MEASLES. 


1227 


ment of this disease, “ At present, cool baths, packings, and extensive 
cold compresses are the usual means employed. The advantages of a 
judiciously administered cold-water treatment in measles are, that it 
usually affords to the patient more speedily and safely than any other 
anti-febrile method, a certain sense of comfort; that it is not apt to 
weaken or otherwise act unfavorably; and that it shortens convales¬ 
cence by permitting the patient to expose himself to the fresh air sooner 
than under any other treatment.” Care should be employed in spong¬ 
ing the skin not to aggravate the irritation by rubbing. In drying 
the patient, the skin should be patted with a soft towel instead of be¬ 
ing rubbed. 

The old-fashioned plan of keeping the patient smothered beneath 
heavy blankets, and constantly in a state of perspiration, is wholly un¬ 
necessary, besides rendering the patient yery uncomfortable. The irri¬ 
tation of the skin, as well as the sensitiveness to cold, may be much 
relieved by inunction of the skin two or three times a day with vase¬ 
line, sweet oil, fresh butter, or any other good unguent. No fears what¬ 
ever need be entertained that the eruption will be driven in by 
cold applications, as there is no danger whatever from the application 
of cold water to the surface, except in the last stages of the disease, 
after the eruption has disappeared. No hesitation need be felt in ap¬ 
plying compresses and sponging to reduce the fever on account of 
the cough, as this will generally be found to be the best means for re¬ 
lief. Convulsions require* warm baths. Delirium and great restless¬ 
ness indicate congestion of the brain. A slight diarrhea need give no 
occasion for alarm. If this symptom becomes very troublesome, a 
cool enema should be employed two or three times a day. The occur¬ 
rence of pneumonia indicates the necessity for the employment of such 
measures as are elsewhere recommended for that disease. If croupy 
symptoms appear, ice compresses should be applied to the throat. If 
this does not secure relief, the throat and chest should be lightly 
sponged with water as hot as can be borne, care being taken not to 
burn the skin. Hot fomentations are also useful. If severe capillary 
bronchitis occurs, causing greatly diminished respiration, accompanied 
by high fever, Ziemssen recommends the use of the cold pack, which 
he thus describes: “ Several thicknesses of cloth wrung out of cold 
water are laid upon a piecg of flannel of sufficient width to protect the 
bedclothes from becoming wet. The naked patient is then placed 
upon the sheets and enveloped in them. Lively kicking and scream- 


1228 


DISEASES ANI) THEIR TREATMENT. 


ing ensue, giving depth and force to the previously superficial inspi¬ 
ration. By degrees the child becomes more quiet, and soon falls asleep. 
The cold wrappings are to be renewed every half-hour or so, until the 
temperature, pulse, and frequency of respiration are remarkably di¬ 
minished. This is usually the case in a couple of hours.” 

This treatment may seem quite heroic, but it is recommended by 
the highest medical authority in the world. With reference to the 
old sweating method of treatment, Prof. Thomas, previously quoted, 
remarks that “ although it has been given up by thousands in the 
treatment of measles, notwithstanding, prejudices are still entertained 
by many against the use of baths, even warm, on account of the sup¬ 
posed possibility of their exerting an unfavorable influence upon the 
cough and catarrh of the air-passages in general. It is to be hoped 
that the favorable results of hydrotherapeutics may overcome this 
prejudice, and that ventilation and cleanliness may in future epidem¬ 
ics gradually cause pneumonia and the other dangerous complications 
of measles, and, we think, their mortality, to sink to an unavoidable 
minimum.” 

The patient should be allowed cooling drinks, as much as desired. 
During the disease, a simple, but nutritious diet should be allowed, 
but stimulants of all kinds should be prohibited. Milk, fruits, and 
grains may be taken in sufficient quantity to satisfy the patient’s ap¬ 
petite, but meat should be prohibited. Good ventilation of the sick¬ 
room should be maintained throughout the disease, and care should 
be taken to prevent, so far as possible, the contraction of the disease 
by those who have never had it. 

After recovery, all the clothing employed about the patient, includ¬ 
ing bedding, should be thoroughly disinfected. The sick-room should 
first be disinfected by burning sulphur. It should afterward be thor¬ 
oughly scrubbed and aired. This is not so important as in some other 
infectious diseases, but will do no harm, and may be the means of 
preventing severe illness and death. 

GEBMAX MEASLES—RIBEOLA. 

This disease so closely resembles the preceding that its inde¬ 
pendent existence is not fully recognized by physicians. Persons not 
skilled in diagnosis would certainly be unable to distinguish it from 
measles. It is claimed, however, that an attack of rubeola affords no 


SCARLET FEVER. 


1220 


protection from measles, and vice versa. The treatment and general 
management of the disease is precisely the same as that of measles, 
however, and hence we need not give it further attention here. 

SC’ARLATIS.l-SCABLET FEVER. 

SYMPTOMS. — The disease begins with fever, lassitude, and headache; pains in the 
back; flushed face; coated tongue, nausea, or vomiting; in children, convulsions. On 
the second day, eruption appears in the form of numerous minute dots of a bright scarlet 
color, which rapidly run together and soon cover the whole body. At the end of five to 
nine days, the fever subsides, and the skin begins to peel off. 

This is an intensely contagious and infectious malady. Unfortu¬ 
nately, this fact has not been recognized until recently, and is not now 
as generally known as it should be. 

The first symptoms generally make their appearance from four to 
seven days after exposure. In addition to the symptoms mentioned 
above, one which is very characteristic pertains to the tongue, which 
presents what is termed a “ strawberry appearance ” after the white 
coating has begun to disappear, occasioned by the enlargement of the 
papillae, causing them to project through the white coating. 

The edges and tip of the tongue are usually red in all but mild 
cases of the disease. The throat is more or less affected with inflam¬ 
mation, sometimes at the beginning of the disease, at other times soon 
afterward. In severe cases, inflammation of the throat is the most 
serious symptom of the disease. The glands under the jaw become 
swollen and painful, and thick, tenacious mucus clogs the throat and 
larynx. The inflammation may often extend into the nose. Occa¬ 
sionally the inflamed glands suppurate. In some instances, the inflam¬ 
mation is so intense that it is rapidly fatal, when it is said to be 
malignant. 

Various complications are apt to occur in this disease, among the 
most common and serious of which are inflammation of the ears, 
meningitis, pleurisy, inflammation of the bowels, inflammation of the 
joints, and acute inflammation of the kidneys, giving rise to dropsy, 
which is one of the most fatal of all the infectious diseases in very 
young children. The mortality frequently reaches three-fourths of 
all who are attacked. The chances of life increase with the age of the 
patient. 



1230 


DISEASES AND THEIR TREATMENT. 


Treatment.—Undoubtedly the great fatality of this disease is in 
a large degree attributable to improper treatment or in neglecting to 
employ efficient measures with sufficient promptness. Mild cases re¬ 
quire only a simple diet, thorough ventilation, the use of tepid sponge 
baths, cool compresses to the bowels or wet-sheet packs, and perhaps 
cool enemas, and other measures which have been recommended for 
reducing the temperature in fever, together with good nursing. If 
the eruption is a little slow in making its appearance, or shows a 
tendency to recede after it has appeared, a warm full bath and spong¬ 
ing of the skin with hot water or hot and cold sponging, together 
with warm drinks, are the measures to be employed. When the other 
symptoms are very severe, ice compresses should be applied to the 
throat if possible, and the patient should be given pieces of ice to hold 
in the mouth. When the breath is very foul, a solution of chlorate of 
potash two or three drams to the pint, or permanganate of potash 
half a teaspoonful to the pint of water, may be used as a gargle. 
Carbolic acid in the proportion of a dram to a pint of warm water is 
also an excellent gargle. The other gargles recommended for diph¬ 
theria are also indicated in this disease when the inflammation is 
high, and swelling and irritation of the throat become excessive. 

Rheumatic symptoms in the joints require the use of the hot pack 
or the warm full bath. In a majority of cases the principal danger is 
from the high temperature. ' This should be vigorously combated by 
means of the cold pack, tepid sponging, and other measures already 
indicated. The popular idea that the eruption “ may be driven in ” 
by this method of treatment is a mistaken one. The same remarks 
made respecting water treatment in measles are equally applicable to 
this disease. When dropsy occiu-s from inflammation of the kidneys, 
the same treatment should be employed as elsewhere recommended 
for acute nephritis. The patient should be allowed no solid food, and 
if there are symptoms of suppression of urine, no food at all should be 
allowed for twelve hours. The patient should be induced to drink as 
much water as possible, and the skin should be kept in a state of 
active prespiration by means of warm packs. The use of meat should 
be strictly prohibited until the symptoms of kidney disease have 
passed away. If vigorous treatment is employed at the very begin¬ 
ning of the disease, death will rarely occur, notwithstanding the seri¬ 
ous character of this affection. 


BOSE HASH. 


1231 


Owing to the gravity of this disease and its infectious and contagious 
character, the most thorough measures should be taken to secure isola¬ 
tion of the patient during the attack and thorough disinfection of the 
sick-room. No one should be allowed to see the patient during his ill¬ 
ness except the nurses and those who are protected from the disease by 
having previously suffered from it. At the very beginning of the dis¬ 
ease, window curtains, carpets, and all other articles which may afford a 
hiding-place for the infectious germs, must be removed from the room 
to be occupied by the patient. All clothes used about the patient should 
be disinfected by dipping them into a solution of chloride or sulphate of 
zinc, or should be burned. It is a good plan to keep a tub two-thirds 
filled with a strong disinfecting solution (see section on “ Disinfection ”) 
into which cloths soiled by use about the patient may be thrown as soon 
as used. It should be recollected that the patient is more likely to com¬ 
municate the disease during the period of desquamation, when the skin 
is peeling off, than at any other time, as the little particles of dead 
skin which float in the air about the patient will communicate the dis¬ 
ease if inhaled. This danger may be in some degree obviated by giv¬ 
ing the patient frequent warm sponge baths during the attack, and dur¬ 
ing the period of desquamation anointing the skin with vaseline, sweet 
oil, lard, or some other unguent twice a day. 

When the patient has entirely recovered, the sick-room and every¬ 
thing contained in it, or which may have become infected by the con¬ 
tagious disease, should be disinfected by means of disinfecting lotions, 
and fumigations with burning sulphur or chlorine gas. Sulphur is 
much more convenient to use than chlorine, and is equally effective. 
The method of employing it is described on page 579. 


KOSi: CASH. 


This is an eruptive fever which is characterized by a red rash, 
which differs from the rash of both measles and scarlet fever, although 
bearing a resemblance to each. The fever runs high and the throat is 
often very seriously affected. Some cases are followed by dropsy, 
like scarlatina. It is thought to be a modification of either scarlet 
fever or measles, but it is not yet fully decided which. It is a mild 
disease, and rarely fatal. The treatment should be essentially the 
same as recommended for measles. 


1232 


DISEASES AND THEIR TREATMENT. 


CEBEBBO-SPI1AL ME^OCilTIS—SPOTTED FEVER. 

SYMPTOMS.—A violent chill, or chilliness; fever; great weakness; severe head¬ 
ache; vomiting excited by attempting to sit up ; stiffness of the neck ; head often drawn 
backward, and back bent; drowsiness or stupor; great restlessness; face pale or con¬ 
gested, expressive of great suffering ; sometimes entire loss of consciousness; delirium ; 
convulsions; skin very sensitive; pain produced by the slightest motion of the limbs; 
eruption beginning on the face with spots like cold sores, and gradually extending to the 
whole body ; eruption varied, some spots like flea bites, others like prickly heat or nettle 
stings, still others being simply red patches ; bowels irregular. 

This disease is infectious and probably also contagious. Much 
study has been bestowed upon the affection for the purpose of ascer¬ 
taining its origin. It is supposed by some that the disease is caused 
by the use of grain affected with ergot. For further information on 
this point, see page 408. It generally occurs in epidemics, but isolated 
cases are occasionally met with. During the war it prevailed with 
great intensity in some parts of this country. 

In some epidemics, the disease has a mild course, while in others it 
is rapidly fatal. The patient is generally taken down very suddenly 
when feeling as well as usual. Children under fifteen years of age 
are the most frequent victims, but all ages are subject to the disease. 
The predisposing causes are poor food, damp, overcrowded, badly ven¬ 
tilated, and filthy dwellings. The disease is often mistaken for 
typhoid or typhus fever, from which it sometimes can be distinguished 
only with great difficulty. 

Treatment. —This is sometimes a very fatal malady. The mor¬ 
tality in various epidemics has ranged from 30 to 70 per cent. The 
disease in some cases continues only a few days; in others it may 
be prolonged for several months, in spite of all treatment. The gen¬ 
eral fever should be combated by cool compresses and sponge baths. 
The special indication is for the application of ice by means of ice 
compresses, or better, ice packs to the head, neck, and spine. This 
generally relieves the headache and delirium, greatly diminishing, if it 
does not entirely relieve, the pain and contraction in the neck and 
back. Some recommend that the head should be shaven in order that 
it may be more easily and thoroughly cooled. The cold head pour is 
a very valuable remedy. In case the continuous application of cold 
to the head produces marked symptoms of depression, as indicated by 
slowness of the pulse, chilliness, etc., it should be discontinued for a 
time, or the patient should be placed in a warm blanket pack. 


SMALL - FOX. 


1233 


This measure is an excellent means oi‘ relieving the tenderness of 
the flesh and joints. If these measures of treatment are faithfully 
carried out from the very beginning of the disease, recovery may be 
looked for in the great majority of cases, and such unpleasant results 
as inflammation of the ears, resulting in deafness, and blindness from 
injury to the optic nerves, may be avoided. As remarked before, it 
is often difficult to distinguish between this disease and typhoid 
fever at the beginning, and hence it is well to begin active measures 
as.soon as the first symptoms make their appearance, even after the 
real nature of the disease cannot be made out with certainty, espe¬ 
cially when an epidemic of the disease is prevailing. The same pre¬ 
cautions to prevent the extension of the disease by thorough disinfec¬ 
tion should be observed during and after the attack as have been di¬ 
rected in respect to scarlet fever. 


SMALL-POX. 

SYMPTOMS. — Chill, or repeated chilliness, followed by fever continuing till eruption 
appears ; intense headache, and pain in the back ; vomiting; tongue coated, and no ap¬ 
petite ; offensive breath ; sometimes scarlet rash on abdomen and inside of thighs; sleep¬ 
lessness, sometimes delirium; at the end of the second to fourth day, eruption of small 
red pimples beginning on the face, neck, and wrists, then extending to the trunk and lower 
extremities; attended by severe burning and itching; mucous membrane of mouth and 
throat also show the eruption ; sore throat; fever, pain in the back and nausea subside 
when eruption appears; the spots enlarge, and about the eighth day become filled with 
matter, and center becomes depressed; skin now much swollen ; fever rises again ; after 
three or four days the pustules begin to dry, and in two or three days are covered with 
brown scabs, which gradually loosen; severe itching. 

This is one of the most dreaded of all infectious diseases. This is 
partly owing to the fact that it is one of the most contagious of all 
diseases of this class. The symptoms generally appear from ten days to 
two weeks after exposure. The characteristic features of the eruption 
are at first a shot-like feeling presented to the finger by the small red 
spots which appear first upon the back, breast, and arms, gradually ex¬ 
tending to the whole body. On the second day, the points become en¬ 
larged and elevated, forming dark red papules. By the third day, they 
become still further enlarged and filled with a milky fluid forming vesi¬ 
cles, which continue to enlarge for four or five days longer, becoming 
conical and as large as a pea. The point of the cone now becomes de¬ 
pressed, so that the vesicle shows a little hollow in the center and is said 
to be umbilicated. The fluid contained in them becomes thick and yel- 

f* i , 


1234 


DISEASES AND THEIR TREATMENT. 


low. This is termed the suppurative stage, which is attended by a re¬ 
turn of the fever which generally almost entirely subsides on the ap¬ 
pearance of the eruption. Sometimes the vesicles run together, forming 
large spots, when the disease is said to be confluent. This is the worst 
form of the disease. After recovery, most patients present a larger or 
smaller number of slight depressions in the skin known as pock-marks, 
due to the eruption. 

In the mild form of the disease known as varioloid, the fever is much 
lass intense, the eruption generally less profuse, and the vesicles do not 
matterate or become pustules. In the severe form of the disease pneu¬ 
monia, bronchitis, dysentery, and hemorrhage, are likely to occur in con¬ 
nection with the second fever, and are frequently the cause of death. 

Small-pox has been known as a dreaded disease for more than a thou¬ 
sand years, during which time it has frequently raged with great sever¬ 
ity in various countries. During the Middle Ages it must have been 
very common to have given rise to the proverb current at that time, 
“ From small-pox and love, but few remain free.” 

Cause. —Small-pox is undoubtedly the result of -infection of the 
system by a specific germ, the origin of which is still wrapped in mys¬ 
tery. Although it is known that the disease has existed for many cen¬ 
turies, it is not known how it originated, or what country is its native 
home. Experience with the disease has shown that bad food, uncleanly 
and unhygienic habits, intemperance, dissipation of all sorts, unsanitary 
conditions, and the crowding together of large numbers of people, greatly 
facilitate the propagation of the disease and increase its fatality. 

Dui'ing the last two decades of the last century the mortality from 
this disease constituted one-twelfth of the total mortality in Berlin. 
During the same century the mortality from small-pox amounted to 
30,000 persons annually. During the seventeenth and eighteenth cen¬ 
turies the deaths from this disease in England amounted to one-eleventh 
of the total mortality. According to the eminent Dr. Curschmann, of 
Berlin, from whose exhaustive article in Ziemssen’s Cyclopedia of Med¬ 
icine we cull these facts, small-pox came to be dreaded more than the 
plague. The disease continued its ravages notwithstanding the most 
earnest efforts of the most eminent physicians to stay its progress. It 
even penetrated to the jungles of Africa and the wilds of North and 
South America, where it carried off whole tribes of savages. 

Vaccination. —It was early observed that a person who had once 
had small-pox was not very liable to suffer from it a second time. Ex- 


SMALL - POX. 


1235 


periments made in China and India at a very early period showed 
that when the disease was induced by inoculation it was ntuch less 
severe than when contracted in the usual way. This led to the em¬ 
ployment in those countries of inoculation as a means of prevention 
of the disease. The same practice was introduced into Europe. It 
never became popular, however, from the fact that death not infre¬ 
quently occurred in consequence of inoculation, and it was found that 
the disease was as violent when communicated by those suffering from 
the effects of inoculation as when acquired in the usual way. 

In the eighteenth century, the supposed discovery was made in 
various parts of the world that a disease known as cow-pox was iden¬ 
tical with small-pox in human beings. According to Humboldt, this was 
known to the mountaineers of Mexico for many years before the time 
of Jenner. In Gloucestershire, England, there was a traditional belief 
that persons who had acquired cow-pox by milking cows affected with 
the disease were thereby protected from small-pox. This belief led 
Jenner to experiment with the virus of cow-pox, and his experiments 
resulted in the invention of vaccination as a means of protection from 
small-pox. 

The peculiarity of small-pox in lower animals is that its manifes¬ 
tation is chiefly local. In the cow, the pocks or pustules occur almost 
exclusively upon the udder and teats. In horses the disease is confined 
to the foot-joints. Sheep, goats, pigs, asses, dogs and monkeys are 
also subject to this disease. 

The evidence is very strong that the so-called small-pox of ani¬ 
mals is really the same disease as affects human beings, but the emi¬ 
nent authority quoted freely admits that the facts relied upon “ do not 
absolutely prove it.” Experience does seem to show, however, that in¬ 
oculation with the virus of cow-pox, or with that obtained from the 
same disease in other animals, will produce a disease supposed to be 
modified small-pox, which will to some extent exercise the same pre¬ 
ventive influence as the real disease itself. On this point the author 
before mentioned says :— 

“ In spite of the efforts of its opponents, no unprejudiced person 
at the present day can any longer be in doubt as to the efficacy and 
eminent practical value of vaccination. In countries where it has 
been introduced, and in a measure systematically carried out, the num¬ 
ber, the intensity, and the extent of small-pox epidemics have been no¬ 
tably diminished, and in a manner which of itself renders the idea of 


123G 


DISEASES AND THEIR TREATMENT. 


mere coincidence inadmissible. In this connection nothing could be 
more convincing than the exceedingly interesting and graphic account 
which Kussmaul gives of the mortality from variola, in Sweden, dur¬ 
ing a period of one hundred years, in the latter half of which vacci¬ 
nation was universally practiced. Moreover, for Germany, France, and 
England a somewhat similar decrease in the small-pox mortality might 
be demonstrated. If, notwithstanding all these proofs, we for the mo¬ 
ment entertain the supposition, improbable as .it is, that this decrease 
in the epidemics is a matter of mere accident, it at once falls to the 
ground as soon as we proceed further into detail. We see, first of all, 
that where vaccination is regularly practiced in very early life, the 
mortality of children from small-pox, instead of being as enormous as 
amongst those not vaccinated, is almost nil. We notice, further, that 
where the vaccination of adults, as for example in the Prussian army, 
is performed with regularity, epidemics of the disease no longer occur. 
With these facts before us, the idea of mere coincidence is out of the 
question. The trial of vaccination in the Prussian army has conclusively 
demonstrated the efficacy of the measure, to test which we have only 
to compare the relative immunity of soldiers during great epidemics 
of small-pox with the mortality in classes of the same general age in 
the civil community where vaccination is imperfectly carried out.” 

Dr. Alonzo Clarke, professor of the theory and practice of medi¬ 
cine in the College of Physicians and Surgeons in New York City, 
and one of the most eminent physicians of this country, in a lecture 
on small-pox reported in the Medical Record , remarked as fol¬ 
lows :— 

“ Vaccination has been generally practiced in civilized nations for 
seventy years; it took it about ten years to acquire general favor, 
since which time almost everybody has been vaccinated. And the 
history of the last seventy years gives us a longer duration of human 
life every succeeding ten years (a less number of deaths in proportion 
to the number living); and if everybody be vaccinated, and every¬ 
body’s life be made shorter by vaccination, you observe that this is 
Tather a singular commentary. Every ten years is marked as giving 
additional length to human life (diminishing the proportions of deaths 
every year to the number living). I know no other commentary that 
need be made in regard to it.” 

The above quotation presents a practical argument which those 
who oppose vaccination under any and all circumstances will find hard 


SMALL - POX. 


1237 


to meet unless they can show that the statement respecting the length 
of human life is incorrect. 

It is admitted by all who are in any degree conversant with the 
subject that vaccination is not free from disadvantages and even dan¬ 
gers. Experience shows very clearly that it affords immunity only for 
a period of eight to twelve yeai's. It is settled beyond question that 
it may be the means of communicating the worst and most loathsome 
diseases, when humanized lymph is employed, though this evil may be 
wholly avoided by the use of bovine virus, or that taken direct from 
a calf suffering with the disease. It appears to us that in all cases in 
which vaccination is employed, only the latter kind of virus should be 
used. AVe have never known of any injury arising from bovine virus, 
and think the evidence is very clear that small-pox may be prevented 
in this way by vaccination. 

In some countries, vaccination is made compulsory by law. This has 
aroused a vigorous opposition on the part of those who are opposed to 
the practice, and at the present time efforts are being made, especially 
in England and Scotland, to secure a repeal of the compulsory laws. 
The anti-vaccinators are not wholly unsustained in their efforts, quite a 
number of eminent English physicians having taken a stand in opposi¬ 
tion to the practice. Quite recently, a petition signed by several hundred 
physicians was presented to the English parliament, calling for the 
repeal of the obnoxious laws. 

It is probable that the benefits of vaccination on the one hand, and on 
the other its evils, have been considerably exaggerated. It may be con¬ 
sidered as thoroughly settled, however, that vaccination with human 
virus, that is, with scabs or matter taken from the sore produced in 
persons by vaccination, should be entirely discarded, and that bovine virus 
alone, if any, should be employed. 

Treatment. —The patient should be kept quiet in bed. Should be 
giyen but very little simple, easily digested food. He may be allowed to 
take cool or cold water, lemonade, etc., at pleasure. The sick-room 
should be well ventilated, and should be kept at a temperature of G0° 
or 65°. As the disease cannot be broken up or interrupted in its course 
by any known remedy, the thing to be aimed at in treatment is to cany 
the patient safely through the ordeal, and to aid nature in the process of 
eliminating the poison with which the system is struggling. The high 
fever which occurs previous to the eruption, should be relieved b} means 
of large cool compresses laid upon the body, and changed as often as they 


1238 


DISEASES AND THEIR TREATMENT. 


become warm, together with cool sponging. The wet-sheet pack re¬ 
newed every fifteen or twenty minutes until the fever is lessened, is a 
very efficient remedy. When the face is flushed and the headache 
severe, ice compresses or ice bags should be applied to the head. If there 
is much vomiting and retching, the patient should swallow small bits of 
ice. Ice compresses should also be applied about the neck when the 
throat symptoms are severe. 

The burning and itching of the eruption is best allayed by means 
of cold compresses, which should be changed as often as they become 
warm. If the odor is very bad, a lotion composed of an ounce of car¬ 
bolic acid, one-half pint of glycerine, and two pints of water, may be 
applied two or three times a day. The solution should be well shaken 
each time before it is used. It has the effect not only of correcting the 
bad odor, but also to allay itching of the skin. Frequent inunction of 
the whole body with vaseline or sweet oil should be practiced once or 
twice a day. 

When the scabs are formed, and are coming off, the patient should 
take a warm bath twice a day. Various plans have been adopted for 
the purpose of preventing “pitting.” One o'f the most common, and 
probably quite as effective as any, is that invented by the ancient 
Arabian physicians, which consists in letting out the contents of each 
pustule by a fine needle passed under the skin a little ways from the edge 
of each vesicle. Touching the pustules once or twice a day with tincture 
of iodine is also well recommended as a means for preventing pitting. 
Another remedy recommended by some physicians is keeping the pa¬ 
tient in the dark; but this plan is not a good one, as the deprivation 
of sunlight has a bad effect upon the course of the disease. Keeping the 
face covered with cotton well soaked in carron oil, a mixture of equal 
parts of olive oil and lime water, is also an excellent measure to prevent 
pitting; but the mixture has a bad odor, and is gummy and disagreeable. 
Covering the face with a thick layer of starch paste is excellent for the 
same purpose. None of these plans are entirely successful, however, aiid 
simple inunction of the skin, and the continuous application of the cold 
compresses, are probably as effective as any measures which can be em¬ 
ployed. Adding a little soda to the water in which the patient is bathed, 
will facilitate the separation of the hard crusts which form near the 
conclusion of the disease. 

The old-fashioned sweating process in which the patient was smoth¬ 
ered beneath heavy blankets, and kept in a highly heated apartment de- 


SMALL - POX. 


1239 


prived of fresh air, and still further heated by stimulating drinks, cannot be 
too strongly condemned. This method of treatment is a relic of the Dark 
Ages. There are no grounds 'whatever for fear that the eruption will be 
driven jn by the proper application of water, even at quite a low tem¬ 
perature. Care should be taken, however, that the patient is not ex¬ 
posed to drafts, although there is much less danger of taking cold even 
from this source than is generally supposed. 

Some years ago we saw an account of a patient who became delirious 
while undergoing treatment by the old-fashioned method, and while the 
attendant was absent for a few moments, threw himself out of the 
window into a snow-bank, where he was found by the attendant upon 
his return. The result, instead of being disastrous as might have been 
supposed would be the case, was in the highest degree favorable; the 
exposure to cold having the effect to diminish the fever in such a degree 
that the patient pretty soon became conscious, and made a good recovery. 

Some years ago, when practicing in connection with one of the dis¬ 
pensaries in New York City, we had ample opportunity for observing 
the tenacity with which the ignorant classes cling to the old idea that 
fresh air is fatal to small-pox. In one case, we found a little boy suffer¬ 
ing with the worst form of the disease, lying in a crib unconscious, 
dressed in the same clothing in winch he had been taken sick four or 
five days previous, and almost stifled with the foul and heated atmos¬ 
phere of the unventilated room. Notwithstanding our most earnest 
appeals for fresh air for the little patient, the parents insisted on keeping 
the windows and doors tightly closed. The little fellow survived, not¬ 
withstanding, but that he did not die was certainly not due to the ef¬ 
forts of his parents in his behalf. 

It is now pretty well settled that the disease cannot be averted nor 
mitigated by vaccination after exposure, even though it be performed 
immediatel 


1240 


DISEASES AND THEIR TREATMENT. 






























































































MALARIAL DISEASES. 


124-1 


MALARIAL DISEASES. 


Nearly all parts of the temperate and torrid zones are subject to 
some form of malarial disease. There is probably little doubt in the 
minds of any great number of intelligent physicians at the present day, 
that the cause of this class of affections is an organic germ of some 
kind, although its exact nature may not be as yet precisely made out. 
Malarial diseases occur with the greatest frequency in the vicinity of 
marshes and lands subject to overflow, as borders of lakes, low lands 
adjoining rivers, etc. The danger from these sources exist not while 
the soil is submerged, but while it is drying up. A great increase of 
frequency in the occurrence of malarial disease has also been observed 
to result from the breaking up of new land, and especially from the 
exposure of what is termed “made land,” in digging trenches for 
the purpose of laying water pipes, etc., in cities. In New York City, 
a large portion of which is built upon low marshy land which has 
been filled up since the city has been improved, it has been frequently 
observed that malarial diseases of various sorts quickly make their 
appearance upon streets in which deep trenches are being dug for the 
purpose of laying water and gas pipes. It would be a mistake to sup¬ 
pose that low marshy districts are the only ones affected. For some 
reason not well understood, certain localities which exist at quite high 
altitudes are also subject to malaria. For example, it is met with in 
the Apennines at a height of 1,100 feet, in the Pyrenees at an alti¬ 
tude of 5,000 feet, in the island of Ceylon, more than 6,000 feet above 
the level of the sea, and in Peru, at a height of 10,000 feet. It is 
found upon the high bluffs of Gibralter, as well as on the low plains 
of Italy. 

Not infrequently an individual may be exposed for months or 
even years to malaria without the appearance of any of the character¬ 
istic symptoms of malarial poisoning until the attack is excited by 
unusual fatigue, taking cold, exposure to fog or night air unusually 
heavily laden with the poison, or some similar cause. Experience 
seems to show that exposure to the poison when the stomach is 



1242 


DISEASES AND THEIR TREATMENT. 


empty, especially early in the morning or evening, is very likely to 
occasion an attack. Sleeping in damp beds, living in basements or 
cellars, or in houses densely shaded by tall trees, may render the sys¬ 
tem susceptible to the poison, and thus occasion an attack. There is 
also reason for thinking that the disease may be communicated 
through water. The author of the article on malarial disease in 
Ziemssen’s Encyclopedia, reports a case in which a body of soldiers 
who filled their canteens from a marshy district before embarking on 
a voyage, all suffered symptoms of malarial poisoning soon after 
drinking the water, the only ones of their number who escaped be¬ 
ing the few who purchased water from the sailors, none of whom 
were attacked. The disease may make its appearance in a few hours 
after a person has been exposed to the poison, as by a ride in the night 
air, or a boat ride in the evening or early morning ; or several weeks 
or months may elapse before the characteristic symptoms make their 
appearance. 

What Is Malaria? —This interesting question has been often 
asked, and frequently answered, though not in a manner which has 
been considered satisfactory. Profs. Klebs, of the University of 
Prague, and Tomassi-Crudeli, of the University of Rome, have to¬ 
gether conducted an investigation of the malaria of the Roman Cam- 
pagna, with the following conclusions:— 

1. The poison of malaria is met with in malarious localities even 
during the season when man does not contract malarial disease. 

2. At this season of the year the poison is found in the layers of 
the air in contact with the surface of the ground in malarial sections. 
The experimenters collected the poison by means of powerful blowers 
by which large quantities of air were forced against the surface of 
glass smeared with glycerine, in which the poison was caught and 
retained. • 

3. Large quantities of water hinder the development of malaria. 

4. The poison of malaria is a distinct organism, belonging to the 
genus bacillus. It is found in the soil of malarious regions in the 
form of minute spores. 

5. When the malarial spores or germs are received into the system 
of an animal, they develop into long filaments which separate by 
transverse division into shorter filaments, new spores being developed 
at the points of division. The organism has been named bacillus 
malaria. 


MALARIAL DISEASES. 


1243 


In experiments upon animals, the observers found that liquids 
containing the spores described, when injected into the blood of rab¬ 
bits, produced malarial fever possessing the characteristics of remittent 
fever in man, causing great enlargement of the spleen,—commonly 
known as ague-cake in human beings,—together with increase of col¬ 
oring matter in the spleen and other parts of the body. When the 
liquid was filtered before injection, so as to remove the spores, no such 
results were observed. 

The effects of this poison whatever it may be, are far more serious 
than is generally supposed. When a person has been long exposed to 
the influence of malaria, a sort of tolerance on the part of the system 
may be established, so that active symptoms of malarial poisoning 
may not appear, though the evil effects are still being wrought. 

Chronic Malarial Poisoning is a very common condition in 
malarial districts. It is generally indicated by a peculiar sallow 
complexion, general debility, dyspepsia, enlargement of the liver 
and spleen, greater or less degree of mental depression, and various 
other disturbances of the system. In malarious countries, almost 
every disease is complicated with the effects of this poison. The 
idea which many people have entertained that malaria in some way 
acts as a curative for consumption, has no foundation whatever. 

Protection f rom Malaria .—In view of the gravity of the disease, 
it is certainly important that proper measures should be taken to pro¬ 
tect the system against injuries from it so far as possible. The best 
means of accomplishing this is removal of the sources of the infection 
so far as possible. Marshes and low lands should be drained. This 
may be done either by ditches, or by the planting of rapidly growing 
trees. Among the most useful for this purpose is the Eucalyptus 
globulus. The common sun-flower has also been highly recommended 
by those who have employed it successfully for the same purpose. 
These trees and plants operate, not by destroying the poison, but by 
draining the damp soil from which it is generated and thus prevent¬ 
ing its formation. Individuals who are obliged to live in malarious 
districts, as are a laro’e share of the inhabitants of this countrv, should 
adopt every precaution possible to avoid all unnecessary exposure to 
the poison, and especially to avoid all known exciting causes. The 
old idea that whisky is a preventive of malarial poisoning has been 
long since exploded. 


1244 


DISEASE* AND THEIR TREATMENT. 


There is no doubt but that the malarial germs may be conveyed a 
considerable distance by winds. They are also conveyed by fogs. On 
account of the condition of the atmosphere during the night, it is prob¬ 
able that they are more abundant in the air at this time than during 
the light part of the day. There is also good reason to believe that 
the germs are most abundant in the lowest strata of the air. On this 
account, persons who live in the upper stories of buildings are less 
likely to suffer than those who occupy lower stories or basements. 

There is reason for believing that the susceptibility to malarial 
poisoning is considerably affected by diet. A simple, wholesome, nu¬ 
tritious diet fortifies the system against diseases of all kinds by in¬ 
creasing its general vigor. A diet of such a character as to induce an 
inactive state of the liver and a weak condition of the digestive organs, 
will be likely to encourage the contraction of malarial diseases. A 
few years ago, we met a gentleman who resides in a very malarious 
district in the State of Indiana, who has given much attention to the 
matter of dietetics. He informed us that although every other fam¬ 
ily in the town had suffered from malarial disease, himself and his 
entire family had escaped. They were of course exposed to the ma¬ 
larial germs as well as their neighbors, but by their careful dietary, 
their systems were fortified so as to be able to eliminate the poison 
without severe injury. 

HTERMITTE^T FEVER—ACilE-CHILLS AAD FEVER. 

SYMPTOMS .—COLD STAGE: Yawning; stretching of the limbs; headache; nau¬ 
sea, and perhaps vomiting; nails blue; goose-flesh ; thirst; shivering, or violent shak¬ 
ing; back-ache; pain in the calves of the legs; the chill lasts thirty minutes to three or 
four hours. 

HOT STAGE: Fever comes on gradually; headache increased; skin hot; some¬ 
times lasts three to twelve hours. 

SWEATING STAGE: The fever is followed by copious perspiration, during which 
headache and other symptoms subside ; the patient goes to sleep and wakes up feeling 
quite well, and remains so until the next attack. 

This is one of the most common of all the forms of malarial disease. 
The above symptoms may be varied more or less in different cases. For 
example, the chill may be lacking entirely, or it may be replaced by 
other nervous symptoms, as convulsions. This is most likely to occur 
in children. Cases in which the characteristic symptoms of the chill are 
not marked, are sometimes termed “ dumb ague.” Several varieties of 


INTERMITTENT FEVER AND AGUE-CHILLS. 


1245 


ague are described, according to the length of time between the parox¬ 
ysms. When the patient sutlers a dull attack, the disease is called 
quotidian. The form in which it occurs every other day is known as 
the tertian type. When the chill occurs every fourth day it is said to 
be of the quartan type. Cases occur which come on the fifth, sixth, 
and even the thirtieth day. Occasionally, double types occur. A per¬ 
son suffering with the double quotidian type has a paroxysm twice a 
day. In the double tertian type, the paroxysm may occur twice in the 
same day, or the two sets of paroxysms may occur on different days, 
when we have an imitation of the quotidian form. The quartan vari¬ 
ety, or “ four-day ague,” as it is sometimes termed, is often quite diffi¬ 
cult to cure. The paroxysms may occur at a regular hour on stated 
days, or an earlier or later hour. The chill nearly always occurs in 
the forenoon, or sometime between midnight and noon. The most ob¬ 
stinate form of the disease is that in which the paroxysms occur with 
great regularity. 

Among other symptoms may be noted a muddy complexion, coated 
tongue, often yellowish dinginess of the white of the eyes, enlargement 
of the spleen, and tenderness of the spleen and liver. When the spleen 
becomes greatly enlarged, as is often the case with chronic malarial af¬ 
fections, it is known as “ ague-cake.” 

Treatment. —When possible, the patient should remove to a non- 
malaricns locality. This is particularly important in severe cases, be¬ 
cause one attack does not insure a person against a second, but rather 
increases the liability. In selecting a residence, care should be taken to 
avoid settling in a malarious locality. The popular remedy for malarial 
diseases of all kinds is quinine. The efficacy of this drug in checking 
the paroxysms of ague is undoubted. When given in sufficient quan¬ 
tity, the disease may be interrupted in almost every case. Unfortunately, 
however, the drug does not seem to possess the power to neutralize the 
poison, since the paroxsyms often show an obstinate tendency to re¬ 
turn when interrupted in this way without further treatment. In order 
to effect a permanent cure, it is necessary that the patient should be sub¬ 
jected to thorough eliminative treatment. Packs, hot-water baths, 
vapor baths, and Turkish and Russian baths, are the best for this pur¬ 
pose. When these are first employed, the paroxysms can be interrupted 
by the use of a very small dose of quinine, when a very large one would 
otherwise have been required ; and if the eliminative treatment is con¬ 
tinued for a time, the disease is much less likely to return. 


1246 


DISEASES AND THEIR TREATMENT. 


Although quinine is supposed to be the great specific for malaria and 
almost indispensable for the successful treatment of the disease, we have 
repeatedly demonstrated the fact that the disease is curable without it, 
and in fact without any drug whatever. Our usual plan of treating 
ague is this : If a patient comes to us suffering with chills every other 
day, having already passed through his regular paroxysm, we begin 
treatment with a wet-sheet pack about five or six o’clock in the after¬ 
noon. The patient is kept in the pack an hour, and is allowed to sweat 
profusely. The pack is followed by a wet-sheet rub, after which a thor¬ 
ough fomentation is applied over the liver, spleen, and bowels. A copi¬ 
ous enema is administered if the bowels are constipated, and the pa¬ 
tient is put to bed with a wet girdle about him. The next day the hot¬ 
air or vapor bath is administered about ten o’clock A. M., being followed 
by another wet-sheet rub and a fomentation over the liver. In the 
evening, a wet-sheet pack with a fomentation is again administered and 
the patient is put to bed without the abdominal girdle, well wrapped in 
woolen sheets and wearing a woolen night-dress. Having ascertained 
the time at which the next chill will occur, the attendant should be on 
hand at least two hours before the paroxysm is expected to begin, so as 
to be ready in case any irregularity should occur. The patient is now 
carefully observed, his temperature being taken every half-hour with 
the thermometer. The first indication of the approach of the chill is a 
slight rise in temperature. Instead of being 984° it will be 99° or 100°; 
and as the time approaches for the paroxysm to begin, the temperature 
rises to 1001°, 101°, or even higher. When the attendant finds his tem¬ 
perature rising, he uses the thermometer every fifteen minutes, and if he 
finds it rising quite rapidly he knows that the chill may be expected 
very soon, and at once begins vigorous efforts to forestall it. Having 
previously got in readiness six or eight bottles filled with hot water, or 
an equal number of hot bricks, hot sand bags, or other means for ap¬ 
plying dry heat, he promptly brings these into requisition, placing a hot 
jug or brick at the patient’s stomach, two at his back, others at his feet, 
the sides of the limbs, at the hands, etc. The blankets are carefully 
tucked about his shoulders, extra covering is put on, and he is allowed 
to drink freely of hot drinks of some kind. We never advise ginger or 
pepper tea, as they are irritating to the stomach. In nine cases out of 
ten, the result of this procedure will be to convert the impending chill 
into a vigorous sweat. This can be accomplished in nearly e^ery case 
when the patient lias had the proper preliminary treatment, and when 


INTERMITTENT FEVER AND AGUE-CHILLS. 


124-7 


the treatment is properly managed. It is necessary to exercise some 
care in its use however. It is important to get the patient sweating at 
just about the time when the chill would have begun. It is also neces¬ 
sary to use great care that the patient is not kept in the dry pack too 
long, since there is usually some fever even if the chill is escaped. 

As soon as it is apparent that all danger of chilling is'past, which 
will not be for an hour and a half to two hours at least, the patient 
should be wiped with dry, warm flannels, under the bedclothes, without 
exposmg him to the air, and the hot jugs or bricks should be one by 
one removed and the extra covering gradually taken off, and thus he 
should be by degrees cooled off*. A very slight exposure at this time, 
or drinking cold water, will bring on the chill. In some cases, a very 
slight chill will occur even in spite of these precautions, but one or two 
repetitions of the dry pack will almost invariably succeed. When we 
have been able to carry out this plan of treatment thoroughly, we have 
rarely failed in effecting a cure, even without the use of any other rem¬ 
edies. One fall we treated thirty or forty cases of malarial fever, and 
succeeded in effecting a cure in every case without other remedies than 
the eliminative treatment and the dry pack. Treatment must be vigor¬ 
ous and thorough. 

The success of this plan of treating the disease depends upon the 
elimination of the poison from the system through the skin. The 
method of elimination for which nature manifests a decided preference 
is indicated by the profuse perspiration to which the disease is subject. 
If the eliminative treatment is continued until the brown coating disap¬ 
pears from the tongue, the disagreeable taste from the mouth, the dingy 
hue from the white of the eye, and the peculiar sallowness from the skiiy 
the dry pack will be almost certainly successful. In fact, we believe 
that anv measure which will interrupt the paroxysm may be considered 
as curative after proper eliminative treatment has removed the greater 
part of the malarial poison from the system. 

From observation and careful study of quite a large number of 
cases, we have come to the conclusion that it is possible for the parox¬ 
ysm to be fastened upon the system as a habit, so that it may continue 
long after the poison by which it was first excited has been eliminated 
from the body. When this is the case, anything which will interrupt 
the periodicity or regularity of the paroxysm will effect a cure. The 
same principles are illustrated in the treatment of other diseases; for 
example, holding the breath to stop hiccough, and practicing gymnas- 


1248 


DISEASES AND THEIR TREATMENT. 


tics to relieve St. Vitus’s dance. We have often known persons to be 
cured of ague by the adoption of some peculiar mode of treatment, such 
as efoinsf down stairs on the hands and knees head foremost, and simi- 
lar apparently absurd measures. We knew of a case in which a 
man cured his daughter of ague by burying her in the ground, leav¬ 
ing only the head uncovered, for three hours, at about the time when 
the chill was expected. Another illustration of the effects of habit 
upon the system is in the frequency with which relapses occur months, 
or even years after a person has removed from a malarious district, 
and has apparently entirely recovered from the effects of malarial 
poisoning. 

These relapses can always be traced to taking cold or some indis¬ 
cretion which occasions a slight fever, the occurrence of which is suf¬ 
ficient provocation to develop the tendency to periodicity existing in 
the system. We have long entertained serious doubts whether this 
form of intermittent fever is really malarial in character except in 
the sense that it is due to a habit impressed upon the system by previ¬ 
ous malarial influences. Cases of this kind are always very mild, and 
yield promptly to the use of the dry pack. 

Treatment During the Paroxysm. —The dry pack is also the 
best measure'to diminish the severity of the chill during the par¬ 
oxysm. Care should be taken not to keep the patient heated up too 
long, as otherwise the fever may be greatly increased in intensity. In 
one case, which we had under observation, the patient fell asleep in 
the chill, and the nurse neglected to remove the hot bricks by which 
he was surrounded, so that when he was aroused, after a short time, it 
was discovered that he had become delirious. The withdrawal of the 
hot bricks, and employment of cold applications to the head, and cold 
sponging, soon reduced the heat and relieved the delirium, however, 
and the patient made a good recovery. 

After the fever is fully established, so that the patient has ceased 
to complain of chilly sensations, the amount of covering should be 
gradually diminished ; and when the fever has reached its height, tepid 
sponge baths or a wet-hand rubbing should be repeated every few min¬ 
utes while the head is kept cool by cloths wrung out of cold or ice 
water. Care should be taken not to begin sponging too soon, or to 
cool the patient too rapidly, as the chill may return. During the 
sweating stage the patient should be wiped off with dry flannels; and 


INTERMITTENT FEVER AND AGUE-CHILLS. 


1249 


at its conclusion, the wet clothing should be exchanged for clean and 
dry garments, and a tepid sponge hath should be administered. 

Cold affusions and the application of ice to the spine has been re¬ 
commended as a means of interrupting the chill. We consider these 
as harsh measures, and never employ them. In fact, about all the 
treatment that is of any benefit during the paroxysm is such as will 
render the patient more comfortable at the time. Nausea may be 
relieved by hot drinks during the cold stage, and sips of cold water, 
or bits of ice, during the hot stage. If the patient has eaten a meal 
just before the beginning of the chill, it is generally best, when there 
is very much nausea, to assist him to empty his stomach by giving a 
warm water emetic. 

The diet of an ague patient should be very plain and simple. But¬ 
ter, meat, sugar, rich sauces, and all kinds of pastry, should be entirely 
avoided. The diet should consist almost entirely of such food as oat¬ 
meal gruel, graham or Indian-meal gruel, rice, baked apples, stewed 
prunes, figs, and grapes. This diet should be continued until the 
tongue clears off, and then the patient should return to his usual diet 
very slowly. The free use of lemons is generally advantageous 
though, as a general rule, patients become tired of them after using 
them freely for three or four days. As before remarked, the disease 
may be successfully treated without the use of quinine or any other 
drug, vet many cases occur in which small doses of quinine, chinoi- 
dine, or some other preparation of Peruvian bark, may be advanta¬ 
geously employed. We have no faith in the popular notion that it is 
better to allow the disease to “ wear itself out.” In many cases the 
patient becomes worn out instead of the disease. Consumption and 
various other constitutional disorders may arise from the long contin¬ 
uance of ague or any other severe malarial affection. If the disease 
does not yield within a week to the measures before described, it will 
invariably yield to a very small dose of quinine, or double the quan¬ 
tity of chinoidine. We rarely find it necessary to use more than four 
to six grains of either. After the patient has had a week s course of 
treatment, as before described, the remedy should be taken during the 
sweating stage at the conclusion of the paroxysm, or four or five hours 
before the time the next paroxysm is expected. Although we think 
it best that the use of quinine should be avoided so far as it can be, 
on account of its disturbing effect upon the digestive organs, we do 
not think there is ground for the popular belief that it injures ihe 
79 


1250 


DISEASES AND THEIR TREATMENT. 


bones or very frequently gives rise to permanent or serious injury of 
any sort. There is, however, some ground for the belief that cases of 
deafness are occasionally produced by its use in large doses. 

Whenever its employment is thought necessary to interrupt the 
paroxysms of ague, it should not be relied upon as a curative measure, 
but should be followed by thorough eliminative treatment, such as 
packs, full baths, hot-air baths, and fomentations over the liver and 
spleen. Daily fomentations over the liver should be continued for sev¬ 
eral weeks, if necessary. In case the spleen and liver are considerably 
congested and enlarged, as indicated by pain and tenderness on pressure 
in the region of these organs, local hot and cold applications should be 
employed daily until the symptoms disappear, and the patient should 
wear for several weeks a moist abdominal bandage at night, replacing 
it by a dry flannel during the day. In bad cases, the moist bandage 
should be worn night and day, being discontinued during the day¬ 
time as soon as evidences of irritation of the skin make their ap¬ 
pearance. 

AGUE-CAKE. 

What is known as ague cake, consists of an enlargement of the 
spleen, which is one of the results of chronic malarial poisoning. The 
spleen is also enlarged in typhoid fever, typhus fever, and various other 
febrile affections. When a person has been long exposed to the influence 
of malaria, the spleen frequently becomes so greatly enlarged that it 
can be felt beneath the lower ribs on the left side. In some cases, 
enormous enlargement occurs, the organ becoming fifteen or twenty 
times its natural size. The result of enlargement of the spleen is, in 
some cases, a condition which has been previously described as lukse- 
mia, a condition in which there is a very great increase in the number 
of white blood corpuscles, more or less pain and tenderness which is 
increased on taking a deep breath, on coughing, sneezing, or produc¬ 
ing pressure over the organ, and an unpleasant feeling of weight in the 
left side in consequence of the enlargement of the spleen. 

Enlargement or congestion of the liver also generally exists in 
these cases, as indicated by symptoms on the right side similar to those 
already described. 

Treatment. —Mosler, Hartz, and other eminent European physi¬ 
cians recommend very highly the use of the cold douche over the region 


CONGESTIVE CHILLS. 


1251 


of the spleen, applied from one to three minutes daily. Dry packs are 
also a favorite and a very successful remedy in Germany. In India, * 
the disease is frequently treated by means of puncturing with long 
needles. The treatment is said to be successful. Our plan of treatment 
is the alternate hot and cold spray or douche, applied over the spleen, gen¬ 
eral derivative baths, as packs and hot-water baths employed two or 
three times a week, and the local use of electricity. When electricity is 
used, the two poles should be applied over the spleen in such a way as 
to pass the current through it. Enlargement of the spleen is said to be 
curable by the use of the various preparations of Peruvian bark. A 
remedy to which attention has been more recently called, is the use of 
the milky juice of the unripe fruit of the pawpaw tree. A teaspoonful of 
the juice is mixed with sugar and divided into three parts, which are 
taken at equal intervals during the day. Electricity used in the manner 
described is very highly recommended by eminent Austrian physicians, 
and we consider it of great value. 

PERNICIOUS INTERMITTENT FEVER—CONGESTIVE CHIEFS. 

SYMPTOMS.—Chill longer and harder than usual; convulsions ; epilepsy; tetanus; 
symptoms resembling hydrophobia or delirium, followed by stupor ending with sweat; 
coldness after sweating stage ; hemorrhage from bowels ; congestion of the lungs; pneu¬ 
monia ; pleurisy ; symptoms resembling those of cholera ; jaundice. 

Pernicious intermittent fever appears in a variety of forms, most 
of the symptoms of which are included in the above list, though all are 
not found in any one case. The paroxysm may occur suddenly, without 
warning, or may be preceded by one or more paroxysms of the usual 
character, or may b$ gradually developed, the symptoms becoming more 
severe with each successive paroxysm. The disease is most frequent in 
the Southern States and in hot countries. According to Dr. Drake, it 
has prevailed at various times along the southern shore of Lake Michi¬ 
gan, between Chicago and the mouth of the St. Joseph River, and at 
various points on the shores of Lakes Erie and Huron. 

Treatment. —This is a very dangerous malady, and requires prompt 
and vigorous treatment. The same measures which have been prescribed 
for ordinary intermittent fever should be employed,but with still greater 
vigor. During the chill, the most energetic measures should be em¬ 
ployed to excite action in the surface of the body by hot and dry appli¬ 
cations and vigorous rubbing of the skin with hot flannels. The inhala- 


1252 


DISEASES AND THEIR TREATMENT. 


tion of a few drops of nitrite of amyl or of chloroform we have found ef¬ 
fective in interrupting a congestive chill. Pilocarpin, a remedy which 
possesses the power of producing copious perspiration, is also useful for the 
same purpose. Symptoms relating to the stomach and bowels should be 
treated as when the same symptoms occur under other circumstances. Ice, 
and cold compresses should be applied to .the head with great thorough¬ 
ness, and ice should also be applied to the spine as soon as the chilly sen¬ 
sations have passed away. Some recommend the application of ice to 
the spine during the chill, and there is no doubt that good may be ac¬ 
complished by this measure if properly used. If employed, care should 
be taken to confine the application to a narrow strip j ust over the spinal 
column. There is less danger of chilling the patient than is generally 
supposed if this precaution is observed. 

After the attack, everything should be done to fortify the patient 
against a succeeding paroxysm, which is very likely to be more severe 
than the first, if it occurs. When possible, a physician should be called 
in. A full dose of quinine will diminish the liability of a second attack 
and may thus be of benefit. The same precaution should be observed to 
prevent the occurrence of another paroxysm as has been described in the 
treatment of ordinary intermittent fever for preventing the chill. 

REMITTENT OK BILIOUS FEVER. 

SYMPTOMS.—Chill followed by fever and sweating; no complete intermission ; all 
the other symptoms of ague or intermittent fever are present; sometimes jaundice; re¬ 
mittent fever may either follow, or terminate in, ague. 

The principal distinction between this disease and intermittent fever 
is the fact that in remittent fever there is no complete intermission in 
which the patient is entirely free from fever. At the commencement of 
the attack the remission is generally quite marked, sometimes lasting a 
few hours and occasionally extending to one or two days, often corre¬ 
sponding exactly to the intermission in ague. After a few days the fe¬ 
ver generally becomes continuous. 

Remittent fever may generally be distinguished from typhoid fever 
by the fact that the temperature is usually the highest in the morn¬ 
ing. The opposite of which is true in typhoid and typhus fevers. 

Typho-Malarial Fever. —Remittent fever may be complicated with 
typhoid fever, constituting a disease known as typho-malarial fever. 
When typhoid fever occurs in malarious districts, it is very likely to be 


MASKED INTERMITTENTS. 


1253 


complicated with malarial. In these cases, either element may be the 
predominating- one. 

Tvpho-malarial fever is not, as many suppose, malarial fever in which 
the typhoid condition occurs, but an actual union of the two diseases. 
Under the name of “ camp fever,” typhoid-malarial fever was very prev¬ 
alent in some portions of the army during the war. This form of fever, 
is much more grave than either simple malarial or typhoid fever. It Is 
distinguished from either remittent or typhoid, by the fact that it pre¬ 
sents a mixture of the symptoms characteristic of each. 

Treatment. —The treatment of this disease consists in the employ¬ 
ment of packs, full baths, hot-air baths, and other vigorous elimina¬ 
tive measures. 

The wet-sheet pack is really one of the most valuable remedies 
which can be used in this class of diseases. It may be adminis¬ 
tered either during the fever or during the remission. The object of 
its employment during the fever, is for the purpose of reducing the 
temperature. During the remission, it may be used as an eliminative. 
The hot-air or vapor bath should be used during the remission. When 
the fever is high, the patient should be sponged frequently with tepid 
water, and tepid compresses changed as frequently as necessary should 
be applied to the abdomen. Constipation of the bowels may be re¬ 
lieved by daily enemas. When the fever is high, cold enemas, retained 
as long as possible, may be employed with advantage. The same di¬ 
rections respecting diet, medicine, etc., which have been given in de¬ 
scribing treatment for intermittent fever, should be followed in the 
treatment of this disease. 

MASKEI> INTERMITTENT*. 

Persons living 1 in malarious countries often suffer from obscure dif- 
Acuities, the cause of which may be usually mistaken for some other 
than the real one. In many cases it will be found that the real cause 
of a large number of peculiar affections, especially functional disturb¬ 
ances of the nervous system, is chronic malarial poisoning. One 
of the most frequent diseases produced by malaria is neuralgia, 
which most often affects the face. The intercostal and sciatic nerves 
are also frequently affected. Occasionally the heart is the seat of the 
neuralgic pain, in which case the patient suffers with very severe at¬ 
tacks of palpitation, difficulty in breathing, accompanied by a severe 
pain affecting the left side, and extending down the left arm. 


1254 


DISEASES AND Til Dili TREATMENT. 


In these attacks, the skin is generally cold and the patient may 
become unconscious. Paralysis of sensation, loss of hearing or speech, 
and other nervous disturbances may be produced by malaria. Sleep¬ 
lessness at night and drowsiness during the day-time are other symp¬ 
toms of chronic malarial poisoning. Jaundice, arising from an inactive 
condition of the liver produced by the poisonous influence of malaria, 
is very frequent. 

Enlargement of the spleen, which almost always results from re¬ 
peated attacks of malarial disease, sometimes gives rise to a peculiar 
coloration of all the internal organs. In a case of this kind, the con¬ 
dition of which we had the opportunity of examining, post-mortem , 
the brain was so deeply colored as to present a purplish appearance. 
When due to malaria, these affections are generally periodical in char¬ 
acter. For example, malarial neuralgia will be likely to occur at a 
regular hour each day, as does the chill in ague. 

Treatment. —The only cure for this class of affections is elimination 
of the malarial poison from the system. Sometimes the patient is too 
weak to bear sufficiently vigorous treatment. In this case the employ¬ 
ment of quinine is advisable. In some cases, the disease seems to re¬ 
sist all ordinary remedies, so long as the patient remains in a malarial 
locality, and it then becomes necessary to advise him to remove to a 
less malarious location. Fomentations, electricity, massage, and such 
other measures as are elsewhere recommended for the various condi¬ 
tions included under this head when produced from other causes, are 
equally applicable as means of palliation or of aiding in recovery. 


i 


DISEASES OF TEE SKIN AND HAIR. 


1255 


DISEASES OF THE SKIN AND HAIR 


The anatomy, physiology, and general hygiene of the skin, have 
been considered in the first part of this work, and hence space need 
not be devoted to this part of the subject in this connection. 

Many popular errors are prevalent respecting diseases of the skin, 
which originated at a time when the diseases of this portion of the 
body were very little understood. Modern investigations in this 
branch of medicine, through the aid of the microscope, have brought 
to light many interesting facts which explain much that was formerly 
very obscure. Among the numerous popular errors with reference to 
this class of diseases, one of the most common is the idea that all erup¬ 
tions of the skin indicate an obscure state of the blood. While it is 
true that many diseases arise from morbid conditions of the blood, 
this is by no means universally the case; in fact, the majority of skin 
diseases are distinctly local in character. The skin is not affected by 
morbid conditions of the blood more frequently than are the liver 
kidneys, lungs, nervous system, and other parts of the body. Another 
error which prevails very extensively, is the idea that internal mala¬ 
dies of a serious character are likely to occur from the “ striking in ” of 
eruptions of the skin. We have frequently been asked by patients suff¬ 
ering from troublesome eruptions, whether it would be safe to cure the 
disease, the impression being that the eruption would occur upon the 
mucous membrane of the stomach, bowels, or lungs ; or that some serious 
internal malady would be developed. The opinion of those who have 
had the largest experience in the treatment of skin diseases is decidedly 
opposed to this theory; and it is probable that there is no more reason 
for thinking that an internal malady might be developed by curing a 
disease of the skin, than the contrary; namely, that disease of the 
skin might result from curing some internal disorder. It is probable 
that in most, if not all, of the instances in which internal disease seems 
to result from disorders or eruptions of the skin, the relation of the 
two is wholly due to coincidence. 

Causes. —The skin is by no means so simple an organ as it appears, 
being, in fact, composed of several sets of organs closely combined. 



1256 


DISEASES AND TIIEIB TREATMENT. 


From its complicated structure, and its location upon the exterior of the 
body, the skin is very liable to inj ury from the influence of external ir¬ 
ritants of various sorts, such as friction from clothing or scratching; the 
the extremes of heat and cold; the action of acids or alkalies; various 
vegetable irritants, as vegetable and animal parasites. Persons engaged 
in certain trades, as brick-layers, masons, millers, bakers, cooks, wash¬ 
erwomen, etc., are liable to particular forms of skin disease, originating 
from the action of various irritants produced by these occupations. 

Next in importance as a cause of skin disease, should be mentioned 
errors in diet. Indigestion is indeed a very frequent accompaniment of 
skin disease; and in a large number of cases, it is possible to trace the 
causative relation. The use of pastry, the excessive use of fats and 
sugar, fried food, condiments, as mustard, spices, and particularly 
pepper, excessive use of meat, and the use of tea, coffee, tobacco, 
and alcoholic liquors, are very frequent causes of certain forms of skin 
disease. '• Skin affections are also, in many cases, dependent upon other 
diseases, as diseases of the kidneys, inactivity of the liver, constipation 
of the bowels, scrofula, and syphilis. The skin erruptions which occur 
in eruptive fevers and which are the result of the disturbance of the sys¬ 
tem by a specific poison, need not be here considered, as the eruption it¬ 
self is but a minor symptom of the disea.se. The popular notion of at¬ 
tributing every disease to a “ humor,” as remarked above, is without 
scientific foundation. 

General Principles of Treatment. —The same kind of treat¬ 
ment is not effective for all kinds of skin diseases. The fashionable cus¬ 
tom of resorting to mineral springs for the cure of skin diseases, no mat¬ 
ter what may be their nature, is most unphilosophical, and results in 
great injury, since, while a few cases may be benefited, a much larger 
number are rendered worse. The same is true of any other single 
method of treatment. No matter how successful a remedy may be in 
one case, in another it may be as signally unsuccessful. Diseases of a 
purely local character require a purely local treatment. Those in which 
the general system is chiefly at fault, may require only general treat¬ 
ment, or both general and local; for example, parasitic diseases are 
cured by local remedies alone. The same is true of such diseases as 
warts, corns, dandruff, ulcers, or cancer of the skin. Scrofulous erup¬ 
tions, and affections of the skin due to morbid conditions of the blood 
or of the internal organs, require only general treatment. Local in- 


DISEASES OF TEE SKIN AND HAIR. 


1257 


flammations, hemorrhages, nervous affections, and diseases of the glands 
of the skin, require both general and local treatment, in some cases one 
and in other cases the other being most important. 

Local remedies chiefly consist of cleansing, stimulating, or astringent 
lotions, unguents, or of applications capable of destroying vegetable 
or animal parasites. General measures consist of remedies calculated to 
improve the condition of the blood and the nervous system. Proper 
diet is of the first importance, especially in chronic cases. With 
reference to this class of diseases, Dr. Bulkley of New York, one 
of the best American authors on diseases of the skin, remarks 
that in order to accomplish a cure, “ we cannot simply apply a wash or 
a salve, or take a few drops of this or that remedy.” Thorough atten¬ 
tion must be given to strict compliance with all h}gienic rules. Pickles, 
salads, deserts, etc., rich sauces, pepper, mustard, and all stimulating con¬ 
diments, fats, fried food, excessive quantities of meat, excessive use of 
sugar, and all articles of a stimulating and clogging nature, must be 
wholly avoided. Tea, coffee, tobacco, beer, ale, wine, cider, and all alcoholic 
beverages, narcotics and stimulants of all sorts must be scrupulously 
avoided. The diet must be very plain and simple. Excessive quantity 
is equally as bad as errors in quality. Thorough mastication of food is 
very impoi'tant. A fruit and grain diet is much to be preferred to a 
mixed diet. Milk and eggs can be taken in moderation with a little flesh. 
The less meat the patient uses, the better. Errol’s of diet on the part of 
the mother, is one of the most frequent causes of skin diseases in infants. 
The children of mothers who are in the habit of drinking ale, porter, 
beer and wine, or taking large quantities of tea or coffee, are very likely 
to suffer with skin diseases. 

Some diseases, particularly nettle-rash, or urticaria, are caused by par¬ 
ticular articles of food, such as oysters, clams, lobsters, mushrooms, bana¬ 
nas, strawberries, pine-apples, etc. In these cases, it is, of course, neces¬ 
sary to discover the obnoxious article and discontinue it. General baths, 
such as vapor baths, Turkish, or hot-air baths, and the warm full bath, 
are of immense advantage in the treatment of many forms of skin dis¬ 
ease. The various ointments, lotions', cosmetics, etc., which are sold in 
drug stores are generally worthless and frequently worse than useless. 
We have met cases in which exceedingly harmful results had followed 
the use of these preparations. 

Various Forms of Eruptions, etc.—The following are the princi¬ 
pal forms of the several elementary lesions of the skin: 


1258 


DISEASES AND TIIEIB TREATMENT. 


Maculae, or Stains, are simply spots of a round or irregular form, 
not elevated above the surface of the skin. They may be due to de¬ 
posits of blood or the coloring matter of the blood, to fungus growth, or 
to deposits of bile pigment. 

Redness, or Hypercemia .—Due to distention of the arteries or veins. 
When arterial in character, the difficulty disappears upon pressure with 
the finger. It may be accompanied by violent itching and rising of 
temperature; is frequently followed by peeling off of the scarfskin. 
It may be occasioned by local irritation, by changes in the blood, or by 
nervous excitement. 

Wheels consist of reddish swellings with pale centers, which form 
rapidly and disappear as suddenly. The nettle sting is a perfect illus¬ 
tration of the wheel. They are accompanied by heat and severe ting¬ 
ling. Wheels are characteristic of nettle-rash. 

Papula, or pimples, are small hard or raised formations in the skin. 

Vesicles are little sacs in the skin, containing serous fluid or sweat. 

Blebs, or bailee, are simply large vesicles. 

Pustules are small, round vesicles containing pus. 

Squamce, or scales, are detached portions of the thin scarfskin or 
epithelial scales. 

Tubercles are little solid elevations of the skin, larger than papules. 

Nodules are solid masses, larger than tubercles and smaller than 
cherries. Masses larger than cherries are called tumors. 

Scabs or crusts are dry, hard masses of pus and dead skin. 

Excoriation is a removal of the epidermis, exposing, but not in¬ 
juring, the outer skin. 

Ulceration is an excavation made in the skin by disease. It usually 
leaves a scar upon healing. 

Fissure is a crack in the skin, such as occurs on the knuckles when 
the hands are chapped. 

A Cicatrix, or scar, is a growth of hard fibrous tissue, occupying the 
place of the healthy tissue, which has been removed by injury or disease. 
Some diseases of the skin exhibit only one form of eruption, while in 
others, a number of elementary lesions occur, either at the same time, 
or in successive stages of the disease. In some cases, also, two or more 
different diseases of the skin occur at the same time. 


ERYTHEMA. 


1259 


ERTTHE1L4. 

This is a disease of the skin characterized by redness, due to active 
congestion or inflammation. It may occur as a simple diffused redness, 
produced by cold, friction from wearing flannel clothes, the rubbing to¬ 
gether of two folds of skin, etc. It also accompanies various other dis¬ 
eases of the skin. Sometimes, in addition to the diffused redness, an 
eruption of small red pimples occurs on the face or hands. The diges¬ 
tion is often disturbed, and the patient feels slightly feverish. The 
duration of the disease is usually very short, little treatment beinor re - 
quired. A form of the affection with which young children sometimes 
suffer, known as “ chafing ” or intertrigo, is sometimes quite obstinate. 

Treatment. —The diet should be very light and unstimulatinor. A 
warm bath should be taken daily, and the affected parts should be cov¬ 
ered with a thin cloth moistened with tepid water, or with a solution of 
saleratus, a teaspoonful to a pint of water. Intertrigo in young chil¬ 
dren, generally arises from indigestion and want of cleanliness. The 
parts should be thoroughly cleansed with tepid water and eastile soap 
twice a day. They should be afterward bathed with cold water and 
anointed with vaseline or olive oil. Browned flour, corn-meal, starch, 
and various other powders are frequently used. Starch and powdered 
lycopodium seed are frequently used, though it Is doubtful whether 
they are really required. Very often, fuller’s earth may also be useful. 

. When powders are employed they should be dusted upon the parts after 
they have been cleansed and dried. 

URTICARIA—NETTLE-RASH—HIVES. 

This is an eruption characterized by wheels like those caused by 
nettle stings, each consisting of a white raised spot in the center of a red 
patch. This eruption is peculiar for the suddenness with which it ap¬ 
pears and disappears. The first symptom is severe itching of the skin, 
after which the eruption suddenly appears. It Is generally the result 
of errors in diet, particularly the use of unwholesome or any irritating 
food. Canned meats are very likely to occasion it. In some persons, it 
is occasioned by eating certain fruits, as strawberries, raspberries, pine¬ 
apples, etc. It may result from simple indigestion. Bites of bugs, flies, 
lice, etc., should also be mentioned as a cause. The eruption may disap¬ 
pear within two or three hours, or may last two or three days, or longer. 


1260 


DISEASES AND THEIR TREATMENT. 


Chronic nettle-rash is generally clue to dyspepsia or disorder of the 
liver. It is often a very troublesome affection. 

Treatment. —If the patient is suffering with indigestion, a warm 
emetic may be indicated. The itching and burning may be relieved by ap¬ 
plying to the skin a lotion made by dissolving a teaspoonful of saleratus 
or soda in a goblet of water. Vinegar or equal parts of alcohol and 
water, may also be used. Sponging the surface of the body with very 
hot water will generally give relief. Urticaria from bites of insects, or 
nettle stings, in which the pain is often very severe, may be relieved 
by the application of a mixture of chloroform and glycerine, in the pro-- 
portion of one of the former to four of the latter. 

HEAT-RASH. 

This is a form of eruption which often occurs during the intense 
heat of summer. It may consist of simply a diffused redness of the 
parts exposed to the direct action of the sun’s rays, usually termed sun¬ 
burn, or in the form of an eruption of minute, red pimples, known as 
“ prickly heat” eruption, or “ heat eruption,” which is accompanied by 
severe prickling and itching. Sunburn, when severe, is followed by 
peeling off of the epidermis. Prickly heat generally disappears within 
a few hours, but may continue some time and become a real eczema. 

Treatment.—For sunburn, cool the affected parts with tepid com¬ 
presses, and anoint well with vaseline. Persons subject to prickly 
heat should wear silk or cotton next the surface, and should avoid over¬ 
heating themselves by over exertion during hot weather. Irritation of 
the eruption may be relieved by cool baths or cool sponging, bathing the 
surface with soda or saleratus water, a teaspoonful to the pint. After 
bathing, the surface should be dried by a gentle patting with a fluffy 
towel and without rubbing. 

ERYSIPELAS—ST. AMIIOWS FIRE. 

This an inflammation of the skin. It generally affects the head and 
face. It is attended by quite a high fever, which usually begins with 
a chill. The patient is usually weak and prostrated. The skin is 
swollen, red, and glossy. There is a burning sensation in the affected 
parts, and it is tender to the touch. The disease extends quite rapidly, 
in some cases involving the whole scalp and head. Sometimes the dis¬ 
ease extends into the tissues beneath the skin. Blisters and abscesses 


ERYSIPELAS—ST. ANTHONYS FIRE. 


1261 


sometimes form, in severe cases. Sometimes the fever rises so hi oh. as 

© 

to occasion delirium. When the scalp is severely affected, the hair gen¬ 
erally fajls out, but soon grows again after recovery. The disease is 
somewhat contagious ; one attack seems to render a person more liable 
to another. 

Erysipelas is very likely to occur in wounds and after surgical op¬ 
erations, especially in hospitals. In these cases the results are often very 
ser ious. The disease is more common in warm weather than in cold. 
It generally lasts about a week, terminating in the peeling off of the 
epidermis. The form of the disease, known as “ wandering erysipelas ” 
generally attacks the extremities first, rapidly extending toward the 
trunk. In this form of the affection, the fever is generally moderate, 
but it is likely to continue for several months. 

Treatment. —This is quite a serious affection; and unless the at¬ 
tack- is a very slight one indeed, a physician should be consulted at 
once. When the skin is very tense, hot, and painful, cold, and even 
ice compresses, should be applied. There is no danger, as many peo¬ 
ple suppose, of causing the disease to “ strike in.” Cases in which 
the disease extends to the membranes of the brain are not due to the 
eruption being repelled from the surface. The disappearance of the 
eruption is the result of the occurrence of internal inflammation. The 
old plan of treatment by encircling the diseased part with a dark 
line by burning with lunar caustic, is of about equal efficacy 
with the so-called “ sympathetic remedies ” often employed for this 
affection. Nothing equals the application of cold for reducing the 
local inflammation. It should be carefully watched, however, and as 
soon as the color of the affected part becomes bluish purple, or a 
bright scarlet, the cold should be exchanged for hot fomentations in 
order to excite activity of the blood-vessels and overcome the slug¬ 
gishness of the circulation of the affected part. The cranberry poul¬ 
tice, and various other similar remedies, possess no special value in 
this disease.* The general fever by which it is always accompanied, 
and which sometimes runs very high, should be treated by means of 
cool compresses, cool sponging, wet-sheet packs, and cool enemas. 
The diet of the patient should be very light, and unstimulating in 
character. 

CHILBLAINS. 

This is an inflammation of the skin, produced by exposure to severe 


1262 


DISEASES AND THEIR TREATMENT. 


cold. It affects parts which have been partially frozen. The feet are 
most likely to be affected. The skin is red and somewhat swollen, espe¬ 
cially in the vicinity of the joints. There is also much burning and 
itching. In some cases the skin becomes cracked or ulcerated. 

Treatment.— For the cure of severe cases of chilblain, a hot and 
cold foot bath should be taken every night just before retiring Car¬ 
bolic-acid ointment, containing ten drops of carbolic acid to the ounce of 
vaseline or lard, is a very excellent remedy. Cabbage leaves are also a 
remedy which enjoys some reputation. Another remedy highly recom¬ 
mended is gently rubbing the affected parts with lemon juice just before 
gfoinsr to bed. When ulceration occurs, carbolic-acid ointment should be 

o o 

applied with pledgets of cotton. 

COLD OR FETED SORES-HERPES. 

In this disease, the eruption consists of patches of little blisters or ves¬ 
icles, each of which is surrounded by a little ring of inflamed tissue. The 
eruption is most always accompanied by some fever and pain, or smarting, 
in the affected part. They do not generally burst, but dry up, the con¬ 
tents first becoming milky and then a crust forming which falls off in a 
few days, leaving a reddish stain in the skin. A very common form of 
the disease is known as shingles, in which the eruption occurs on one side 
of the trunk, following the course of the nerve. The technical name of 
this form of the disease is Herpes Zoster. It is supposed to be due to an 
inflammation of a nerve of sensation. There is a popular notion that 
if this disease encircles the body, the patient will die. This idea is incor¬ 
rect, however. The disease never does encircle the body from the fact 
that the nerve extends only to the central line, though cases have oc¬ 
curred in which corresponding nerves on opposite sides of the body were 
affected, making a seeming exception to the general rule. The result is 
no more serious in these cases, however, than in others. A still more 
common form of herpes is met in the little sores which form about the 
mouth in fevers, known as cold-sores or fever-blisters. A similar erup¬ 
tion sometimes occurs about the genital organs. 

Treatment. —The parts should be protected from irritation by the 
friction of clothing, and rubbing should be particularly avoided, as the 
disease will be greatly aggravated thereb} r , in some cases, scars be¬ 
ing formed. An attack of shingles, if not properly treated, sometimes 
leaves a neuralgia behind it. The affected parts should be dusted with 


SALT RHEUM, MOIST TETTER, AND SO ALL. 


12G3 


powdered starch, or smeared with carbolic-acid ointment,—ten drops of 
carbolic acid to the ounce of vaseline,—covered with cotton or wool. The 
neuralgia, which sometimes continues afterward, should be treated by 
fomentations. The formation of cold-sores can generally be checked 
by the application of spirits of camphor to each blister. 


ECZEMA-SALT.RHEUM-MOIST TETTER-SCALE. 

I 

This is one of the most common of all skin diseases. It occurs in a 
great variety of forms and at all ages, and is said to constitute one-half 
of all the cases of skin disease. It is not contagious, as many persons 
suppose. Its most common location is on the face and scalp, and about 
the thighs. When the eruption first begins, it appears as a number of 
red points, papules, or vesicles, which run together, and, after being 
scratched, exude moisture. It is accompanied by great itching. After 
a time, scabs are formed. In infancy, the scalp is most often affected, 
when the disease is termed scald-head, or milk-crust. The eruption is 
also sometimes called tooth-rash, in children, when it occurs during the 
teething period. When the eruption has a free liquid discharge, it is 
sometimes called moist or running tetter. A mild form of eczema some¬ 
times attacks infants in hot weather, when it is termed heat eruption, 
red-gown, or red-gum. What is known as chafing, or intertrigo, is also 
a form of eczema. Eczema is frequently seen in children in the form of 
raw, red patches, with a moist surface, situated within the bend of the 
elbow or knees, or behind the ears. Washerwoman’s, brick-layer’s, gro¬ 
cer’s and baker’s itch are different forms of eczema in which the hands 
are affected, the cause being the various irritants to which the hands of 
these different classes of persons are exposed. Eczema of the legs is often 
observed in old people and persons of sedentary habits. An exceedingly 
aggravating form of the disease is frequently due to varicose veins, and 
sometimes gives rise to ulcers. In acute cases, the eruption generally 
presents a red surface, exuding moisture. In chronic cases, the skin is 
thickened and covered with dry, hard scales. It is almost always ac¬ 
companied in all its stages and forms by fearful itching. It is some¬ 
times difficult to detect, owing to the fact that it may resemble almost 
any other disease of the skin. 

Eczema may be produced by anything which irritates the skin, 
poison dye-stuffs, colored underclothing, stockings, hat linings, ar¬ 
nica, poison ivy, friction of the skin, uncleanliness, especially in chil¬ 
dren whose diapers are not properly changed. Irritating soap, ex- 


12G4 


DISEASES AND THEIR TREATMENT. 


posure to heat and cold, and various other changes, are frequent causes 
of eczema. Dyspepsia, rheumatism, gout, scrofula, and any disease 
which greatly deteriorates the general health, may produce eczema. 
We have frequently seen very severe cases of eczema produced by 
wearing the moist abdominal bandage for too long a time. 

Treatment. —The disease is often very chronic and frequently ob¬ 
stinate It is, of course, necessary that all the known causes of the 
disease be first removed. When there are external irritants brought 
in connection with the skin by the daily occupation, either the patient 
must rest from labor or engage in some other business. It is very im¬ 
portant to give attention to the general health, especially the improve¬ 
ment of the digestion, and the removal of gouty, rheumatic, or scrofu¬ 
lous conditions of the system. These conditions have been fully de¬ 
scribed elsewhere. In many cases a course of thorough eliminative 
treatment is required to get the blood in a good condition. The irri¬ 
tation or itching may often be relieved by bathing the parts in salera- 
tus water, a drachm to the pint, by carbolic-acid ointment, ten drops 
to the ounce of vaseline, by bran tea, starch powder, and other sooth¬ 
ing applications. A very excellent lotion for use in these cases is the 
following: Two drachms of carbonate of soda, one ounce glycerine, 
seven ounces of bran tea or slippery-elm water. In eczema of the 
head, it is often necessary to cut the hair close to the scalp. When 
thick scabs are formed, they may be removed after softening with 
vaseline or sweet oil, which should be freely applied at night and cov¬ 
ered with a cloth held in place by a night-cap or bandage. 

PSORIASIS—DRY TETTER. 

This disease may affect persons of all ages but is most common in 
adults. The eruption consists in separate spots or patches of a dull 
red color covered with an abundance of white, branny scales which 
fall off readily. The separate patches are generally circular. The 
eruption occurs most often on the outer surfaces of the joints, as of 
the elbow, the front of the leg, or knee, being by this particular, dis¬ 
tinguished from eczema, which most often affects the inner surfaces, 
as the bends of the elbows and knees. It often attacks the scalp, 
Avhen it is the cause of dandruff. Psoriasis also differs from eczema in 
that it seldom presents a moist surface and rarely itches. The disease 
is sometimes very chronic, lasting many months or even years. The 


FACE PIMPLES. 


1265 


causes of the affection are somewhat obscure. It is probably generally 
due to disorders of nutrition. It is not in the slightest degree con¬ 
tagious. Sometimes eczema and psoriasis are combined. 

Treatment. —This disease is sometimes very difficult to cure, and 
it has a stubborn tendency to return. Very frequently, just as one 
set of spots have disappeared, another crop will make their appearance. 
Especial attention should be given to the general health. The diet 
should be simple, but unstimulating; it should be mostly fruits and 
grains. The patient should take frequent baths. We have seen some 
cases very greatly benefited by the vapor bath. Packs are also use¬ 
ful, but the skin should not be excited too greatly, especially when the 
eruption has a very reddish appearance. Carbolic-acid ointment and 
tar soap are of some value as local applications. Bathing the affected 
parts with saleratus or soda water is also useful. 

ACAE—FACE PIMPLES. 

This is a very common affection, especially between the ages of 
fifteen and thirty years. The seat of the disease is the sebaceous fol¬ 
licles or oil-glands of the skin. The eruption consists in pimples scat¬ 
tered over the face, neck, back, and chest. The inflammation of each 
follicle may run its course in three or four days, or may continue for 
a week or ten days. When the inflamed part becomes indurated, or 
hardened, the inflammation may continue for several weeks. Several 
varieties of the disease are observed ; that just described is the most 
common. Another form consists in obstruction of the outlets of 
the sebaceous glands, producing what are sometimes termed flesh- 
worms, or grubs. This form of acne is indicated by little black 
specks, seen upon different parts of the face, but chiefly upon the skin 
of the nose. Each speck makes the obstructed outlet; and if pressure 
is made on either side, something having the appearance of a small 
grub may be pressed out. Upon careful examination, this so-called 
grub proves to be a mass of hardened sebaceous matter, or sebum, 
which has assumed its grub-like form by being pressed through the 
small mouth of the follicle. The black speck, giving to this little cyl¬ 
inder of fat the appearance of a head, is simply a small accumulation 
of dirt. The technical term for one of these little masses is comedo. 
When examined under a microscope, these are often found to contain 
a whole family of parasites, male, female, and their numerous progeny. 

80 


12G6 


DISEASES AND THEIR TREATMENT, 


In Plate VIII may be seen an excellent representation of these 
parasites, which rejoice in the title of demodex folliculorum. It is 
not probable that this parasite gives rise to the disease, but rather that 
the distended follicle furnishes an agreeable home for this insect, which 
is closely related to the accirus scabvei, or itch mite. In another form 
of acne, in which the nose and the adjoining portions of the cheek are 
chiefly involved, in addition to the pimples described there is intense 
congestion and redness of the parts, due to enlargement of the blood¬ 
vessels which are sometimes so much distended as to be distinctly visi¬ 
ble. This form of the disease is termed acne rosacea. In still another 
form of the affection the inflammation is chiefly confined to the roots 
of the hairs. This form is sometimes known as barber s itch. The 
chief causes of acne are erroneous dietetic habits. People suffering 
with acne can bring on an attack at any time by the use of rich 
pastry, fried food, and large amounts of sugar or sweet food, etc. 
Doughnuts, griddle cakes, cheese, hot bread, preserves, candies, and 
similar dietetic abominations, are very active causes of different forms 
of this affection. Acne rosacea is very frequently the result of using 
alcoholic liquors in some form, on which account it is sometimes 
termed, when seen in persons addicted to drinking, the “ rum-blossom.” 
Acne is sometimes the result of debilitating habits, particularly secret 
vice in young persons, though it should be by no means supposed that 
every young person affected with this disease is addicted to secret vice. 

Treatment. —This disease is often very obstinate. It may only 
be cured by entire discontinuance of all the causes. The person 
subject to it must live upon the most simple and unstimulating diet. 
Articles of food mentioned as causes must be scrupulously avoided. 
The diet of the patient should consist of cooked grains and fruits. 
Fat meats, and fat in all forms, used as seasoning in food, must be* 
strictly excluded from the dietary. The less sugar taken the better. 
Hot coffee must also be avoided, together with alcoholic liquors and to¬ 
bacco. Daily baths, the wet-sheet pack two or three times a week, 
fomentations over the region of the liver, and the abdominal bandage 
worn nights, are the principal measures of treatment to be recom¬ 
mended. Disorders of digestion, of the liver, of the menstrual func¬ 
tion, and other internal maladies should receive such attention as the 
particular case may demand. It is especially important that consti¬ 
pation of the bowels should be relieved by proper diet, and, if neces¬ 
sary, by the enema or other measures recommended for this condition. 


COMEDO, OR GRUBS. 


1267 


hen there is much irritation of the face, warm poultices, hot vapor 
douches, and sponging with water as hot as can be borne, are the 
proper remedies. A soft sponge should he used. 

The face should be kept covered with vaseline so as to protect it 
from the air. Cocoa butter will answer the same purpose. In the 
variety of the disease chiefly characterized by grubs in the skin, the 
internal use of glycerine in doses of two or three teaspoonfuls, taken 
half an hour after each meal, has been highly recommended. It is 
probably beneficial by preventing fermentation of the food. The face 
should be washed two or three times a day with a solution of soda, 
saleratus, or borax, a drachm to a pint of water. These lotions are 
improved by adding an ounce of glycerine to each pint of water. An 
ointment composed of thirty drops of carbolic acid, two drachms of 
glycerine, half an ounce of vaseline, thoroughly mixed, is very useful 
in chronic cases in which there is considerable induration. If irrita¬ 
tion of the skin is produced, a little more vaseline may be added. The 
ointment should be applied at least twice a day, after the face has 
been washed with soda or saleratus solution. The following prepara¬ 
tion is also useful as an ointment to be applied at night, being thor¬ 
oughly rubbed in: Sulphur and glycerine, a teaspoonful each ; vas¬ 
eline, one ounce. The ointment may be scented with rosemary, or 
any other agreeable oil. The last-named remedy is also excellent for 
use in acne rosacea. 

COMEDO, OK G1U BX. 

When these are present in large numbers, the face appears as 
though gun powder had been blown into it, or pepper sprinkled over 
it. It is best to remove them, as, if not removed, nature undertakes 
the work by setting up an inflammation about each one and produc¬ 
ing real acne. They may be squeezed out by pressure between the 
nails, but are best removed by a little tube with an opening about the 
thirty-second of an inch in diameter, or a watch key, which should be 
pressed directly down upon the affected gland, care being taken not 
to injure the skin by too great pressure. The further treatment of 
comedo should be the same as recommended elsewhere for oily skin. 

PEMPHIGUS-WATER BEERS. 

This eruption consists of water blisters, varying in size from that of 
a pea to that of an egg, or larger. 


1268 


DISEASES AXD THEIR TREATMENT. 


Treatment. —This is a very severe disease, and is often fataL 
The blebs should not be ruptured, but the fluid may be let out of 
them by pricking with a needle. Hebra, the great dermatologist of 
Vienna, several years ago insisted that bathing was injurious in these 
cases ; but we see by late reports that he is now treating them by pro¬ 
longed immersion in water about the temperature of the body. He 
keeps some cases immersed six or eight months. 


OIPETIGO. 

This is an eruption characterized by small pustules. It is really a 
variety of eczema. It frequently occurs about the mouth and nose in 
children. There is a contagious variety of this affection in which the 
pustules are small and flat, and spread rapidly over the body, generally 
beginning on the upper part of the body and extending downward. 

Treatment. —The treatment is essentially the same as that recom¬ 
mended for eczema. 


ECTHYMA. 

This is a mild form of inflammation of the skin. It is character¬ 
ized by small pustules surrounded by a ring of hard tissue. The 
eruption is frequently produced by scratching induced by lice. The 
eruption may be occasioned by local irritants of any kind in persons 
who are badly nourished. 

Treatment. —Remove the cause, if due to the presence of lice. 
When the pustules become ulcerous, carbolic-acid ointment should be 
applied. If due to debility, attention should be given to the general 
health. If the ulcerations become quite severe and foul, the following 
is an excellent preparation: Boil a teaspoonful of starch in two tea¬ 
spoonfuls of glycerine and six of water; when nearly cold, add a tea¬ 
spoonful of tincture of iodine. Apply a little to each ulcer ever}' day 
or two until a more healthy appearance is produced. 


PITYRIASIS. 


This disease consists in an excessive shedding of the scarf-skin in 
the form of branny scales. It may result from local irritation or general 
mal-nutrition. It very frequently affects the scalp, being one cause of 
dandruff. A peculiar form of the disease, known as pityriasis rubra, 


PBUBIGO AND ELEPHANTIASIS. 


12G9 


or red pityriasis, begins on some part of the body as a red scaly 
spot, which rapidly extends over the whole surface. The body is in¬ 
tensely red, and covered by scales which fall off in large quantities. 
The face is also red, as well as other parts of the body, and the head 
is affected by profuse dandruff. 

Treatment. —The latter forms of the affection are relieved by 
simple inunction of the skin. The skin should be kept constantly 
covered with some simple unguent, as vaseline, olive oil, or cocoanut 
oil. In the severe form of the affection, the same treatment should 
be employed, with the addition of daily sponging with water as hot 
as can be borne. 


PRURIGO. 

This is a disease of the skin characterized by small, hard, pale, 
or flesh-colored pimples, which, in their earlier stages can be felt under 
the skin often before they are visible. The eruption is attended by vio¬ 
lent itching, and a sensation as of ants crawling upon the skin. 

Treatment. —Vapor baths, packs, full baths, hot sponging of the 
skin, and improvement of the general health. 

ELEPHANTIASIS. 

There are two varieties of this disease, one known as elephan¬ 
tiasis arabum, the other, elephantiasis Grcecorum. The latter disease 
is that more commonly known as leprosy. The first mentioned disease 
consists in a chronic enlargement of some portion of the body. The 
part most likely to be affected is the leg, which becomes thickened and 
clumsy, sometimes to such a degree as to render the patient weary of 
life. The principal seat of the disease seems to be the skin. There 
is considerable pain in the affected part, the skin of which may be 
either smooth or ulcerated. Next in frequency to the legs, the geni¬ 
tal organs are affected, sometimes attaining an enormous size. The 
nose is a frequent seat of the disease in spirit drinkers, sometimes at¬ 
taining mammoth proportions. This disease is sometimes called ele¬ 
phant-leg or barbadoes leg. 

In true leprosy, three classes of symptoms appear: 1. Discoloration 
of the skin, which acquires, in spots, a light coffee hue; 2. A deposit in 
the skin of tubercles of a dull red color ; 3. Loss of sensation in certain 
parts, particularly in the extremities, due to disease of the trunks. 


1270 


DISEASES AND THEIR TREATMENT. 


The thickening of the skin chiefly occurs about the eyebrows, cheeks, 
forehead, and nose, giving to the patient a very singular appearance. 
The hands are frequently distorted, the fingers being contracted, giv¬ 
ing to them a claw-like appearance. After some years, the tubercles 
ulcerate, causing gangrene of some parts of the body, especially the 
fingers and toes. Loathsome odors emanate from the body. This 
disease is sometimes imported to this country; and Dr. Bulkley, of 
New York, claims to have observed cases in that city which origin¬ 
ated there. 

Treatment. —There is little chance for effecting a cure in either 
of these maladies. In some cases of elephantiasis Arabrum confined 
to a single part of the body, amputation has been sometimes performed 
with advantage. Two remedies, one known as gurjun oil, and a more 
recent one, chaulmoogra, are much used in India for leprosy, and are 
said to have been effective in curing a number of cases. Improved 
dietetic and hygienic conditions are especially important in the treat¬ 
ment of leprosy, since it has been found to occur more frequently in 
badly-fed persons, and those surrounded by unsanitary conditions. 
The use of salt meats is said to favor the production of the disease, 
which indicates that all foods of this kind should be avoided as much as 
possible. A recent writer sugests that the use of partially decomposed 
flesh, which is common in some portions of the countries where leprosy 
originates, may be the cause of this dreadful disease. 

MEDICI\ AL ISIS l I*T HOYS. 

Many medicines occasion eruptions upon the skin. Arsenic pro¬ 
duces herpes, hardness of the palms of the hands, eczema, and ugly 
ulcerations, by contact with the skin. Iodide of potash produces acne. 
Bromide of potash produces acne and ecthyma. Tar is a cause of 
comedo and acne. Copaiba occasions terrible itching, and frequently 
urticaria and vesicular eruptions. Arnica and sulphur both give rise 
to eczema. 


OILY SRLY. 

In some persons there is an excessive production of sebacous mat¬ 
ter or sebum, due to morbid activity of the fatty glands of the skin. 
The skin of such persons presents a shiny look. Little beads of oily 
matter may be seen at the mouths of the glands near the roots of the 


DANDRUFF OR D AND RIFF. 


1271 


hairs. The forehead, nose, and cheeks are most frequently affected. 
When the scalp is affected, the condition may be indicated by soiling 
of the pillow. Acne is frequently accompanied by this condition. 

Treatment. —The only treatment to be employed is the frequent 
application of soap. When many of the glands are clogged up, as indi¬ 
cated by the abundance of grubs, the surface should first be thoroughly 
rubbed with warm oil. Cocoanut or almond oil is the best. Af¬ 
ter half an hour, the surface should be rubbed with a flannel cloth, 
thoroughly saturated with soap moistened with warm water, and 
stretched over the fingers; or a soft sponge may be used. This is 
best done at night, just before retiring. When the secretion of fat is 
very profuse, the operation may be repeated two or three times a day. 

DRY SKI A. 

A condition of deficient secretion of fat is very frequently met 
with in cases of dyspepsia and in persons suffering with other wast¬ 
ing diseases. The best remedy is the daily application of the oil bath, 
which should be given according to the directions on page 673. 

DiXDlUFF OR 1> A ADR IFF. 

This is a condition in which branny scales are shed from the scalp 
in great abundance. It may be due to eczema or pityriasis, as already 
remarked, or may result from a disorder of the sebaceous glands, and 
from acne. The 'latter is the most common cause of the disease. In 
this form of the affection, the abnormal secretion of the fat glands 
appears upon the scalp as yellowish scales. This condition is akin to 
that described under the head of oily skin, being, in fact, a dry form 
of the same disease. This condition is sometimes present upon the 
nose and cheeks as well as the scalp. It is often a very annoying 
complaint. When affecting the scalp, it sooner or later results in loss 
of the hair. This is not because the dandruff* destroys the hair, but 
because the same disease which causes the dandruff interferes with 
the nutrition of the hair, thus occasioning its loss. On account of its 
tendency to produce baldness, the disease should never be neglected. 
Dandruff is generally occasioned by disorder of the digestion, or some 
other debilitating disease. 

Treatment. —Restore the general health by proper attention to 
the digestion and general hygiene. For dandruff of the face, apply 


1272 


DISEASES AND THEIR TREATMENT. 


the same remedies recommended for the skin. The scalp should also 
be treated in the same way, by gentle shampooing with ordinary 
washing soap, once or twice a week. A very soft brush should be 
used. Neither a stiff brush nor a fine comb should ever be used for 
removing dandruff. For shampooing, a liniment composed of equal 
parts of castor-oil and alcohol maybe rubbed on the scalp, or an oint¬ 
ment composed of a drachm of tannin to an ounce of vaseline. 

IHILIA A \ I> WI7VS. 

Milia consists of little globular bodies found just beneath the sur¬ 
face of the skin, chiefly upon the face, in the vicinity of the lower 
eyelid. They consist of sebaceous follicles, the mouths of which have 
been entirely closed up, causing an accumulation of sebaceous matter. 
Wens are milia on a large scale. They occur most frequently on the 
scalp and face. 

Treatment. —Open the top of each little globule with a needle, 
and squeeze out the contents by pressure between the finger nails or 
with a watch-key. Wens are to be treated upon the same principle- 

EXCESSIVE SWEAT—IIYPERIDKOSIS. 

This is a condition in which the sweat-glands are excessively active. 
The palms of the hands and feet are most often affected, sometimes 
to such an extent as to give to these parts a parboiled appearance. 
Persons troubled with excessive sweating of the feet, generally carry 
with them a disagreeable odor, due to the perspiration with which 
the stockings, and even boots or shoes, become saturated. 

Treatment. —Take each night and morning an alternate hot and 
cold foot bath, dipping the feet first into the hot, and then into the 
cold water, every half minute for fifteen or twenty minutes. Wipe 
the feet dry, and apply a strong decoction of white-oak bark, or a 
solution of tannin in water, two drachms to the ounce, or, better still, 
a solution of tannin and gtycerine in the same proportion. The old 
boots or shoes saturated with perspiration, should be disused, and a 
new pair purchased. The stockings should be changed every day. 
Rubbers, and other impervious foot coverings, should not be worn, or 
should be kept on as short a time as possible. Cloth boots are better 
than leather, on account of giving the air access to the feet. 


ITCHING—PR URITIS. 


1273 


OFFENSIVE PERSPIRATION. 

This is a condition which is sometimes exceedingly annoying. It 
is occasioned by the excretion in the sweat of elements of an offensive 
character. Odors of various kinds are produced. Rheumatic persons 
are generally most disagreeably affected. The arm-pits are the por¬ 
tions of the body most frequently affected, the offensive odor arising 
from the feet being due to decomposition of the sweat, and not to the 
abnormal character of the secretion. This condition is sometimes 
very difficult to overcome. The best remedy is thorouo-h cleansing of 
the parts, at least twice a day, with soap and water, or some dis¬ 
infectant lotion, as permanganate of potash, a solution of chlorinated 
soda, or with two or three per cent of carbolic acid. Washing the 
affected part with a solution of chloral, a drachm to the ounce, is a 
recently recommended remedy. What is known as Bromidrosis, is a 
condition in which the perspiration imparts to the clothing some 
peculiar color. 


ITCHING-PRIRITIS. 

Itching is due to some form of skin disease when accompanied by 
an eruption. When not accompanied by eruption it is usually due to 
some iritating element in the blood, to parasites, to the wearing of flan¬ 
nel under-clothing, or to some disorder of the nerves. Very often an 
eruption appears where none existed at first, in consequence of scratch¬ 
ing. Itching increased at night, and accompanied by a pimple rash in 
the bend of the arms, front of body, and between the fingers is very 
suspicious of the itch. Itching about the fork of the thigh is indica¬ 
tive of parasites. Wandering itching at night with no visible erup¬ 
tion in the day time is characteristic of urticaria. 

Many persons are greatly troubled with an itching, usually with¬ 
out eruption, on the approach of cold weather. This has been termed 
vnnter pruritis. In some of these cases little pimples may be seen at 
the roots of the hairs. This form of itching is due to inactivity 
of the skin, with a clogged state of the liver in consequence of the 
excessive use of sweets, fats, and animal food. It is most active in 
cold weather on account of the lessened activity of the skin at that 
time. Eczema and other skin affections may be excited by scratching. 

Treatment. —Correct diet. Encourage the activity of the liver and 
bowels by fomentations over those organs. Kneading and percussing 
the bowels, wet-sheet pack vapor baths, enemas when necessary, and 


1274 


DISEASES AND THEIR TREATMENT. 


obedience to all hygienic laws. When there is great irritation, apply 
saleratus or soda water, a dram to the pint, carbolic-acid ointment,, 
borax-water, and sometimes starch. Anointing with simple vaseline 
is often effective. For temporary relief, vinegar, lemon juice, and so¬ 
lution of carbonate of soda, a drachm to the pint, are also excellent. 
Frequently galvanism is very effective in removing intolerable itching, 
either applied to the affected parts, or to the nerve centers from which 
the nerve supply is furnished, or to both. 

PURPURA—THE PURPLES—LAAI> SCURVY. 

The eruption consists of small round spots or blotches in the skin, 
bright red at first, soon becoming of a darker hue and then fading after 
a few days, presenting the various colors seen in a fading bruise. First 
appears in the legs. A disease known as purpura hemorrhagica is a 
more severe form of the same affection, the amount of blood exuded 
beneath the skin being very much greater. Sea scurvy is an allied 
disease which is accompanied by other symptoms of a grave character. 
The principal causes of the disease are confinement too closely to ani¬ 
mal food, especially salt meat and innutritious food. It is very com¬ 
mon among English women who live on strong tea and white bread. 

Treatment. —This consists almost exclusively in improvement of 
the dietary. Tonic baths, massage, and electricity are also useful aids 
in treatment. The tissues of the legs should be supported by elastic 
bandages or stockings. 

o o 

FRECKLES—LEA TIGO. 

These consist in an increase of the pigment or coloring matter of 
the skin in small spots. They most often occur in persons who have 
delicate skins, being greatly increased by exposure to sun and wind, 
though hot produced by them, as is tan. They do not necessarily indi¬ 
cate an inactive state of the liver. Quite eminent authority on lung 
disease declares that freckles indicate a predisposition to consumption. 

Treatment. —Very difficult of removal, and impossible if patient 
continues exposure. It is better to have the freckles than to forego 
the valuable influence of the sunshine and fresh air. The advertized 
lotions and cosmetics are either dangerous or useless. The following 

o 

are a few of the best-known remedies for the removal of freckles and 
tan:— 


MOTH PATCHES—MOTHER'S MARK. 


1275 


1. Three tablespoonfuls of fresh scraped horse-radish; buttermilk, 
a pint. Allow to soak six or eight hours, shaking occasionally. Ci¬ 
der vinegar is sometimes used in place of the horse-radish. Apply to 
the face at night, leaving on till morning. 

2. Two tablespoonfuls of lemon juice; an equal quantity of water; 
a tablespoonful of glycerine ; a heaping teaspoonful of powdered borax. 
Apply three or four times a day, drying after fifteen or twenty min¬ 
utes with a fluffy towel. 

MOTn PATCHES-ITVER SPOTS—CniOASMA. 

The brownish spots of irregular shape and size often seen upon the 
face, and popularly known as “ liver spots,” are similar to freckles, but 
larger in size. They often accompany disease of the liver, and are, not 
infrequently present in diseases of the womb, which may be due to the 
fact now well understood that disease of the liver is a not infrequent 
cause of disease of the womb. 

Treatment. —Little or nothing can be done for these blemishes ex¬ 
cept to improve the general condition as much as possible. 

MOTHER'S iMARIt-MOLE-MWS. 

These are of various kinds : 1. Raised brown .spots on the face, or 
moles; 2. Brown spots producing hair; 3. A tumor composed of enlarged 
blood-vessels, constituting the true “ port wine ” or “ mother’s mark.” 
These marks do not originate in ante-natal influences, as many persons 
suppose. Their origin, is, however, obscure. 

Treatment. —Washes and other external applications are of no 
value. They can only be removed by a surgical operation. Electricity 
has proved of great service in those cases in which it has been tried. 

ILRmSM AAD PIEBALD SKI A. 

An Albino is an individual whose body is lacking in coloring mat¬ 
ter, the pigment being absent. In some individuals this condition is 
shown in a partial loss of color, producing a spotted appearance. The 
disease most often occurs in negroes, giving them a very peculiar ap¬ 
pearance. 

FISH-SKIA DISEASE— ICnTHY OSIS. 

In this disease the surface is hard and dry, and is marked off 


1276 


DISEASES AND THEIR TREATMENT. 


in such a way as to give the appearance of scales. Patient seldom 
perspires. Skin often cracks. In slight cases, small patches of brown 
warty growths appear. When these are abundant, the patient is termed 
a “ porcupine man.” 

Treatment. —Probably incurable ; but the sufferings incident to the 
disease can be very greatly mitigated by warm, alkaline baths and un¬ 
guents. Use about three ounces of soda or borax in a full bath tub of 
water. Bran baths and wet compresses are also useful. Careful at¬ 
tention should be given to the general health. 

SCIERODEMA. 

A condition in which portions of the skin are hardened and have a 
hide-bound appearance. The tissues cannot be taken up between the 
thumb and finger or wrinkled. Often attacks the nape of the neck. 
The hardened portion, which has a yellowish appearance, may extend 
over a large area, or be confined to bands. In some cases, the stiffness 
interferes with the movements of j oints and with respiration. 

Treatment. —Improve the general health. Soak the affected part 
in water one or two hours daily, or apply a warm poultice for the same 
length of time, and after drying, rub well with vaseline, cocoanut or 
olive oil. 


KELOID. 

A firm, prominent, pinkish nodule which often appears in a scar 
from a burn or surgical operation, and sends out processes which contract 
and pucker the tissues. In a severe case which we met in a city hospi¬ 
tal, the growth existed upon the face and produced a hideous deformity. 
The disease should be let alone. Removal does no good, as it returns. 

LUPUS—EATING TETTER. 

This disease is characterized by the growth in the skin of tissue sim¬ 
ilar to that of a healing sore. Its most favorite site is the cheek, near 
the nose. The affection often appears upon both sides of the face and 
bridges the nose. After a time ulceration occurs. It is a scrofulous af¬ 
fection. 

Treatment. —Removal by means of caustics. The galvano-cautery 
is the best means to use. The general health must be improved by all 
hygienic means. 


ITCH—SCABIES. 


1277 


CALLUS. 

This is a thickened condition of the epidermis or scarf skin. It is 
most likely to occur over joints and the prominent points of bones. 
It is generally produced by prolonged pressure. Its object is the 
protection of the sensitive parts beneath from injury. A callus does 
not usually require treatment except when the part becomes inflamed. 
The proper treatment is soaking in very hot water for fifteen or twen¬ 
ty minutes three or four times a day, and the wearing of a poultice or 
wet compress the balance of the time. 

Corns are modifications of the callus, the treatment of which is de¬ 
ferred to the section on surgery. 


ITCH—SCABIEI. 

This disease is by no means so frequent in this country as in some 
others. It is said to constitute about one-fourth of all the cases of 


skin disease in Glasgow. The dis¬ 
ease, as is now well known, is caus¬ 
ed by the presence of an animal 
parasite, the acarus scabiei, shown 
in Plate YIII. This little insect 
which is barely visible to the un¬ 
aided eye, burrows in the skin, 
making a somewhat crooked chan- 
nel in which it deposits its eggs 
(Fig. 339), which in due time are 
hatched, and rapidly develop into 
full grown acciri. The female is 
the cause of all the mischief, as 
she alone burrows, the purpose be¬ 
ing to deposit the eggs just under 
the surface of the epidermis, dhe 
track left by the insect in burrow¬ 
ing can be readily seen by the aid 
of a small magnifying glass as a 
little dotted line about one-fourth 
of an inch in length. The erup¬ 
tion varies much in different cases, 
sometimes being very scanty, in 
other cases resembling a bad case of 



Fig - . 339.—Female Itch Mite Laying 
Eggs in a Burrow. 


eczema. It is most often found 




1278 


DISEASES AND THEIR TREATMENT. 


between the fingers, in the bend of the elbows and knees, and upon 
the front of the body. The itching in some cases is most intolerable, 
in others slight. It is most severe at night. It is in some cases very 
difficult to decide whether or not a patient has scabies or some other 
skin disease. 

A variety of the disease known as grocer’s itch is sometimes pro¬ 
duced by the irritation of an insect known as the acarus sacchari. 
Plate X. 

Treatment. —The only efficient remedies are such as will kill the 
parasites. No internal medication is required. The insects may be 
destroyed in a variety of ways; by smothering, by drowning, or by 
poisoning. The itch insect requires air as well as larger animals. If 
the sk'in is thickly smeared with mutton tallow or some other unguent 
of considerable consistency, the unguent being applied at least twice a 
day for some time, a cure may be effected. Prolonged immersion in 
water, and daily wet-sheet packs, followed by thorough shampoo¬ 
ing, are effective measures if perseveringly employed; but the most ex¬ 
peditious manner of getting rid of the vermin is to apply to the skin 
some unguent containing substances poisonous to them. The patient 
should take a thorough soap bath at night, soaking the body for at 
least an hour in the warm water. If possible, a vapor bath should 
be taken before the full bath, so as to thoroughly loosen the old epi¬ 
dermis. In the full bath the skin should be thoroughly shampooed 
with a flesh brush and soft soap. After the bath, the patient should 
apply to the affected parts of the body and contiguous parts any one 
of the different ointments given on pages 800 and 801. If sulphur 
ointment is used, it should be left on over night and worn during the 
next day if the odor is not very objectionable. The next night the 
same process should be repeated. Care should be taken to change all 
the clothing at the beginning of treatment and again at the close. One 
or two applications are usually sufficient. A third one is only occa¬ 
sionally required. The irritation of the skin may be somewhat aggra¬ 
vated by the treatment. It will subside in a few days under the use 
of simple vaseline ointment. Some persons make the mistake of keep¬ 
ing up their vigorous treatment so long as there is an eruption. It 
should be understood that the eruption and the real cause of the dis¬ 
ease are two distinct things. 

The clothes of a patient who has had treatment for itch should 


LICE. 


1270 


be thoroughly baked for at least two hours. Clothing' will readily 
withstand a temperature of 350° without scorching. 


LICE. 

Pediculosis, or lousiness, may result from the infesting of the body 
by any one of three varieties of the louse insect, or pediculus. They 



Fig. 340. The 

Head Louse. 



Fig. 341. The 

Body or Clothes Louse. 



Fig. 342. The 

Crab or Pubic Louse. 


are known respectively, as the head louse, the body or clothes louse, and 
the crab louse or “ crabs.” See Figs. 340, 341 and 342 for repre¬ 
sentations of these three kinds of lice. Lice 
multiply very rapidly. A single female will 
produce in the course of a couple of months 
5,000 new individuals. Very frequently an 
eruption may be seen, which is produced by 
the irritation of the insect and the scratch¬ 
ing of the patient. Head lice deposit their 
eggs or “ nits ” upon the hair, as shown in Fig. 

343. Sometimes these are the only traces of 
the insect to be found. These “nits ” cling very 
closely to the hairs to which they are attached 
until they are destroyed or hatched. 

Lice do not usually exist except on persons 
who are filthy in their personal habits, although 
the most cleanly individual might become in¬ 
fested by contact with a person who harbored 
them in large numbers. Very frequently these 
parasites exist for a long time unsuspected. They can only be detected 



Fig. 343. Nits or Eggs of 
the Head Louse. 














1280 


DISEASES AND THEIR TREATMENT. 


by careful scrutiny of the affected parts for the insects or their “ nits. ” 
Body lice generally deposit their nits in the seams of the garments, and 
themselves usually cling to the clothing when it is removed. 

Treatment. —For head lice, saturate the hair with kerosene oil 
two or three times a day for two or three days; then wash the head 
with soap and water. This is not a very agreeable remedy, but is a safe 
and certain cure. Another remedy is a lotion made by steeping half an 
ounce of bruised stavesacre seeds in a pint of equal parts of vinegar 
and alcohol. Wash the head with the solution twice or three times a 
day for a day or two. The following is another good remedy: Car¬ 
bolic acid, one drachm; glycerine, one-half ounce; alcohol, one ounce 
Mix the carbolic acid thoroughly with the alcohol and glycerine, then 
add four ounces of water. Shake well before using. Must be em¬ 
ployed with some caution, but is a good remedy. Bathe the head 
with it carefully twice or three times a day for two days. 

Body lice can usually be cured by changing the clothing, and warm 
bathing with soap and water. It is better, however, to apply to the 
skin of the affected parts some parasiticide ointment. The following 
is excellent: Soak half an ounce of powdered stavesacre in an ounce 
of hot olive oil for half an hour; add an ounce of vaseline. This oint¬ 
ment is also excellent for head lousiness. It should be well rubbed in. 

The crab louse usually affects the hair of the covered jnortions of 
the body only. The best remedies are cleanliness, thorough washing 
with soap, and the application of mercurial ointment. Care should be 
taken in the use of this ointment, as harm may be done by its absorp¬ 
tion into the system. In order to render a small quantity efficient, it 
is a good plan to clip close to the skin the hair of the affected parts. 
The ointment should then be applied at night and washed off in the 
morning, the clothes being changed for new ones, or those which have 
been freed from the parasites. Kerosene oil, or crude petroleum, may 
also be used as directed for head lousiness, and is a safer remedy. 

In all varieties of lousiness the bed clothing, as well as personal 
clothing, should be thoroughly boiled, or baked in an oven, as this is 
the only means of destroying the insects and their eggs. In cases of 
body lousiness, the seams of the clothing should be ironed with a flat¬ 
iron as hot as can be used without scorching. If this plan is not suc¬ 
cessful, the seams may be saturated with a solution of carbolic acid,, 
twenty drops to the ounce of water. 


RINGWORM. 


1281 


RINGWORM. 



Fig - . 344.—Ringworm Para¬ 
site, grea ly magnified. 


This is a parasitic disease, in which a fungus grows upon the skin. 
The scalp, the beard, the nails, or the general surface of the body may 
be affected. In Fig. 844 may be seen the appearance of the fungus 
under the microscope. Fig. 345 shows an 
affected hair greatly magnified. The fungus 
is called, scientifically, tricopkyton tonsu¬ 
rans. It is a contagious affection. 

O 

When it occurs on the body, the disease 
usually spreads in a circle, from which the 
affection takes its name. 

When the scalp is affected, the hair falls 
in circular spots, upon examination of 
which numerous short stumps of hairs may 
be seen, in which respect this disease differs from baldness due to 
other causes. The affected portions of the scalp present the appear¬ 
ance of the skin of a plucked fowl, and numerous white scales. The 
disease extends into the hair follicles and the hairs. The affection is 
quite obstinate, and when it exists for a long 
time, may occasion permanent baldness. It occurs 
most often in charitable institutions, where a 
large number of children are brought together. 

O O O 

Ringworm of the beard, or sycosis, commonly 
known as “ barber’s itch,” is a not uncommon 
malady, but often very obstinate to cure. It 
rarely occurs except in persons accustomed to be 
shaved at a barber shop, where the disease is 
almost always contracted. Not infrequently a 
very considerable degree of inflammation of the 
skin of the face is produced, giving rise to nod¬ 
ules, pustules, and various other forms of erup¬ 
tion. 

The fingernails are sometimes affected by 
this disease, as well as other parts, becoming dry, 
thickened, brittle, and opaque. 

Treatment. —When the disease occurs upon the 
face of the body, or upon a part not covered with long hair, it may 
be readily cured by the application of a solution of carbolic acid made 
81 



Fig - . 345.—A Hair af¬ 
fected by Ringworm. 


general sur- 







1282 


DISEASES AND THEIR TREATMENT. 


as follows: Carbolic acid, one drachm; glycerine, one-half ounce; 
water, two ounces. Apply to the affected parts with a brush, daily, 
until the disease disappears. A solution of sulphurous acid is also an 
excellent remedy, made as follows: Burn two or three ounces of 
sulphur in a tight box, by placing it on the under-side of a hot stove 
cover, supported by a brick. Place in the box before closing it a 
shallow earthen vessel filled with water. The water will absorb the 
smoke arising from the combustion of the sulphur, and will thus 
become charged with sulphurous acid. Apply as directed for carbolic 
acid. Ink is a domestic remedy usually successful. Another remedy 
sometimes used with success, is wearing over the part a penny wet 
with vinegar. 

When the scalp and beard are affected, the hair must be pulled 
out by means of pincers before the remedy is applied. This is neces¬ 
sitated by the fact that the disease penetrates to the bottom of the 
hair follicles. The hair thus pulled out always grows again, as the 
roots are left. Several months’ treatment is often necessary to effect 
a cure in these cases, the same hairs having to be pulled again and 
again before they remain healthy. The remedy must be applied, and 
well rubbed in each time, after a portion of the affected hairs have 
been pulled, and once or twice a day in addition. 


FA YUS. 


This is another vegetable parasitic disease of the skin. See Fig. 
34G. Any portion of the skin may suffer, but the scalp is most likely 

to be affected. The disease is characterized by 
the formation of yellow crusts, which are de¬ 
pressed at the center, at which a hair may 
generally be seen. The affection begins in 
the hair follicles, and extends to the whole 
skin of the affected part. The crusts are 
formed almost wholly by the growth of the fun¬ 
gus. They have an odor similar to that of mice, 
which are also very subject to this disease. 
Treatment. —This malady is very obstinate, being more difficult 
of cure than ringworm of the scalp. It requires the same remedies. 



Fig-. 346. 


TIAFA YERSICOf.OR. 


The old name for this affection is pityriasis versicolor. It consists 


OVER GROWTH OF THE HAIR.. 


1283 


in an eruption of slightly elevated, irregularly shaped, yellowish, or 
brownish spots, most often found upon the chest. This is also a par¬ 
asitic disease. The microscopic appear¬ 
ance of the fungus peculiar to it is shown 
in Fig. 347. It is often mistaken for 
“ liver spots.” It is contagious; may last 
any length of time. 

Treatment.— Wash the parts and 
the whole body thoroughly every day 
with soap and water, and then apply 
any of the remedies recommended for 
ringworm. It is not difficult of cure; but 
treatment should be continued for some 
time after the eruption disappears, in 
order to insure a permanent cure. 

mitSlTES—OVElUiUOWTII OF TIIF 
I1A1R. 

This morbid condition consists in an 
abnormal development of the fine, short 
hairs. It is most troublesome in ladies, 
in whom the hair of the upper lip is 
■sometimes sufficiently developed to form 
a mustache. We recently met a case 
in which a full silken beard had grown, 
may be seen two most remarkable examples of hirsutes, 

. Treatment.— The so - called depilatores 
sold for the relief of this condition are worth¬ 
less. They do nothing more than to remove 
the external portion of the hair, only penetrat¬ 
ing a short distance into the hair follicle, and 
hence the hairs soon grow again. Being usu¬ 
ally composed chiefly of lime, considerable 
irritation is not infrequently produced, and 
sometimes quite severe disease of this portion 
of the skin. Pulling out the hairs is only 
temporary in its effects, although more last¬ 
ing than any depilatory. The only cure is 
•destruction of the root of the hair or its folli- 



Fig. 347. Parasitic Fungus of 
Time Versicolor. 


In Fig. 348 and 349 

O 



Fig. 348. 
















1284 


DISEASES AND THEIR TREATMENT. 



cle. This may be accomplished by passing into the follicle a fine 
glover’s needle and twisting it about in such a way as to excite 
sufficient inflammation to obliterate or close it. Sometimes a heated 

needle is used *for the purpose. 
The best plan of all is to pass 
a current of electricity through 
the needle after it has been 
inserted into the follicle. Gal¬ 
vanic electricity is necessary 
for this purpose. The last 
method of treatment can be 
employed only by a skillful 
physician. 


RAI,I>AESS. 


There are two varieties of 
baldness, the ordinary form, 
and what is known as “ patchy 
baldness,” a form in which the 
hair is lost only in circum¬ 
scribed spots. The loss of hair 
usually begins first at the tem¬ 
ples, the forehead, or the crown, 
gradually extending. It is very common in old age, being the result 
of the general decline in nutrition which occurs in advanced life. 
When it occurs in early or middle life, it most commonly results from 
the disease of the scalp known as dandruff (page 1271). Baldness 
also results from eczema and from ringworm and favus. Tempo¬ 
rary baldness not infrequently follows erysipelatous, typhoid, and 
other fevers. Baldness may be occasioned by anything which deteri¬ 
orates the general health. Excessive brain labor, resulting in conges¬ 
tion of the head and too much heat in the scalp, may produce it. 
It may be the result of dyspepsia, of excesses of various kinds, and 
of any debilitating disease. Men suffer more than women, which is 
probably due to the fact that women do not so habitually overheat 
the head by the constant wearing of warm head coverings. In some 
cases, the disease is hereditary. 

Treatment. —Prevention is the best remedy, as many cases are in- 



GRAY HAIR. 


1285 


curable. The scalp should never be overheated. Head coverings 
should be light, and should allow free access of air to the head at all 
times. The hair should not be harshly brushed with a stiff brush, 
and should never be combed with a fine, sharp-toothed comb. This is 
particularly true if dandruff is present, as the measures referred to 
will certainly aggravate the difficulty. When the hair is very dry, a 
little fine unguent of some kind may be employed; but the common 
practice of “ greasing ” the hair is a bad one. Such harsh mixtures as 
are often employed by barbers in shampooing are very harmful to the 
hair. Soap should be rarely used unless of the finest quality, but the 
head should be kept clean by frequent washing with warm water, 
shampooing with the white of egg, followed by thorough rinsing. 

When the scalp is smooth and shiny, especially in cases of “patchy 
baldness,” which is due to nervous disease of the scalp, little can be 
expected from treatment. If a large number of hairs are still present, 
however, even though they are very .short and thin, something may 
be done. The case is much more hopeful in young than in old 
persons. When hereditary, little can be expected from treatment. 
First attention should be given to the general health. The various 
stimulating lotions which are advertised for this purpose should be 
carefully avoided, as they will be rarely successful, and may do much 
harm. No amount of stimulation of the scalp will effect more than 
temporary benefit unless the general nutritive forces of the patient 
are also improved by attention to hygiene. 

It is rarely necessary to cut the hair close, and shaving the scalp 
is quite unnecessary. If the scalp is dry, a little fine oil should he 
rubbed upon it daily with much gentle friction. If dandruff is pres¬ 
ent, treat as directed on page 1271. If the case is obstinate, consult a 
physician. 

UKAl HAIR—CAVITIES. 

Loss of color of the hair is due to a failure of the papillae to se¬ 
crete the usual amount of coloring matter. A hair rarely loses its 
color; hence grayness, or loss of color, begins at the root of the hair. 

Treatment. —There is no remedy but dyeing, and that is by no 
means always safe, since all the popular hair dyes contain lead or 
some other substance of a poisonous nature. Cases of lead poisoning 
from the use of hair dyes are by no means uncommon. The following 


128G 


DISEASES AND THEIR TREATMENT. 


hair dye is recommended by the eminent Professor Hager which 
may be used with perfect safety : Subnitrate of bismuth, one ounce ; 
glycerine, fifteen ounces. Heat together in a water-bath for an hour. 
Add carefully a strong solution of caustic potash, while stirring the so¬ 
lution, until it becomes clear. Then add a very strong solution of citric 
acid until the test paper shows the mixture to be nearly neutral. Add 
sufficient rose or orange-flower water to make two pints. Color slightly 
with aniline, as desired. 





INFLAMMATION OF THE PROSTATE GLAND. 


1287 


DISEASES OF THE MALE GENERATIVE ORGANS. 


i\rLiiniArio\ of tiie prostate glaad-prostatitis. 

SYMPTOMS. — Pam and heat in the fork of the thighs, with tenderness on pressure ; 
pain increased by urination, and by moving of the bowels; bearing down feeling in the 
bladder and the rectum ; a hard slight swelling felt in the fork of the thighs and rectum : 
may be retention of urine. 

Causes. —May result from taking cold, from sexual excesses, from 
the use of diuretics, and from disease of the rectum. The most com¬ 
mon cause is gonorrhoea, or clap 

Treatment. —Hot fomentations to the perinseum; hot enemas three 
or four times a day or frequent cold enemas. When inflammation is 
high, as indicated by severe throbbing pain, cold enemas should be re¬ 
tained as long as possible. The patient should have a very simple diet, 
should take no meat, eggs, or condiments of any kind. Alcoholic liq¬ 
uors of all sorts should also be carefully avoided. The patient should 
maintain perfect quiet in bed so as to lessen the danger of permanent 
injury. 

i :\ea r <; e ui:\ t of the prostate. 

SYMPTOMS.—Hard lump to be felt in the fork of the thighs, or rectum, at the base 
of the bladder, which is sensitive to pressure; slow, difficult, and painful urination; in 
many cases, symptoms of bladder disease. 

The body situated at the base of the bladder, the so-called prostate 
gland, is now well understood to be not a gland at all, but a mass of 
muscular fibres which surround the seminal ducts and by contraction ex¬ 
pel the seminal fluid. When often stimulated to contraction by excessive 
sexual indulgence or by self-abuse, hypertrophy, or overgrowth of the 
muscular body, takes place. Enlargement may also result from inflam¬ 
mation. It is a very common disease in old men, to whom it occasions, 
very great inconvenience by producing painful and difficult urination, and 
in some cases actual retention, making the use of the catheter neces¬ 
sary. It is a difficulty which is often neglected, very much to the det¬ 
riment of the patient. 

Treatment. —Free water-drinking, careful avoidance of alcoholic 



1288 


DISEASES AND THEIR TREATMENT. 


liquors, strong tea and coffee, tobacco, the use of condiments and stim¬ 
ulating foods of all kinds, and a diet consisting chiefly of fruits and grains, 
are the principal hygienic measures to be adopted in this disease. Hot 
fomentations applied to the perimeum daily, together with injections of 
hot water into the rectum in quantities from a pint to a quart, are the 
best means for diminishing the hardness and enlargement. The water 
employed for the injection should be as hot as the patient can bear; and 
the temperature may be 102° to 106° at first, and increased to 110° 
if possible; a prolonged hot spray to the perimeum is still more effective 
than fomentations. The spray may be employed with hot and cold 
alternations with good effect. If the trouble is not relieved quite 
promptly by the simple means suggested, the case should be brought to 
the attention of a skillful surgeon. 


BALANITIS. 

SYMPTOMS.—Heat and itching at the end of the penis; a creamy discharge ; red and 
raw patches on the surface of the mucous membrane. 

Causes. —The principal cause of this disease is lack of proper clean¬ 
liness. It occurs most frequently in persons having a long or tight fore¬ 
skin ; the disease corresponds to vulvitis in females; it is also occasioned 
by mechanical irritation and by gonorrhoea. 

Treatment. —Careful washing and drying the affected parts three 
or four times a day will speedily effect a cure in the majority of cases. 
If there is considerable swelling, a cold compress should be applied con¬ 
tinually. If the disease is somewhat obstinate, a solution of alum or 
sulphate of zinc, in the proportion of a grain or two to an ounce of water, 
may be applied once a da}^. The cure will also be facilitated by the use 
of carbolic acid ointment made by mixing ten drops of carbolic acid 
with an ounce of vaseline. For a radical cure, circumcision, or an equiv¬ 
alent surgical operation, is necessary. 

CATARRH OF THE FRETIIRA—URETHRITIS. 

SYMPTOMS.—Swelling and redness at the external end of the urethra ; burning along 
the urethral canal, especially during urination ; slight mucous discharge before or after 
urination; sticking together of the lips of the mouth of urethra. 

This disease often occasions great anxiety and serious trouble from 
its similarity to a slight attack of gonorrhoea. 

Causes. —Irritation of the urethra by foreign bodies, as by the 


INFLAMMATION OF TI1E TESTICLE. 


1289 


awkward use of the sound or catheter, or by irritating injections into 
the urethra; sexual excesses, especially self-abuse; very frequent noc¬ 
turnal emissions; coitus during menstruation. 

I reatment. —This disease generally recovers of itself within a few 
days, though it sometimes continues for several weeks, especially when 
the anxiety of the patient leads him to frequently squeeze or press the 
organ to ascertain the presence of the discharge. Cool sitz baths and 
local douches should be daily employed. If there is considerable pain, 
the hot douche or spray is the best means of relief. Sexual indulgence 
should be entirely abstained from. The patient should avoid condi¬ 
ments, tea, coffee, tobacco, alcoholic liquors, and all other irritating 
causes. 

Gonorrhoea. —This disease does not differ from the preceding ex¬ 
cept in its contagious character and greater severity. The treatment 
of the disease consists in complete rest in bed for a few days, avoid¬ 
ance of exposure to cold, and the same measures as recommended for 
simple catarrh of the urethra. Severe cases require the attention of a 
physician. The results of neglected or badly treated gonorrhoea are 
sometimes most serious and life-long in character. 

PRIAPISM. 

SYMPTOM.—Constant and often painful erection. 

This condition is almost the invariable result of sexual excess of 
some sort; it frequently results from masturbation, the direct cause be¬ 
ing the irritation produced by too frequent local excitement. Priapism 
often accompanies disease of the brain and nervous system. 

Treatment. —In cases in which it does not arise from the causes 
last mentioned, one of the most essential elements of treatment is men¬ 
tal control. Indulgence in sensual thoughts is one of the most com- 
mon causes of this humiliating disease. The best means of local treat- 
ment are the local application of cold to the affected part, and hotfomen- 
tions applied to the sacrum. If the local application of cold is not ef¬ 
fective, relief may sometimes be obtained by the hot douche or spray 
taken at as great a heat as can be given without injuring the tissues. 

mi.AMMATlOA OF THE TESTICXE. 

SYMPTOMS.—Pain and sensation of weight in the testicle; pain extending up the 
cord ; uneasiness in the lower part of the back and the groin ; swelling of the testicle; 
scrotum full and tense; cord swollen and sensitive to pressure; slight fever; frequent 
urination; constipation ; nausea and vomiting. 


1290 


DISEASES AND THEIR TREATMENT. 


This disease is generally caused by dissipation or by the extension of 
a gonorrheal inflammation from the penis to the testicle. 

Treatment. —Rest in bed with fomentations to the affected part are 
the best measures for relieving pain ; some surgeons advise the applica¬ 
tion of adhesive straps in such a manner as to compress the inflamed 
testicle. This seems to us to be an unnecessary procedure, as the same 
results can be obtained without, and with less pain to the patient and 
no risk of injury. The bowels should be well kept open by enemas. In 
case the patient should have much fever, cool sponge baths, and per¬ 
haps wet-sheet packs, should be employed. The testicles should be sup¬ 
ported by a suspensory bag for some time after the acuteness of the in¬ 
flammation has subsided, in order to prevent a relapse and to prevent 
the disease from becoming chronic. 

o 

JfOCTIRMI EMISSIONS-SEMMAL TOSSES—EXHAUSTED 

VITALITY. 

Seminal emissions occurring during sleep, usually accompanied by 
erotic dreams, are known as nocturnal or night pollutions, losses, or 
emissions. In addition to its characteristic feature, the disease is often 
accompanied by a long train of symptoms which are intimately con¬ 
nected with the local affection, or grow out of the debility arising from 
the continual drain upon the system, for a full account of wdiich the 
reader is referred to the author’s work entitled, “Plain Facts for Old 
and Young.” 

This disease is usually the result of self-abuse, but may result from 
sexual excesses of any kind. It is common in married men who have 
abused the marriage relation, when they are forced to temporary conti¬ 
nence from any cause. It also occurs in those addicted to mental un- 
chastity, though they may be physically continent. It is not probable 
that it would ever occur in a person who had been strictly continent and 
had not allowed his mind to dwell upon libidinous imaginations. In 
many cases such a condition of weakness and local debility is reached 
that an emission is produced by the slightest excitement. Mere prox¬ 
imity to a female, or the thought of one, may be sufficient to produce a 
pollution, attended by voluptuous sensations. But after a time the 
organs become so diseased and irritable that the slightest mechanical 
irritation, as friction of the clothing, the sitting posture, or riding horse¬ 
back, will produce a discharge which may or may not be attended by 
sensation of any kind. Frequently a burning or more or less painful 


NOCTURNAL EMISSIONS. 


1291 


sensation occurs; erection does not take place. Even straining at stool 
will produce the discharge, or violent efforts to retain the feces when 
there is unnatural looseness. 

Treatment. —In cases in which the disease is of short duration, a 
cure can generally be affected quite readily ; in those of longer standing, 
the task is more difficult, but still the prospect of recovery is very fa¬ 
vorable, provided the co-operation of the patient can be secured ; without 
this, little can be done. But in these cases the patient may as well be 
told at the outset that the task of undoing the evil work of years of sin 
is no easy matter. It can only be accomplished by determined effort, 
by steady perseverance in right doing, and in the application of neces¬ 
sary remedies. Those who have long practiced secret vice or other 
sexual excesses, or long suffered severely from the effects of sexual trans¬ 
gression, have received an injury which will inevitably be life-long to a 
greater or lesser extent in spite of all that can be done for them. In such 
cases, a cure consists in reducing the frequency of the emissions so that 
the general health will not suffer, which point is generally reached when 
an emission occurs but once in four to six weeks. 

In the attempt to cure this disease, the thing of first importance is 
that the patient should obtain command of his thoughts ; by this means, 
he can do more for himself than all the doctors can do for him. “ But 
I cannot control my thoughts,” says the patient. A young man said to 
me, “O doctor, you don’t know how I feel. I despise myself ; I hate 
myself ; I often feel inclined to kill myself. My mind is always full of 
abominable images ; my thoughts run away with me and I cannot help 
myself.” The tears ran down his face in streams as he told me of his 
slavery. All possible means must be employed to attract the patient’s 
attention from himself, from brooding over his ills. Occupy him, inter¬ 
est him, or teach him to occupy and interest himself. The enthusiastic 
study of some one of the natural sciences is a most excellent auxiliary 
in effecting this. 

Daily exercise should be taken to the extent of fatigue. It is better 
that those who are still strong enough should have some regular em¬ 
ployment which will require exercise. Those who prefer may secure 
exercise and recreation in the pursuit of some study that involves neces¬ 
sary physical exertion ; as, botany, geology, or entomology. The col¬ 
lecting of natural-history specimens is one of the most pleasant diver¬ 
sions, and may be made very useful as well. No single form of exercise 


1292 


DISEASES AND THEIR TREATMENT. 


is so excellent as walking. Four or five miles a day are none too many 
to secure a proper amount of muscular exercise. Gymnastics, the 
“health-lift,” “Indian clubs,” “dumb-bells,” rowing, and other forms of 
exercise are all good; but none of them should be carried to excess. 
Ball-playing is likely to be made a source of injury by exciting, in vig¬ 
orous competition, too violent and spasmodic action. 

Careful regulation of the diet is a matter of paramount importance. 
The science of physiology teaches that our very thoughts are born of 
what we eat. A patient that lives on pork, fine-flour bread, rich pies 
and cakes, and condiments, drinks tea and coffee and uses tobacco, can 
make no permanent improvement without reformation. The food must 
be simple and unstimulating. Much flesh-meat, condiments, tea, coffee, 
beer, tobacco, and all stimulants must be strictly avoided. It is better 
for the patient to eat but twice a day, and never later than three or 
four hours before bed-time. 

Sufficient sleep should be taken, but dozing must be avoided. Never 
go to bed with the bowels or bladder loaded. The bladder should be 
emptied j ust before retiring. It is also a good plan to form the habit of 
rising once or twice during the night to urinate. The position in sleep¬ 
ing is of some importance. Sleeping upon the back or upon the ab¬ 
domen favors the occurrence of emissions; hence, it is preferable to sleep 
on one side. 

Various devices are employed, sometimes with advantage, to prevent 
the patient from turning upon his back while asleep. The most simple 
is that recommended by Acton, and consists in tying a knot in the 
middle of a towel, and then fastening the towel about the body in such 
a way that the knot will come upon the small of the back. The un¬ 
pleasant sensations arising from pressure of the knot, if the sleeper turn 
upon his back, will often serve as a complete preventive. Others fasten 
a piece of wood upon the back for a similar purpose. Still others prac¬ 
tice tying one hand to the bed-post. None of these remedies should be 
depended upon, but they may be tried in connection with other means 
of treatment. Soft beds and pillows must be carefully avoided. Feather¬ 
beds should not be employed when possible to find a harder bed ; the 
floor, with a single folded blanket beneath the sleeper would be prefer¬ 
able. Soft pillows heat the head, as soft beds produce heat in other 
parts. A hair mattress, or a bed of corn husks, oat straw, or excelsior 
—covered with two or three blankets or a quilted cotton mattress— 
makes a very healthy and comfortable bed. Too many covers should 


NOCTURNAL EMISSIONS. 


1293 


be avoided with equal care. The thinnest possible covering in summer, 
and the lightest consistent with comfort in winter, should be the rule. 

As a curative means, the cool or cold sitz bath is one of the most 
efficacious of all remedies. It should be taken daily, and mav often 
be repeated, with benefit, several times a day. Its effect is to relieve 
the local congestion, and thus allay the irritability of the affected parts. 
When but one bath is taken daily, it should be just before retiring at 
night. Other methods of treatment are described in our work devoted 
to this subject.* 

Drugs are usually of little value, as the most they can do, at least 
in the great majority of cases, is to temporarily check the disease. 
Permanent recovery demands the strictest attention to improved hy¬ 
giene. The employment of rings, pessaries, and numerous other 
mechanical devices for preventing emissions, is usually futile. No 
dependence can be placed upon them. Some of these contrivances are 
very ingenious, but they are all worthless, and time and money spent 
upon them are thrown away. 

In conclusion, we would say to those who may have the misfortune 
to be suffering in this manner, Never consult a quack. The news¬ 
papers abound with lying advertisements of remedies for diseases of 
this character. Do not waste time and money in corresponding with 
the ignorant, unprincipled charlatans who make such false pretensions. 
Do not consult traveling doctors. Physicians of real merit have plenty 
of business at home. They are not obliged to go abroad in order to se¬ 
cure practice. Persons who resort to this course are, without exception, 
pretentious quacks. Consult only some well-known and reliable phy¬ 
sician in whom you have confidence. It is far better to consult your 
family physician than to trust yourself in the hands of some one whom 
you do not know, and especially one who makes great pretensions to 
knowledge. 

Treatment of Self-Abuse. —The method adopted must differ ac¬ 
cording to the age of the individual patient. In children, especially 
those who have recently acquired the habit, it can be broken up by ad¬ 
monishing them of its sinfulness, and portraying in vivid colors its ter¬ 
rible results, if the child is old enough to comprehend such admonitions. 
In addition to faithful warnings, the attention of the child should be 
fully occupied by work, study, or pleasant recreation. He should not 


* “Plain Facts for Old and Young.” 



1294 


DISEASES AND THEIR TREATMENT. 


be left alone at any time, lest he yield to temptation. Work is an ex¬ 
cellent remedy; work that will really make him very tired, so that 
when he goes to bed he will have no disposition to defile himself. It 
is best to place such a child under the care of a faithful person of 
older years, whose special duty it shall be to watch him night and day 
until the habit is thoroughly overcome. 

In younger children with whom moral considerations will have no 
particular weight, other devices may be used. Bandaging the parts 
has been practiced with success. Tying the hands is also successful 
in some cases; but this will not always succeed, for they will often 
contrive to continue the habit in other ways, as by working the limbs, 
or lying upon the abdomen. Covering the organs with a cage has 
been practiced with entire success. A remedy which is almost always 
successful in small boys is circumcision, especially when there is any 
degree of phimosis. The operation should be performed by the sur¬ 
geon without administering an anaesthetic, as the brief pain attending 
the operation will have a salutary effect upon the mind, especially if 
it be connected with the idea of punishment, as it may well be in 
some cases. The soreness which continues for several weeks inter¬ 
rupts the practice, and if it had not previously become too firmly fixed, 
it may be forgotten and not resumed. If any attempt is made to 
watch the child, he should be so carefully surrounded by vigilance 
that he cannot possibly transgress without detection. If he is only 
partially watched, he soon learns to elude observation, and thus the 
effect is only to make him cunning in his vice. 

In adults, or youths, a different plan must be pursued. In these 
cases, moral considerations, and the inevitable consequences to health 
of body and mind, are the chief influences by which a reform is to be 
effected, if at all. These considerations may be urged with all possi¬ 
ble eloquence and earnestness, but should not be exaggerated. The 
truth is terrible enough. If there are any special influences which 
may be brought to bear upon a particular individual,—and there al¬ 
ways will be something of this sort owing to peculiarities of tempera¬ 
ment or circumstances,—these should be promptly employed and ap¬ 
plied in such a manner as to secure for them their full bearing. But 
after all, the most must be done by the individual himself. 

SPEKMATORKn<EA. 

This is really an advanced stage of the preceding disease in which 


IMPOTENCE. 


1295 


seminal losses occur without the knowledge of the patient, as when 
straining at stool, or by passing off in the urine. It is almost invaria¬ 
bly accompanied by an extreme degree of irritability of the urethra 
near the base of the bladder. The seminal fluid escapes in some cases 
just after urination in the form of a few whitish drops. It must not 
be supposed, however, that a discharge of this kind is always of a sem¬ 
inal character, as it is more often simply mucus. The real character 
of the discharge can be determined only by a careful microscopical 
examination. 

Treatment. —All that the patient can do for himself has been in¬ 
dicated under the preceding disease. Cases of this kind require the 
attention of a skillful physician. 

IMPOTENCE. 

Impotence, or a lack of sexual power, may be due to a great variety 
of causes, among the chief of which are sexual excess, particularly self¬ 
abuse, mental influences, the use of liquor, opium, and particularly the 
use of tobacco. The influence of tobacco in producing this condition 
has been long suspected, and is now well recognized by many physicians. 
At a late meeting of the British Medical Association several eminent 
physicians reported several cases of impotence in which the disease was 
undoubtedly the result of tobacco-using. The first effect of the drug is 
to excite the sexual organs; the ultimate result of this morbid excite¬ 
ment as stated, is partial or entire loss of sexual power. 

Treatmeut. —When impotence is the result of long-continued sexual 
abuse, complete recovery is impossible ; though even in the majority of 
these cases at least partial improvement can be secured. When the im¬ 
potence is accompanied by nocturnal emissions or spermatorrhoea, these 
affections must of course be cured before sexual power can be regained. 
Treatment that is good for one of these conditions is also the best for 
the other. The patient should abstain from the use of all narcotics and 
stimulants, including tea, coffee,'.strong spices and other condiments, as 
well as tobacco and alcoholic liquors. It is necessary that he also re¬ 
frain from any attempt to exercise the sexual functions, and to avoid 
sexual excitement of all kinds. Every possible measure should be 
adopted for improving the condition of the general health. In addition, 
the alternate hot and cold douche or spray should be applied to the parts 
daily. Two or three times a week a local application of electricity should 


1296 


DISEASES AND THEIR TREATMENT. 


be made. The latter measure is one of the best means of treatment we 
have ever employed. We have found the last-named remedy to be very 
essential in the treatment of bad cases of impotence. When this condi¬ 
tion arises from moral influences, as lack of confidence, the remedy con¬ 
sists in the removal of the causes so far as possible by appropriate mental 
and moral treatment. 


STERILITY. 

This condition may arise from a great variety of causes, among 
which may be mentioned various diseases, as diabetes, Bright s disease, 
dyspepsia, consumption, as well as disease of the testicles, including vari¬ 
cocele and various tumors to which the organ is subject. In some cases 
sterility is due to obstruction of the seminal ducts, which may arise from 
stricture of the ducts from inflammation or failure of the testicles to de¬ 
scend from the abdominal cavity to the scrotum. The use of tobacco, 
opium, and alcoholic drinks, should also be recognized as causes of ste¬ 
rility. All of these drugs destroy the vitality of the spermatozoa, the 
essential elements of the seminal fluid. 

Treatment. —The treatment of this condition wholly depends upon 
the cause. When this is of such a nature that it can be removed, recov¬ 
ery may take place. Cases in which there is permanent closure of the 
spermatic cord are usually incurable. Beal sterility is, fortunately, a 
very rare affection in men, though by no means so uncommon in women. 

SEIJBA1GIA OF TIIF TESTICLE. 

Under this head are included two conditions, in one of which there 
is unnatural sensitiveness to touch or pressure, and the other in which 
there is constant pain of a neuralgic character, sometimes very distress¬ 
ing. The pain is most often of a dull, aching character, and frequently 
extends up the cord to the body. In some cases the neuralgic pains ex¬ 
tend to the inner portion of the thigh, upon the side in which the dis¬ 
ease exists. It may originate from any one of the following causes : self¬ 
abuse and other sexual vices and excesses, disease of the prostate, in¬ 
flammation of the testicle, acid urine, dyspepsia, gout, varicocele. The 
last-named disease is almost invariably accompanied by neuralgia. 

Treatment. —Recovery will generally take place quite speedily 
when the causes of the disease are removed. The pain is generally re¬ 
lieved by local applications of cold. Cold applications to the lower part 
of the back are especially useful and should be emplo 3 T ed in the form of 


VENEREAL DISEASES. 


1297 


an ice-pack, and may be used from one to three hours a day according 
to the urgency of the case. Applications of dry heat or of the hot spray 
will also be found useful in relieving local pain. 

TUMORS OF TIIF TESTICEE. 

The testicles are subject to fibrous and cancerous growths, as well as 
various other kinds of tumors. The only remedy to be recommended in 
these cases is removal of the affected organ. 

S1PHILIS-POX. 

Of the three forms of venereal disease, this is of vastly greater 
consequence than either of the other two, gonorrhoea and chancroid, 
since this is a constitutional affection, while they are purely local in 
character. 

The symptoms of this disease are too numerous for full consider¬ 
ation here, and we can only notice some of the chief features of the 
disease. It has three distinct stages. The first is a local manifesta¬ 
tion, known as chancre. Two or three weeks, or longer, after exposure, 
a small, hard, reddish pimple makes its appearance, usually upon the 
genitals, although cases have occurred in which the disease was con¬ 
tracted by kissing, when the chancre was formed upon the lip. The 
pimple increases in size for a few days, and finally ulcerates, and dis¬ 
charges slightly. It does not usually give much inconvenience, and 
is, in fact, not infrequently unnoticed. In this respect the chancre 
differs much from the chancroid, a very important distinction. After 
a few days the glands of the groins become somewhat enlarged, 
although not very painful. After one to three months the secondary 
stage of the disease appears, as an eruption of red spots, which are 
followed by pimples. After a time, larger pimples or pustules make 
their appearance, leaving behind them pock marks like those of small¬ 
pox. Ulcers also appear in some cases. Simultaneously with the 
occurrence of the eruption, slightly raised spots of a whitish color, 
known as mucous patches, appear on the mucous membrane of the 
lips and tongue. A slight discharge arises from these patches, which 
is of a very contagious character. The patient also has sore throat, 
and often sore eyes; and after the general health has become con¬ 
siderably impaired, suffers greatly with pains in the head, arms, legs, 
breast, and particularly in the joints, though the pain is not confined 

82 


1298 


DISEASES AND THEIR TREATMENT. 


to them as in rheumatism. Small swellings, known as nodes , which 
are tender on pressure, appear on the shins and other parts. 

The above symptoms disappear after a few weeks, and the patient 
may seem to be well for several months or years; hut unless the dis¬ 
ease has been properly treated, it is all the time at work in the system, 
and next makes its appearance in the deeper tissues, particularly in 
the bones and cartilages of the nose and skull. Not infrequently the 
nose is greatly disfigured, or even wholly destroyed. The liver, lungs, 
kidneys, heart, and other internal organs, are also likely to be affected. 
No other disease makes such fearful ravages in the human consti¬ 
tution as this. 

Treatment. —There is a great difference of opinion among phy¬ 
sicians concerning the treatment and the curability of this disease. 
The eminent Prof. Van Buren, of New York, who has had a very 
extensive experience in the treatment of this affection, stated in our 
hearing, a few years ago, that he never dared to assure a patient that 
he was well, no matter how completely free from disease he might 
seem to be. Others claim to be able to effect a cure in nearly all cases. 
Mercury has been looked upon as the great antidote for syphilis; but 
as shown elsewdiere (see pages 764-6), there are grounds for doubting 
the efficacy of this drug. According to Prof. Hughes Bennett, M. 
D., F. B. S. E., President of the Royal Medical Society of Edinburgh, 
the mercurial treatment is being rapidly superseded by the “ simple ” 
method, which consists in careful regulation of all the habits of the 
patient, good hygiene, avoidance of spices, condiments, meat, and all 
stimulating foods, and the use of tepid baths and other eliminative 
treatment. Two or three full baths may be taken daily with advan¬ 
tage, unless the patient is very weak. The vapor, hot-air, Turkish, 
and Russian baths are also useful. The wet-sheet pack is a very 
admirable remedy. Fomentations and tepid compresses should be 
applied to irritable parts. The patient should drink from one to two 
quarts of water daily. By these means the poison may be eliminated 
from the system; while by the mercurial treatment, according to Dr. 
Bennett and several other eminent German physicians, the mercurial 
treatment only checks the manifestation of the disease, thus merely 
delaying the expulsion of the poison from the system. "With refer¬ 
ence to the success of this mode of treatment, Dr. Bennett remarks : 
“ More than eighty thousand cases have been submitted to experi- 


CHANCROID. 


1299 


merit, by means of which it has been perfectly established that syph¬ 
ilis is cured in a shorter time, and with less probability of producing 
secondary syphilis, by the simple than by the mercurial method.” 
The same author further remarks: “ The intensity of the disease in 
modern times has declined exactly in proportion as its treatment by 
mercury has diminished, and the disorder been left to follow its nat¬ 
ural course. When we treat syphilis on the same principles that we 
do scarlatina and small-pox, it will prove infinitely less fatal than 
those disorders.” 

In order to be effectual, the treatment must be continued for months 
after the symptoms of the disease have disappeared, as the malady 
may appear even after the lapse of many years, and if not in the life¬ 
time of the transgressor, may appear in his posterity. 

CHANCROID. 

This is a painful ulcer or sore, which secretes a contagious matter, 
usually appearing upon the genitals within a few days after exposure. 
If not properly treated, these sores often last several months. There 
may be several present at the same time. In many cases, a painful 
swelling occurs in the groin, on one side or on both, from enlargement 
of the glands in this region. The swelling may disappear by absorp¬ 
tion, or suppurate and form an abscess. This form of venereal dis¬ 
ease does not give rise to constitutional symptoms. 

Treatment. —Keep the sore clean, employ a restricted diet, prac¬ 
tice absolute continence, and refrain from active exercise for a few 
days. Meat, stimulants, spices, and tobacco, should be carefully 
avoided. The specific poison may be destroyed by touching the sore 

with a strong caustic of some sort. 

© 


1300 


DISEASES AND THEIR TREATMENT. 


DISEASES 0E WOMEN. 


A remarkable increase in the number and frequency of that large class 
of maladies known as diseases peculiar to women, has attracted the atten¬ 
tion of many observing physicians. The fact has received many differ¬ 
ent explanations. One author attributes the difficulty to faulty meth¬ 
ods of education, particularly the attempt of young women to compete 
with their brothers in the study of the classics and the higher mathe¬ 
matics. Another, adducing the fact that American women seem to 
suffer more than those of any other nation, finds an explanation in the 
asserted fact “that all animals tend to deteriorate in this country.” 
No reason is offered why America should not be as healthy a country 
as any other upon the globe, but attention is called to the fact that 
numerous classes of people have occupied the territory in succession, 
from which it is argued that no race can long continue an existence 
here without degeneration; thus placing the responsibility wholly upon 
nature and removing it from the shoulders of those who, according to 
our view, are only suffering the consequences of their own transgression 
of nature’s laws, combined with inherited weaknesses and morbid ten¬ 
dencies. 

We have become satisfied from the somewhat extended opportuni¬ 
ties of observation which we have enjoyed, that the cause of the in¬ 
creased frequency of diseases pecuilar to the female sex are more directly 
attributable to bad habits of dress, diet, and unnatural and injurious 
personal and social habits of various sorts, than to any other causes. 
We cannot conceive it to be possible for a woman to dress in accordance 
with the requirements of fashion for any length of time, without be¬ 
coming seriously diseased in the functions peculiar to her sex. 

The process of perversion which finally results in serious diseases be¬ 
gins at a very early period. In the words of the eminent Prof Emmett, 
who stands foremost in the ranks of specialists in the treatment of 
this class of diseases, ‘ at the very dawn of womanhood the young girl 
begins to live an artificial life, utterly inconsistent with the normal de¬ 
velopment. The girl of the period is made a woman before her time 
by associating too much with her elders, and in diet, dress, habits, and 



DISEASES OF WOMEN. 


1301 


tastes, she becomes at an early age but a reflection of her elder sisters. 
She may have acquired every accomplishment, and yet will have been 
kept in ignorance of the simplest feature of her organization, and of the 
requirements for the preservation of her health. Her bloom is often as 
transient as that of the hot-house plant, where the flower has been 
forced by cultivation to an excess of development, by stunting the 
growth of its branches, and limiting the spread of its roots. A girl is 
scarcely in her teens before custom requires a change in her dress. Her 
shoulder-straps and buttons are given up for a number of strings about 
her waist, and the additional weight of an increased length of skirt is 
added. She is unable to take the proper kind or necessary amount of 
exercise even if she were not taught that it would be unladylike to 
make the attempt. Her waist is drawn into a shape little adapted to 
accommodate the organs placed there, and as the abdominal and spinal 
muscles are seldom brought into play, they become atrophied. The 
viscera are thus compressed and displaced, and as the full play of the 
abdominal wall and the descent of the diaphragm are interfered with, 
the venous blood is hindered in its return to the heart.” 

Although mothers have been repeatedly warned of the danger of 
thus allowing their daughters to sap the very foundation of their life 
in early womanhood, it is rare indeed that a mother can be found who 
has the moral courage to stand up against the tide of public opinion 
and bravely refuse to bow to the mandates of fashion. Health, happi¬ 
ness, usefulness, comfort, are all sacrificed upon the throne of the fickle 
goddess to whom so many thousands pay an onerous but willing hom¬ 
age. So long as this strangely inconsistent course is persisted in, wo¬ 
man will continue to be the chief supporter of the medical fraternity, 
whose skill and ingenuity are taxed to the utmost in devising means for 
the relief of her multitudinous and painful ills; at least three-fourths of 
which might be easily avoided by better attention to the laws which 
govern her sexual nature. 

Among other general causes of disease in woman may be mentioned 
novel reading, an evil habit indulged in by a very large proportion of 
the young ladies of the present day, and the result of which is the de¬ 
velopment of a weak sentimentalism, and the production of nervous¬ 
ness, hysteria, and a long list of maladies which depend largely upon 
morbid mental states. 

Another very frequent cause which should be mentioned in this con¬ 
nection, is carelessness at the menstrual period. Few women, at least 


1302 


DISEASES AND THEIR TREATMENT. 


in early life, exercise that care at this time that is absolutely necessary 
to avoid incurring danger of producing serious disease. Young women 
attend parties, concerts, balls, and various entertainments in all sorts of 
weather, and without proper attention to protection by suitable clothing, 
irrespective of the menstrual function, the consequence of which is 
the contraction of colds at this susceptible period, and the establishment 
of various irregularities which lay the foundation for serious diseases in 
future years. There is no doubt but that a large share of the chronic 
diseases from which women suffer the most, have their first beginnings in 
exposure at the beginning of sexual activity. The greatest care should 
be exercised at the time of the establishment of the menstrual flow on this 
account. At least twenty-four hours’ rest should be taken before the time 
for the period to begin. The most of the time during the period should be 
spent in bed. No violent physical or mental exertion should be indulged 
in at this time. Women of barbarous nations, and robust young women 
who have from early childhood been accustomed to active muscular labor, 
perhaps do not require to observe quite so great precaution; but the 
average girl of the present day needs just this sort of care. Mothers 
are generally very remiss in their duty in not watching carefully over 
their daughters at this period, giving them proper instruction and re¬ 
straining them from taking such a course as must result in positive and 
often life-long injury. 

Another active cause in the production of local diseases in women 
is habitual neglect of the bowels. The great majority of women, 
young, old, and middle-aged, suffer with constipation of the bowels. In 
a majority of cases this is largely the result of neglect to attend promptly 
to the calls of nature. By degrees, the bowels lose their natural sensi¬ 
bility, and become torpid and inactive ; the immediate result of this is 
congestion of ail the organs of the pelvis, the uterus and ovaries with 
the rest, and sooner or later the symptoms of disease of these organs 
make their appearance. 

Lastly, we must mention sexual abuses of various sorts as among 
the most positive sources of serious local disease in females as well as 
in the opposite sex. Probably this cause, especially secret vice among 
young women, does not prevail to such a universal extent as it does 
among boys and young men; but evidences are too convincing to be ig¬ 
nored that cases are by no means rare in which this is an active cause. 
Among married women, sexual excesses, for which they are not wholly 
or often chiefly responsible, give rise to a very large share of the 


DISEASES OF WOMEN. 


1303 


maladies from which they suffer. This subject has been quite fully 
treated under the head of sexual physiology and hygiene. 

In concluding these introductory remarks, we would earnestly invite 
the reader’s special attention to the paramount importance of attending 
seriously and promptly to the first evidences of the maladies to which 
this section is devoted. Nearly all this class of diseases, although very 
chronic and obstinate when thoroughly developed, are readily controlled 
by proper and efficient treatment at the outset. False modesty often 
restrains the sufferer from making known her condition to a competent 
medical adviser until it has existed so long that a cure can only be ac¬ 
complished by long-continued and persevering efforts. When apprized 
of this fact, the unfortunate individual often gives up in discouragement. 
In far too many instances when this is not the case, the patient has the 
misfortune to fall into the hands of some physician who blindly follows 
obsolete or routine methods of treatment, perhaps doing the best he 
knows how, but notwithstanding, in no way benefiting the patient even 
after years of treatment. In scores of instances, patients of this kind 
have come to us in utter despair, having lost all faith in all methods of 
treatment, and given up all hope of recovering health. The treatment 
of this class of disease, or “female weaknesses, ” as they are termed by 
the advertising charlatan, is one of the most lucrative sources of revenue 
to quacks of every description. Not hesitating to promise the most 
marvelous results within a short space of time, they excite the hopes of 
their victims only to leave them deeper than ever in the slough of despond. 
A person who has been thus imposed upon a few times, is generally in 
about as wretched a condition, both physically and mentally, as an in¬ 
dividual can well be. It is partly for the purpose of rendering sufferers 
from this class of diseases sufficiently intelligent upon the subject of 
their ailments to enable them to discriminate between the competent 
and reliable physician and the ignorant pretender, that this section is 
written. Another object in its preparation which we may mention 
in conclusion, is to inspire those of this large class of sufferers into whose 
hands this work may fall with hope and courage, by the assurance 
that there are rational and successful methods of treatment which w ill 
reach almost every case, no matter how chronic or how apparently 
hopeless it may be, provided they are skillfully adapted to each partic¬ 
ular case and faithfully administered. 


I 


1304 DISEASES AND THEIR TREATMENT. 

INFLAMMATION OF THE OVARY. 

SYMPTOMS.—Sudden pain in one or both groins, sometimes extending down the leg 
and the feet; often pain in the breast and the affected side ; increase of pain during 
menstruation; tenderness on pressure; pain in moving the bowels; general distress; 
nausea; more or less fever. 

This disease most frequently results from taking cold during men¬ 
struation, from injury, and from the infection of gonorrhoea. In many 
instances innocent wives have suffered from inflammations which have 
rendered them barren and invalids for life by the last-named cause 
contracted from incontinent husbands. 

Treatment. —Rest, fomentations to the affected part, hot vaginal 
douches two or three times a day, and especially the hot enema taken 
once or twice a day and retained for half an hour or as long as possi¬ 
ble. The patient should remain perfectly quiet in bed, and should not 
attempt to get upon her feet or walk about for some time, or until the 
local irritation is almost wholly subdued. 

CONGESTION OF TIIE OVARY—OVARIAN IRRITATION. 

SYMPTOMS.—Tenderness in the groin; pain in standing or walking; more or less 
continuous pain, aggravated at the menstrual period, which is generally ushered in by 
a chill followed by a fever resembling that of ovarian inflammation. 

This condition is frequently called chronic inflammation of. the 
ovary, and is often accompanied by enlargement of the organ which 
in consequence of some sudden j ar or unusual strain becomes dislocated 
or prolapsed. Ovarian irritation often produces a reflex effect upon the 
system. It is a frequent cause of obstinate dyspepsia, especially of the 
nervous form, accompanied by spinal irritation, by painful headaches, 
and in some cases of serious mental disease really amounting to insan¬ 
ity. 

Causes. —Among the chief causes may be mentioned improper 
dress, taking cold at the menstrual period, disappointment, induced 
abortion, the use of “preventives,” constipation, the opium habit, pros¬ 
tration, and self-abuse. 

Treatment.— The patient should be given the advantage of as good 
hygienic surroundings as possible. Sun baths, massage, complete rest 
at the menstrual period, daily fomentations over the affected parts, the 
daily use of the hot vaginal douche, the hot enema, fomentations over 
the lowei part of the spine, and the local application of electricity con- 


OVARIAN DROPSY. 


1305 


constitute the best known means of treatment. Some eminent surgeons 
have recently resorted to the plan of removing one or both of the ova¬ 
ries in cases similar to this. The effect thus far has been very satisfac¬ 
tory, although the remedy is not entirely free from danger. We have 
treated quite a large number of cases of ovarian irritabillity, and have 
thus far succeeded in effecting a cure without resorting -to a surgical 
procedure. 

OYARIM DROPSY. 

SYMPTOMS.—Begins with dull pain low down on one side of the body; scanty men¬ 
struation, and finally suppression; dragging pain in the bowels; painful and frequent 
urination; difficulty in moving the bowels; great debility; loss of flesh; enlargement 
begins on one side of the body. 

Ovarian dropsy consists in the formation of a cyst in the ovary 
which gradually enlarges until it obtains in some instances of very great 
size, and is filled with fluid which differs in character in different cases. 
The ovary is also subject to the growth of various other tumors, as 
fibrous and cancerous tumors. Ovarian dropsy generally runs its 
course in about four years. The causes are obscure. The difficulty is 
probably occasioned in many instances by inflammation of the ovary. 

Treatment. —The medical treatment of ovarian dropsy consists 
in withdrawing the fluid by means of tapping, or preferably by the use 
of the aspirator, the employment of galvanism and electricity in other 
forms, and improvement of the patient’s health in every possible way. 
In a case which we had under treatment a few years ago, the tumor had 
obtained such enormous size as to give to the patient, naturally a very 
slight woman, a waist circumference of over forty-four inches. The 
plan of treatment in this case was removal of the fluid by means of the 
aspirator, followed by the application of a strong galvanic current over 
the affected part. The result was that the patient was able to leave 
for her home after six or eight weeks’ treatment without the slightest 
trace of any disease; and when we met her a year later, she continued 
well. 

The only radical cure for the disease, however, is ovariotomy, a sur¬ 
gical operation by means of which the diseased ovary, with the cyst 
attached to it, is removed. This is a comparatively recent procedure, 
and is one of the most brilliant operations of modern surgery. When the 
operation was first employed, a very large proportion of those operated 
upon died; but so many improvements have been made since that time 


1300 


DISEASES AND THEIR TREATMENT. 


that skillful operators have now reduced the risk of death to eight per 
cent, or eight in one hundred. A celebrated English operator recently 
performed the last of one hundred successive cases without a single 
death. 


ISFl.DIMATI03i .ABOUT TIIE UTERUS, ETC. 

SYMPTOMS.—Fever ; pelvic pain; small, wiry pulse ; nausea and vomiting ; tender¬ 
ness on pressure just above the pubic bone; painful urination and defecation ; profuse 
menstruation. 

Inflammations of this sort are much more common than is gener¬ 
ally supposed, and are generally very serious in their results. There 
is a strong tendency to the formation of abscesses. Another serious com¬ 
plication is the inflammation of the broad ligament, which subsequently 
contracts, thus becoming shortened. This kind of shortening is a com- 
mon cause of lateral displacements of the utei’us. 

Causes. —Inflammation following child-birth, abortion, taking cold 
during the menstrual period, inflammation of the ovary, gonorrhoea, 
the use of caustics upon or in the uterus, wearing of ill-fitting pessa¬ 
ries, sexual excesses; these are the most common. 

Treatment. —An acute attack can generally be checked by a suffi¬ 
ciently thorough and energetic course of treatment. The patient should 
be kept perfectly still in bed. If the fever is high, the ice-cap should be 
applied with ice-compresses or bags filled with ice-cold water to the 
spine. The most effective measures of treatment, however, are the 
hot vaginal douche and the hot enema. These should be given with 
great thoroughness. The douche should be taken for an hour at a 
time, and should be repeated three or four times a day, or it may be 
given continuously for several hours. This is the most reliable means 
known for cutting short an inflammation after it has begun. Hot ap¬ 
plications should be made to the feet to balance the circulation. The 
hot blanket pack, as a means of inducing prespiration, is an excellent 
measure in this disease, as it relieves the congestion of the internal or¬ 
gans. Chronic cases require the persistent use of fomentations over the 
lower part of the abdomen,hot douches two or three times a day,together 
with rest in bed and complete functional rest of the affected organs. 
Attention should be be given to the improvement of the general 
health by means of a good diet, massage, the use of electricity in vari¬ 
ous forms, etc. We have thought that the absorption of the hardened 


AMEN OBRHCEA . 


1307 


mass felt after an attack of this sort has been in many cases stimu¬ 
lated very greatly by the local use of galvanism. Care should be 
taken, however, to avoid the employment of too strong currents. In 
one case which had been under treatment for some months, with very 
great benefit, though the patient was not entirely cured, the lady be¬ 
came somewhat impatient because we refused to employ as strong cur¬ 
rents of electricity as she wanted, and resorted to a Chicago physician 
who made a speciality of the use of electricity. She received from 
this source the strong current she desired, but the result was most dis¬ 
astrous, as an inflammation was set up which obliged her to return 
to us, and which we had much difficulty in subduing. 

AMEMORRHCEA. 

Amenorrhoea is a condition in which the regular monthly flow is sus¬ 
pended. It is not a disease of itself, being simply a symptom of some dis¬ 
order of the uterine organs. The conditions from which it may arise 
are various. In pregnancy, menstruation is usually suspended, al¬ 
though in exceptional cases the regular monthly flow continues. 
There is some discussion, however, whether in these cases the loss of 
blood is the true monthly menstrual flow. Menstruation is also usu¬ 
ally suspended during nursing, although the function is not infre¬ 
quently resumed two or three months after childbirth. Imperfect de¬ 
velopment of the reproductive organs and obstruction of the uterus 
or the vagina are conditions which occasionally give rise to amenor- 
rhcea. When a mechanical obstruction exists, there is generally en¬ 
largement of the abdomen from accumulation of the menstrual fluid. 
Sudden suppression of menstruation is generally due to taking- 
cold during the menstrual period, or sudden mental shock. When it 
occurs suddenly in this way, the patient generally complains of pain in 
the back, headache, fever, and other unpleasant symptoms. We have 
noticed also, in some cases, temporary suspension of the menstrual flow 
in consequence of a change in diet, in which persons who had been 
accustomed to a stimulating diet, consisting largely of animal fat, in¬ 
cluding a free use of stimulating condiments, suddenly discontinued 
the use of these articles. In these cases, however, we have never ob¬ 
served any impairment of the general health ; in fact, in the majority 
of cases there has been improvement in the general health notwith¬ 
standing the suppression of this function. In the course of a few 
months the function appears again, though as a general rule the flow 


1308 


DISEASES AND THEIR TREATMENT. 


is somewhat less profuse than before. We have observed a few pecu¬ 
liar cases of suppression of menstruation in which the patient suffered 
at the times when menstruation should appear, with peculiar nervous 
symptoms closely resembling a slight epileptic attack. 

Patients suffering with amenorrhoea are frequently subject at the 
time when the menstrual flow should make its appearence to hemor¬ 
rhage in various parts of the body, as from the nose, lungs, stomach, 
bowels, etc. Some cases have been observed in which bloody-sweat ap¬ 
peared at these times. These hemorrhages are sometimes termed vica¬ 
rious menstruation. 

Treatment. —In cases in which the function has never appeared, 
the difficulty is generally due to morbid development, or some form of 
obstruction. For the first condition, such measures should be adopted 
as will improve the patient’s general health, and secure proper develop¬ 
ment. In these cases, the hips are generally narrow and the breasts 
small, and the patient has in many cases something of a masculine ap¬ 
pearance. When the difficulty has existed for a long time, its removal 
may be impossible; hence the importance of giving attention to the 
matter in time. When obstruction exists, as indicated by the periodical 
oecurrence of the usual symptoms of menstruation, but without the 
menstrual flow, and with enlargement of the lower part of the abdo¬ 
men, surgical measures should be resorted to, to allow the accumu¬ 
lated fluid to escape. This should be done gradually, however, and in 
such a way as to prevent the entrance of air, as otherwise decomposi¬ 
tion would occur, which might result in poisoning of the blood. This 
class of persons often suffer much mental annoyance through suspicion 
of pregnancy. 

In cases in which suppression occurs suddenly during the menstrual 
period, the patient should take a hot foot or sitz-bath, or better still, 
a hot blanket pack, and should be made to sweat profusely by this 
means combined with hot drinks. Hot fomentations should be applied 
across the lower part of the bowels, bricks, hot bags, and other simi¬ 
lar applications to the limbs and inside of the thighs. Ice bags or com¬ 
presses should be applied over the lower portion of the spme, and the 
patient should be kept quiet in bed. 

When amenorrhoea exists in consequence of debility or anaemia, as 
in consumption and other prostrating diseases, attention should be 
given to the improvement of the general health by nutritious food. 


PROFUSE MENSTRUATION. 


1309 


daily exercise in the open air, daily massage, with inunctions, elec¬ 
tricity and other tonic measures. In these cases, the amenorrhoea is 
not to be considered as the cause of the existing debility or general 
disease, as is usually thought to be the case. It is simply the result 
of general depression of the system which will disappear with the re¬ 
moval of the cause. In these cases, warm sitz-baths, hot fomentations 
over the bowels, and daily application of the ice compress to the 
lower portion of the spine for an hour or two, are useful measures. 
The local application of electricity by a competent person is also of 
very great advantage. 

Scanty Menstruation. —The length and quantity of the men¬ 
strual flow varies very greatly m different individuals within the lim¬ 
its of life. A person suffers with scanty menstruation when the func¬ 
tion is meagre compared with what is usual for the same individual. 

The principal causes of this condition are consumption, inflamma¬ 
tion of the ovaries, ovarian tumors, anteflexion of the uterus, mental 
depression, chlorosis, and general debility. 

Treatment. —The general treatment should be the same as recom¬ 
mended fo^ similar cases in which menstruation is entirely suspended. 
For a few days before the period should make its appearance, the patient 
should take daily a warm sitz-bath for fifteen or twenty minutes. At 
the time of the period, w r arm enemas and cold compresses applied to 
the lower part of the spine, with fomentations over the bowels at the 
same time, constitute the best measures of treatment. The difficulty 
will generally exist until the patient shows marked evidences of im¬ 
proved health. 

MESORRnAGIA-PROFUSE MENSTRUATION. 

The same remarks made respecting the preceding condition apply 
to this. There is no definite standard as to the length or quantity of 
the menstrual flow. When the flow is much more than usual, or so 
excessive as to produce weakness and prostration either at the time, or 
after, it may be termed menorrhagia. 

Menorrhagia may be produced by either plethora or debility. 
When resulting from plethora, the patient suffers with severe throb¬ 
bing headache, pain in the back, and general symptoms of fever. When 
it results from the opposite condition, the patient is very weak, pale, 
and thin in flesh, and the flow is almost continuous, one period begin- 


1310 


DISEASES AND THEIR TREATMENT. 


ning almost immediately at the conclusion of the other. In addition 
to plethora and debility, menorrhagia may be the result of chronic con¬ 
gestion of the uterus, prolapsus and other displacements, tumors, lacera¬ 
tion of the neck of the uterus, disease of the heart, liver, lungs, and 
other important organs. 

Treatment. —In cases of menorrhagia arising from plethora, the diet 
should be simple and plain. The patient should take but two meals a 
day, and little or no meat. Abundant out-of-door exercise is also es¬ 
sential ; great advantage may be derived from the use of packs, va¬ 
por baths, hot-air baths, and other eliminative treatment, until the 
symptoms of plethora disappear. Daily cold sitz baths between the 
periods are also advantageous. At the time of the period, and about 
twenty-four hours before it is expected, the patient should have com¬ 
plete mental and physical rest in bed. Cold cloths should be applied 
over the lower part of the abdomen and between the thighs. A cold 
or cool enema should be given two or three times a dav. Cold should 
should not be applied for more than an hour or two at a time without 
allowing an interval of half an hour. 

In patients who are pale, debilitated, and have but little blood, 
energetic measures are often needed. The patient should observe the 
directions just given respecting quiet. Cold applications should be 
made to the lower part of the bowels, being replaced once in twenty 
or thirty minutes by a hot fomentation for three or four minutes, 
cold being then applied again. The cold enema and often the cold 
vaginal douche are indicated when the flow is extremely profuse. 
The hot vaginal douche is also useful. 

In one case in which the hemorrhage could not be controlled other¬ 
wise, we had a patient placed in a sitz bath at eighty degrees, having 
the temperature rapidly lowered by the addition of small quantities 
of snow and ice. The desired result was almost immediately obtained. 

In cases in which the hemorrhage is almost continuous from one pe¬ 
riod to another, the patient should remain in bed or lie upon the sofa 
several days after the flow has been checked by the treatment before 
described. This disease can only be permanently cured by improve¬ 
ment of the general health. The same directions for treatment should 
be followed in cases in which the menorrhagia arises from congestion, 
tumors, displacements, or any other of the causes mentioned. When 
the hemorrhage cannot be controlled in any other way, it sometimes 


UTERINE HEMMORRIIAGE. 


1311 


becomes necessary to plug the vagina with cotton in, the manner de¬ 
scribed for checking uterine hemorrhage. 

METRORRHAGIA—UTERINE HEMORRHAGE. 

This is a hemorrhage occuring from the uterus at other times than 
at the menstrual period. The causes are essentially the same as those 
described as occasioning menorrhagia. 

Treatment.— Keep the patient quiet in bed ; apply cold over the 
bowels and between the thighs ; administer cold enemas and cold 
vaginal injections. In case the hemorrhage is severe, much may be 
gained by t}dng a band tightly around one or both lower limbs, thus 
retaining in the legs a large amount of the venous blood. The liga- 
ture should not be retained long enough to do harm, and should be 
gradually removed if the limbs should become considerably swollen 
and purple. Compression may also be practiced by means of a pad 
composed of a folded towel placed over the womb. In severe cases it 
often becomes necessary to plug the vagina. This is best done by 
means of moist cotton. The cotton should be saturated with water 
and squeezed as dry as possible. It should then be soaked for a few 
seconds in a strong solution of alum and again squeezed dry. It 
should then be made into a number of small rolls of a size convenient 
for introduction, and after tying a string ten or twelve inches in 
length around the center of each, they should be passed into the va¬ 
gina and crowded up around the neck of the uterus as tightly as pos¬ 
sible. The whole neck of the womb should be surrounded, and the 
vagina should be packed as full as possible. Care should be taken that 
no spaces are left between the different portions of cotton, and that 
the whole mass is made as compact as possible. This is generally 
known as tamponing the vagina. The operation cannot be thor¬ 
oughly done without the aid of a speculum, and hence a physician should 
be called in every case of uterine hemorrhage sufficiently severe to 
require this mode of treatment. Persistent hemorrhage also demands 
a thorough examination by a competent physician to ascertain the 
real cause of the difficulty in order to adopt the proper measures for 
permanent relief. 

DYSMENORRIHEA—PAIAFl E MENSTRUATION. 

There are said to be five varieties of this affection, which are 
termed respectively neuralgic, congestive, obstructive, membranous, 


131*2 


DISEASES AND THEIR TREATMENT. 


and ovarian. Neuralgic dysmenorrhcea is caused by general neuralgia, 
chlorosis, gouty and rheumatic conditions of the system, high living, 
especially the use of stimulating condiments and excessive quantities 
of meat, sexual excess, and secret vice. Congestive dysmenorrhcea is 
caused by plethora, sudden chill, taking cold at the beginning of men¬ 
struation, chronic congestion of the uterus, retroflexion, cellulitis, tor¬ 
pidity of the liver, and constipation of the bowels. Obstructive dys- 
menorrhoea arises from obstruction of the canal of the uterus by an¬ 
teflexion or other causes, as a fibrous tumor, polypus, or swelling of the 
mucous membrane from uterine catarrh. The variety known as mem¬ 
branous dysmenorrhoea, in which a cast or mold of the cavity of the 
uterus is sometimes expelled, is due to chronic congestion of the uterus, 
which is increased at the menstrual periods almost to a condition of 
inflammation. Ovarian dysmenorrhoea results from congestion and 
inflammation of the ovaries. 

In neuralgic dysmenorrhoea, the patient has throbbing pain in the 
loins and lower part of the bowels, together with neuralgic pains in 
other parts of the body. In congestive dysmenorrhoea, when produced 
by taking cold, as by getting the feet wet just before the time of the 
menstrual period, the patient suffers with severe pain, often accompanied 
by a chill, which is followed by fever. When inflammation is present, the 
pain is dull and heavy. Severe bearing-down pains for a few hours or a 
day or two before the beginning of the flow, with relief either entirely or to 
a great extent as soon as the flow is established, indicates obstruction. 
In membranous dysmenorrhoea, the patient suffers with severe bearing- 
down pains, which cease as soon as the membrane is expelled. Ovarian 
dysmenorrhoea is characterized by pain continuing for several days be¬ 
fore the period, in one or both groins, and extending down the thighs ; 
there is also, usually, tenderness in one or both breasts. The tenderness 
in the groin is more or less marked between the menstrual periods. 

Treatment. —Dysmenorrhoea can generally be cured by the adop¬ 
tion of proper means, provided the real cause is ascertained; though 
when due to fibrous tumors of the uterus, the treatment often fails. 
The most that can be done, however, in the domestic treatment of the 
difficulty, is to palliate the symptoms at the time of the menstrual pe¬ 
riod. Curative treatment can be best managed by a competent physi¬ 
cian. The patient suffering with any form of dysmenorrhoea should 
take care to keep the bowels quite free by a carefully regulated diet, 


NYMPHOMANIA. 


1313 


and the use of the warm water enema when necessary. Laxatives and 
purgatives should be carefully avoided. 

The patient should rest quietly in bed or upon the sofa for a day or 
two before the time for menstruation to begin. On the day it is ex¬ 
pected, or as soon as the pain commences, the patient should take a hot 
full bath or a hot blanket pack, and should afterward be covered with 
warm woolen blankets, with hot water bags or heated bricks to the feet 
and back and over the lower part of the abdomen. The patient 
should be kept as quiet as possible. Severe pain, when not relieved by 
these measures, will often yield to hot fomentations when rapidly ap¬ 
plied; or the application of the hot blanket pack. Especial pains should be 
taken to keep the feet and limbs thoroughly warm. The use of botlifa- 
radic and galvanic electricity is in some of these cases very advantageous. 
We have often secured almost immediate relief from pain by their use. A 
large, hot enema will sometimes give relief. The water should be injected 
slowly, and should be retained for some time, half an hour at least if 
possible to do so. In some cases, hot sitz baths give speedy relief. Fo¬ 
mentations across the lower part of the back are also very advantageous. 
Opium is very frequently resorted to in these cases, but it should be 
avoided as much as possible, as the opium-habit is very likely to be con¬ 
tracted. 

We have met a number of cases in which the habit was produced in 
this way. If anodyne remedies of any sort must be used, gelsemium 
hyoscyamus, and conium are much to be preferred. These remedies 
should of course not be used unless prescribed by a physician. We 
seldom find it necessary to resort to their use, almost invariably secur¬ 
ing relief by the measures described. 

AV.U PIIOIIAAIA. 

This term is applied to a condition in which there is an intense de¬ 
gree of sexual excitement. A female suffering with this affection will 
sometimes commit the grossest breaches of chastity. Its principal causes 
are self-abuse and a complete abandonment of the mind to lascivious 
thoughts. It is sometimes produced by ovarian irritation and by vari¬ 
ous diseases of the brain. The genitals are often found in a state of 
great excitement and abnormal enlargement in this affection. 

Treatment. —Cool sitz baths; the cool enema; a spare diet; the 
application of blisters and other irritants to the sensitive parts of the 

83 


1314 


DISEASES AND THEIR TREATMENT. 


sexual organs, the removal of the clitoris and nymphse, constitute the 
most proper treatment. 

The same measures 'of treatment are indicated in the cases in which 
the disposition to practice self-abuse is uncontrollable by other means. 
In an extreme case of this kind brought to us for treatment a few years 
ago, we were compelled to adopt the last-mentioned method of treatment 
before the patient could be cured. 

STERILITY. 

This condition differs from impotence in that the patient is not in¬ 
capable of the sexual act, but remains childless. 

Causes.— The most common causes are displacements of the uterus, 
contraction of the uterine canal, leucorrhoea, catarrh of the uterus, 
menorrhagia, sexual excess, secret vice, absence of the uterus or ova¬ 
ries. Women who suffer from great losses of blood at the menstrual 
period, and those who are excessively fat are very apt to be childless, or 
if they become pregnant are likely to suffer miscarriage. In a much 
larger proportion of cases of sterility than is generally supposed, the 
difficulty exists in the husband instead of the wife. The causes of 
.sterility in husbands have been considered elsewhere. It may be men¬ 
tioned here that Dr. Noeggerrath, an eminent physician of New York 
City, after a very extensive investigation of the subject, asserts that 
what he terms “latent gonorrhoea” is a very common cause of sterility. 
Dr. N. holds that if a man has once suffered with gonorrhoea, even 
when months or years have elapsed after a cure has apparently taken 
place, he is still likely, in case he marries, to communicate to his wife 
a disease which will render her incapable of childbearing, if he is not 
himself rendered incapable of procreation as a just punishment for his 
sin and folly. 

Treatment. —The various diseases upon which sterility may de¬ 
pend should receive first attention, and all the known causes should be 
avoided, particularly sexual excess. It may be properly mentioned in 
this connection that sexual contact just prior to or within a few days 
after menstruation is much more likely to be successful than at other 
times. 


UTERINE CATARRH. 


1315 


UTERINE CATARRn—ENDOMETRITIS. 

SYMPTOMS. —GENERAL: General debility; pulse weak; countenance pale and 
sallow; digestion slow; bowels very inactive; eyes dull, surrounded by a dark circle; 
nervousness ; headache; hysteria. 

LOCAL: Weakness in the back and lower part of the bowels ; watery or glary dis¬ 
charge, sometimes very copious, often appears in adhesive, stringy masses; scanty or 
suppressed menstruation ; painful menstruation; menorrhagia. 

« 

The mucous membrane lining the cavity of the uterus is subject to 
catarrh as well as all other mucous membranes of the body. This con¬ 
dition is generally termed, inflammation of the interior of the womb, 
.and it has long been treated as such. It has recently been thoroughly 
demonstrated, however, that this is not the case, and that the condition 
•of the mucous membrane of the organ is that of congestion and not in¬ 
flammation. 

Causes. —The most common causes are improper dress; taking cold 
at the menstrual period; sexual excess; self-abuse; and whatever may 
cause congestion of the womb. It occurs very frequently in women 
who for any reason do not nurse their children after childbirth. 

Treatment. —All exciting causes, so far as possible, should be re¬ 
moved. If the patient has been in the habit of wearing the clothing 
tight about the waist and suspended from the hips, and has neglected 
to clothe the lower extremities properly, these matters should receive 
immediate attention. The limbs should be thoroughly clad in flannel 
the greater portion of the year. The feet should be protected by thick 
woolen stockings and warm shoes. The clothing should be so loose as 
to remove all compression about the waist, and should be suspended 
from the shoulders by a waist or properly adjusted suspenders. The 
“emancipation waist, ” “hygienic waist, ” and other articles of clothing 
introduced by the Ladies’ Dress Reform Committee of Boston, are to be 
highly recommended, and we are glad to see that these articles are meet¬ 
ing with general favor and are being introduced into all our large cities. 

The diet of the patient should be nourishing but unstimulating. A 
large proportion of animal food is not advisable. Fruits and grains, 
with a moderate allowance of eggs and milk, constitute the best diet. 
Although excessive exercise, such as running, jumping, lifting, and 
horseback riding are injurious, a considerable amount of daily gentle 
exercise in the open air is very important. The sexual system should 
have entire rest during the course of treatment. In many cases, mar- 


1316 


DISEASES AND THEIR TREATMENT. 


ried women suffering with uterine catarrh are barren. When pregnan¬ 
cy occurs, it is likely to be attended by a great number of complica¬ 
tions, some of which are highly dangerous. 

Careful attention should be given to the regulation of the bowels. 
A thorough movement should be secured daily, the enema being employed 
if necessary. In most cases, however, the inactivity of the bowels may 
be overcome by careful attention to diet, daily kneading of the bow¬ 
els, and wearing the moist abdominal bandage at night. The local 
treatment of the disease consists in the employment of sitz baths and 
hot water douches. The sitz bath should be taken daily, or at least 
every other day, as follows: Begin the bath at 95°, after five minutes, 
lower the temperature to 90°; after ten or fifteen minutes longer, the 
temperature should be lowered two or three degrees more and the bath 
immediately concluded. A warm foot bath should be taken at the 
same time, at a temperature four or five degrees higher than that of the 
sitz bath. In taking the hot douche, the patient should lie upon a bed 
or properly constructed table, with the hips slightly elevated. The 
glass or metal tube attached to the rubber tubing of the syringe should 
be passed up into the vagina behind the neck of the womb. From 
three to eight quarts of water should be employed at a temperature at 
least three or four degrees above that of the body. The best effect is ob¬ 
tained when the temperature of the water is increased to 110°; although 
good results may be obtained if the water is only 100° to 105°. If the 
patient finds disagreeable sensations are produced by a temperature 
which is not sufficiently high to produce the desired results, water of 
a lower temperature as 95° to 100° may be employed first, the temper¬ 
ature being gradually increased until the water is as hot as necessary. 
In occasional instances, disagreeable sensations will follow the first use 
of the hot douche, but this may be avoided by employing water of a 
moderate heat, and gradually increasing the temperature. 

The best instrument for administering the douche is the syphon syr¬ 
inge. Fig. 210. The Davison, and various other forms of syringes 
may also be employed. The hot vaginal douche stands at the head of all 
remedies for uterine diseases of almost every description; but it is im¬ 
portant that it should be administered thoroughly. It is impossible for 
a patient to take the treatment herself in such a way as to accomplish 
much good. It cannot be taken in an upright or sitting position, or in 
any other way than with the patient lying upon the back, with any 
prospect of'good results. The employment of these measures should be 


INFLAMMATION OF THE WOMB. 


1317 


persisted in not only until the slightest symptoms of the local disease 
have passed away, but for several weeks after, and for a few days after 
each menstrual period for several months. It is unnecessary to remark 
that the sitz bath or douche should be suspended during the menstrual 
period unless the disease has assumed such a form as to occasion pain¬ 
ful menstruation, when the hot sitz bath may be necessary to give re¬ 
lief. The injection of irritating lotions of various sorts into the cavity 
of the uterus, a measure of treatment employed by some physicians, is 
in our opinion a hazardous procedure and one that is rarely ever required. 
We have had occasion to see the ill effects of this mode of treatment in 
a number of cases. In a case which came under our care a few months 
ago the patient had recently been treated by an injection into the cav¬ 
ity of the womb of a strong solution of nitrate of silver. The immedi¬ 
ate results were so serious that the lady barely escaped with her life. 
We scarcely need add that the chronic congestion of the organ from 
which she had suffered many years was greatly aggravated in the in¬ 
flammation which followed, in which not only the womb itself, but its 
surrounding tissues were involved. By this one act of imprudence an 
amount of damage was done which can hardly be repaired by many 
months of treatment and may occasion life-long injury. 

niXAJDIATIO^ OF THE WOMB—METRITIS. 

f 

SYMPTOMS. —GENERAL: Similar to those of chronic catarrh of the womb, but 
much more intense ; the patient has many feelings similar to those of early pregnancy. 

LOCAL- Pain in the lower part of the back, extending around the body ; weight, or 
dragging-down feeling in the bowels ; pain just above the pubic bones, with tenderness on 
pressure; frequently, various symptoms relating to the bladder. 

This disease, like the preceding one, has long been mistaken for an 
inflammation, which its name really implies, but which does not in 
reality exist. The condition commonly known as chronic inflamma¬ 
tion of the uterus is really congestion of the organ. In consequence of 
disturbance of the circulation in the womb it becomes engorged with 
blood and speedily becomes enlarged, sometimes reaching a size three or 
four times as larg-e as in health. In consequence of the enlargement 
and increased weight, the organ settles down in the pelvis and thus 
prolapsus or falling of the womb is produced. Sometimes its in¬ 
creased weight tips it over forward, producing another form of dis¬ 
placement, known as ante version. In other cases it tips backward 
against the rectum, producing retroversion; by degrees the anteversion 


1318 


DISEASES AND THEIR TREATMENT. 


or retroversion may become converted into an anteflexion or retroflexion, 
conditions in which the organ is bent upon itself. In some cases it is 
tipped to one side, conditions known as lateroversion or flexion. The 
various symptoms arising from these several displacements are given in 
connection with their consideration elsewhere. 

Causes. —The causes of inflammation of the womb are the same as 
those which have been mentioned. In cases of uterine catarrh, the 
whole organ finally becomes affected, as well as its mucous lining, by 
the long continuance of the causes referred too. Among the most act¬ 
ive causes are sexual excess in married women, secret vice in the un¬ 
married, the employment of various means to prevent conception, and 
improper dress. Very frequently, enlargement or congestion of the 
womb is the result of getting up too soon after confinement, in conse¬ 
quence of which the organ fails to return to its natural size, remaining 
more or less enlarged. Miscarriages and abortions are particularly lia¬ 
ble to be followed by this condition, which is known as subinvolution . 
The wearing of badly fitting supporters should be mentioned as a not- 
infrequent cause of chronic congestion of the womb. 

Treatment. —The treatment for chronic congestion and enlarge¬ 
ment of the uterus is essentially the same as that recommended for 
chronic uterine catarrh, the details of which need not be repeated here. 
The sitz bath, the hot douche, rest from violent exercise and from 
sexual excitement, and the avoidance of all the exciting causes of the 
affection, are the essentials of treatment. The method of treating this 
affection which was popular a dozen years ago, is now pronounced by 
the most eminent medical authorities to be in the highest degree 
irrational, and detrimental to the patient. The cauterizations to which 
thousands of women have been subjected, year after year, the only 
effect of which was to produce an aggravation of other ailments, are 
now condemned in no stinted terms by the very men who once em¬ 
ployed these remedies. 

In our experience during the last few years as Medical Superin¬ 
tendent of the “ Medical and Surgical Sanitarium,” we have met with 
hundreds of these cases, in which caustics had been employed at inter¬ 
vals for periods ranging from six months to twenty years; and we 
have to say that we have never met a case in which there was evi¬ 
dence of substantial benefit from the course of treatment employed. 
The effect of long-continued cauterization is to increase the very difli- 


INFLAMMATION OF THE WOMB. 


1319 


culty which it is supposed to be efficient in curing. What the con¬ 
gested organ needs is not the application of irritating caustics, but 
the use of soothing remedies. The warm sitz bath attracts the 
blood to the surface, and thus relieves the local congestion. The hot 
douche acts efficiently as a remedy, by causing contraction of the 
dilated blood-vessels. Cold injections w T ere formerly recommended for 
this purpose, but the benefit received by their employment w’as very 
slight, if any good at all was accomplished. Cold applications to the 
uterus cause immediate contraction of its blood-vessels, but the con¬ 
traction produced is almost immediately followed by dilatation, so that 
the congestion may be aggravated rather than relieved. Hot appli¬ 
cations cause first a slight increase of congestion, but this condition is 
subsequently followed by a contraction of the blood-vessels, which 
continues for a long time. This is well shown by a simple experi¬ 
ment. The hands dipped in cold water, or rubbed with ice, are at 
first blanched, but in a few seconds become red from congestion of 
the blood-vessels of the skin; while upon the other hand, if the 
hands are dipped in hot water, they become at first reddened, but 
after they have been immersed for a long time the skin becomes white 
through contraction of its small arteries. This is well shown in the 
white and wrinkled skin of the hands of a washerwoman, which have 
been immersed in warm water for several hours. In performing surg¬ 
ical operations upon the womb, when annoyed by troublesome bleeding, 
we have frequently resorted to the use of sponges dipped in hot water 
and applied directly to the organ, and have thus been able to witness 
an ocular demonstration of the utility of hot applications to this 
organ in the speedy checking of the bleeding, and the marked pale¬ 
ness of the organ after the application. 

When there is considerable catarrhal discharge, some benefit may 
be derived from the employment of astringents. In addition to the 
hot w r ater douche, alum, common salt, solutions of tannin, of golden 
seal, and various other astringent substances, are usefully employed 
for this purpose. It is a very good plan to add a teaspoonful of 
powdered alum, or common salt, to the last pint of water employed 
in the douche. 


1320 


DISEASES AND THE III TREATMENT. 


<;RAATE.1R IMLAM1!ATIOA OF THE LIPS OF THE WOMB. 

SYMPTOMS.—Profuse leucorrhceal discharge; general debility; aching around the 
lower part of the body, which is increased by walking or standing; symptoms of catarrh 
or congestion of the womb. 

This condition of the uterus is what is ordinarily treated as ulcer¬ 
ation. It is not true ulceration, however; ulceration affects this organ 
very rarely indeed. The causes are catarrh of the uterus, chronic con- 
gestion, sexual excess, and prolapsus. 

Treatment. —Sitz baths, hot douches, and the use of astringent 
lotions when the uterus is prolapsed. Benefit may sometimes be 
derived by passing up into the vagina, against the mouth of the womb, 
a little ball of cotton saturated with glycerine, or glycerine and tannin. 
A string should be tied about the middle of the cotton ball, so that it 
may be removed when necessary. It should not be kept in place 
more than a day or two at a time. In many cases, the granular con¬ 
dition of the lips of the womb is due to the occurrence of rupture at 
child birth. When the tear is quite a serious one, a surgical operation 
is required. 

STRICTURE OF TIIF I TERIAE CANAL. 

SYMPTOMS.—The patient suffers very painful menstruation and pain, beginning one or 
two days before the menstrual flow begins, being of a “ bearing down ” character. 

Stricture of the canal of the uterus is a cause of the most extreme 
pain in those who suffer with this difficulty. It may be a natural 
defect, which is not felt until the besdnnino; of menstruation, or it may 
result from long-continued uterine catarrh, or from anteflexion, a con¬ 
dition in which the organ is bent upon itself. 

Treatment.— This disease, when dependent upon anteflexion, or 
uterine catarrh, is generally relieved by correction of these conditions. 
AVlien it is congenital, however, in many cases the condition has 
required a surgical operation of some kind. When the oft-repeated 
suffering is long-continued, it may so wear upon the patient as to 
cause a complete breaking down of the nervous system; hence it is 
important that it should receive early and prompt attention; and if 
not speedily relieved, the services of a competent physician should be 
secured. 


TUMORS AND DISPLACEMENTS OF THE WOMB. 


1321 


tituioics or Tin: woo it. 

The womb is subject to various morbid growths, the symptoms of 
which are very similar to those of chronic congestion. In many cases 
a person suffering with uterine tumors knows nothing of the real 
nature of the difficulty until after consultation with a competent 
physician. Among the numerous kinds of malign and malignant 
growths which are found in this organ, we will mention only poly¬ 
pus, fibroid tumors, and cancer. If the patient suffers continually 
with menorrhagia, leucorrhoea, dysmenorrhoea, and continual hearing- 
down pains, she should at once consult an intelligent physician, for 
the purpose of ascertaining the exact local condition. 

The most common tumors of the uterus are polypi. These are often 
very small, but sometimes attain quite considerable size. We have fre¬ 
quently found them present when the patient had no suspicion what¬ 
ever of their existence; and by means of a surgical operation for their 
removal, have relieved the patient of a great amount of suffering. The 
various forms of fibrous cystic, and fibro-cystic tumors which affect 
the uterus, afford the most experienced gynecologist ample scope for 
the exercise of his greatest skill. 

Recent advances in this department of surgery render it possible 
to cure in many cases of this kind what was formerly thought in¬ 
curable. Malignant disease of the uterus is the most hopeless of all 
affections of this kind. It is generally not discovered until after it 
has progressed to a considerable degree of development, when the 
most that can he done is to delay its progress, and relieve the suffer¬ 
ings of the patient. 

i>isi*i.a< i:iii:\ts or this womb. 

The general symptoms of displacement of the womb, are often the 
same as those already described as characteristic of chronic congestion 
of the organ, which is one of the most common causes of displacement. 
The uterus may be displaced in three ways, known as anteversion, 
retroversion , and prolapsus. Lateral displacements also occur, but 
not very frequently. 

aati:vi:ksioa. 

In anteversion, the uterus, while maintaining its straight form, is 
tipped forward against the bladder. The organ is tipped slightly for- 


1322 


DISEASES AND THEIR TREATMENT. 


ward in its natural condition, so that anteversion is simply an exagger¬ 
ation of its natural state. The particular symptoms which arise from 
this form of displacement are painful and frequent urination; aching 
pain just above the pubic bones; in some cases pain in moving the 
bowels; and inability to walk or to be upon the feet on account of the 
aggravation of the local pain. The principal causes of anteversion, are 
enlargement of the womb by violent efforts, as in lifting, jumping, strain¬ 
ing, and especially tight-lacing; the last-named cause is undoubtedly 
one of the most common of all. Anteversion may also be the result of 
the weakening of the ligaments which sustain the uterus in position, 
which may arise from general weakness of the whole system. 

Treatment. —The first matter to be attended to, is removal of the 
cause. This will require attention to the suggestions made for the 
same purpose with reference to chronic congestion of the uterus. Sitz 
baths and hot douches should be thoroughly employed. The patient 
should remain as much as possible in a horizontal position upon the 
back. A properly adapted pessary or supporter will sometimes be of 
great service as an aid to cure, although pessaries are seldom capable 
of effecting a cure of themselves. A surgical operation is sometimes 
necessary, in order to effect a radical cure. Much harm has often 
resulted from depending upon the use of pessaries in these cases The 
supporter is of service; but we can accomplish much more in the treat¬ 
ment of the displacements without pessaries of any sort, than with 
them alone. 


RETROVERSION. 

This condition is that in which the uterus is tipped backward 
against the rectum. The organ may be tipped directly back, or 
inclined more or less to either side. The principal symptoms are con¬ 
stant pain in the lower part of the back ; great discomfort in walk¬ 
ing ; increased pain on moving the bowels, with a sense of obstruction ; 
sometimes spasmodic contraction of the rectum, or bladder; painful 
menstruation, in some cases, chronic inflammation of the bladder. 

Treatment. —The same remark made with reference to cause and 
treatment in connection with the subject of anteversion, applies also to 
retroversion. Frequent sitz baths and daily hot douches are among the 
essentials of treatment. To these should be added daily replacing the 
organ by a competent person. When the organ is not bound by ad- 


PROLAPSUS OF THE WOMB. 


1323 


hesions, replacement may generally be effected by the patient herself by 
the following procedure : The patient should place herself upon the bed 
in a kneeling position. She should now bend forward until the chest is 
in contact with the bed. The limbs should now be moved downward 
until the thighs are perpendicular, so that the pelvis is elevated in the 
air as high as possible. The inlet of the vagina should now be opened 
so as to admit air. This may be done by raising the peringeum with 
the finger. As soon as the air enters, the womb falls forward into po¬ 
sition. When necessary, air may be admitted by means of a glass tube 
inserted before the exercise is begun, or by means of the Davison syringe. 

PROLAPSUS OF TIIF WOMB. 

SYMPTOMS.—Dragging pain in the lower part of the back, extending around the 
body; general tenderness over the pubes ; sensation of fullness in the vagina; irritation 
of the bladder and rectum; discomfort increased by walking or exertion; leucorrhoea; 
painful or profuse menstruation; in very bad cases, protrusion of the organ; symptoms 
sometimes absent. 

Falling of the womb is a very common affection, especially among 
women who have borne children. It also sometimes occurs in women 
who have never been pregnant, but much more rarely. The causes of 
prolapsus are essentially the same as those which induce chronic conges¬ 
tion. When the organ becomes too large, it settles down in consequence 
of its unnatural weight. Prolapsus is also the result of violent muscular 
exertion, rupture of the. peringeum in labor, and of getting up too soon 
after childbirth. Every cause which tends to produce disease of the 
sexual organs in females may occasion prolapsus. The immediate cause 
in chronic cases, and that which presents the greatest obstacle to suc¬ 
cessful treatment, is relaxation of the natural supports of the organ. 

Treatment. —The usual treatment for prolapsus consists almost ex¬ 
clusively in the application of supporters of various kinds. The amount 
of ingenuity which has been displayed in the construction of devices of 
various sorts for the purpose of restoring a prolapsed uterus to its nat¬ 
ural condition is not surpassed by the display of inventive genius in any 
other direction. While pessaries or supporters of some kind are often 
very useful in the treatment of prolapsus as temporary palliatives, and 
as a means of relieving cases which are incurable, they should ever be 
regarded as incapable of producing a radical cure. In many cases they 
actually increase the morbid conditions upon which the prolapsus de¬ 
pends, although giving temporary relief to the most unpleasant symp¬ 
toms attending this form of displacement. 


1324 


DISEASES AND THEIll TREATMENT. 


A rational plan of treatment for prolapsus requires, first, the removal 
of the causes by which the difficulty has been produced, when they are 
still in operation; second, relief of the congestion and enlargement of 
the organ by proper treatment; third, palliation of the painful symp¬ 
toms attending this condition ; fourth, restoration of the natural sup¬ 
ports of the organ to a healthy condition. 

The first indication must be met by thorough and careful attention to 
the laws of sexual hygiene. The second indication is best met by a per¬ 
sistent use of sitz baths and the vaginal douche, which should be taken as 
recommended for the treatment of catarrh and congestion of the womb. 
In many cases, the douche can be taken twice a day with advantage, 
in the morning and again just before retiring at night. Greater benefit 
is derived from this treatment when the patient can remain in a recum¬ 
bent position for some hours afterward. 

In some cases the patient requires rest from walking and other ex¬ 
ercises upon the feet. In the majority of cases, however, it is better for 
the patient to continue as much exercise as can be endured without ex¬ 
cessive fatigue, as it is important that the muscular strength should be 
kept up. The third indication is in part met by the treatment already 
described. The hot douche and sitz baths will generally accomplish more, 
than any other two remedies in relieving the local pain and discomfort 
In many cases, much additional benefit may be derived from wearing a 
properly adapted pessary or supporter. When the womb is prolapsed, 
its circulation is interfered with so that the organ becomes engorged 
with blood. This can be overcome by a restoration of the organ to its 
proper position so as to give freedom to the circulation. The simplest 
form of supporter is a small roll of cotton. It should be pressed up 
against the mouth of the womb after-it has been restored to its proper 
position. It should be introduced while the patient is lying upon the 
back. The ball of cotton should be large enough to be retained in posi¬ 
tion, and should be saturated with glycerine or a weak solution of tannin 
in glycerine before being applied. A string should be tied around the 
center of the roll to facilitate its removal. This application the patient 
can make for herself, though not nearly so well as it can be made by 
a physician. Care should be taken in removing the cotton that the 
organ is not dragged down with it. It should be first loosened by the 
finger to facilitate its removal. Cases which need the application of the 
pessary require the care and attention of an intelligent physician. 


PROLAPSUS OF THE WOMB. 


1325 


The fourth indication is the most important of all, as it relates more 
directly to the radical cure of this affection. Unfortunately, this part 
of the treatment of prolapsus is rarely attended to. Either the physi¬ 
cian fails to appreciate the importance of this part of the work, or the 
patient is satisfied with a mere amelioration of her symptoms, and fails 
to persevere in carrying out the proper methods of treatment until a 
complete cure is effected. In meeting this indication, one of the best of 
all measures of treatment is the daily employment of special exercises. 
General exercise is essential for the purpose of strengthening the general 
muscles of the body ; but there are certain special exercises which may 
be taken, the advantage of which can hardly be overestimated. 

We will describe two or three of the more simple forms of special 
exercise. Let the patient place herself upon a smooth and moderately 
hard surface. A soft, springy bed is not suitable for the purpose. A 
hard sofa will answer very well. The feet should be drawn up as close 
to the body as possible. Let the patient now lift the lower part of the 
body so that the hips and lower portion of the trunk will not touch the 
surface, the body being wholly supported by the feet and shoulders. 
The body should be held steadily in this position for a minute or two, or 
as long as possible without any considerable fatigue to the muscles, when 
the body should be lowered to its original position. After a few min¬ 
utes’ rest, the same exercise should be repeated. This exercise may be 
continued twenty or thirty minutes, according to the patient’s strength. 
By elevation of the hips in the manner described, the contents of the 
lower portion of the abdomen will, by the force of gravitation, be drawn 
from their abnormal position into their original place. Prompt relief 
very often follows the employment of this measure, even the very first 
time it is applied ; and if it is continued daily, and two or three times a 
day when the patient is sufficiently strong, very excellent results may 
be looked for. 

Another movement which is very effective for the same purpose, con¬ 
sists in supporting the body upon the toes and elbows with the face down¬ 
ward, the hips being raised as much as possible. Still more thorough 
exercises may be taken by the aid of an assistant. One of the best of 
tliis sort consists in elevation of the lower extremities by means of an as¬ 
sistant, while the patient lies upon the face, supporting the body by the 
chest and keeping the limbs rigid while the feet are elevated by the assist¬ 
ant. While the hips are elevated in movements of this sort, the intestines 
fall forward in the abdominal cavity, dragging the prolapsed womb after 


1326 


DISEASES AND THEIR TREATMENT. 


them. Movements of this sort not only strengthen the abdominal muscles 
by calling them into active exercise, which of itself has a tendency to lift 
the prolapsed organs into position, but the force of gravitation acts di¬ 
rectly to restore the displaced organ to its normal position. The pa¬ 
tient will also derive great advantage from sleeping with the hips eleva¬ 
ted as much as is consistent with comfort. In addition to these measures, 
the patient may take with advantage certain exercises for developing 
the muscles of the trunk and abdomen, such as bending forward and 
backward, bending sideways, kneading and percussing the abdominal 
walls, lifting weights with hands stretched above the head while laying 
down, etc. 

Electricity is an admirable remedy for use in these cases. It may 
be applied both externally and internally. When applied internally, 
it should be in the hands of a competent physician unless adminis¬ 
tered in connection with the hot douche, see pag-e 703, a plan which 
we very highly recommend. These movements may be taken several 
times a day with advantage. If taken but once, the best time is at 
night just before retiring. This is also the best time for taking an as¬ 
tringent douche. A very excellent plan is to take the movements first, 
then the hot douche, concluding by the injection of a pint of water con¬ 
taining one quarter of an ounce of alum or tannin, or two tablespoonfuls 
of a strong decoction of oak bark. By means of the movements the 
uterus is restored to its natural position, and by the aid of the hot 
and astringent injections, the lower supports of the uterus are toned up 
so as to aid in holding the organ into position. 

Congestion is also relieved by the same treatment; and this gives 
nature the opportunity during the night to do much toward restor¬ 
ing the organ to its normal condition. When the patient suffers much 
with constipation, which is always present in these cases, and very ob¬ 
stinate, the bowels should if possible be relieved at night just before re¬ 
tiring. In case there is loss of desire to move the bowels, which some¬ 
times exists, benefit will be derived frofti the injection into the rectum 
of four tablespoonfuls of cold water containing five or six drops of tinct¬ 
ure of camphor. The solution should be retained ten minutes, by the 
end of which time there is generally a very strong desire to move the 
bowels. 

In cases in which the prolapsus is due to rupture of the perinaeum 
in childbirth, a surgical operation may be required to effect a cure. 
We have met a number of cases of this kind, and by performing the 


FLEXIONS. 


1327 


necessary operation to restore the parts to a natural condition, have ob¬ 
tained the most gratifying results. It has been suggested to secure sup¬ 
port for the prolapsed organ by means of various operations upon the 
vaginal walls. Operations of this sort are seldom required. In cases in 
which the organ is prolapsed to such an extent as to appear outside of 
the body, which is a very rare condition, however, a complete cure can 
rarely be e lice ted, although the organ may be supported by means of 
properly adapted pessaries. 

FLEXIONS. 

From various causes, the womb may become folded upon itself. 
When this occurs anteriorly, it is termed anteflexion. When the organ 
is folded backward against the rectum, the condition is termed retroflex¬ 
ion. Lateroflexion is a condition in which the organ is folded over to one 
side. Anteflexions and retroflexions usually result from ante- and retro¬ 
versions. The principal symptoms of anteflexion are an irritable condi¬ 
tion of the bladder, with a frequent desire to urinate; a severe pain at the 
beginning of menstruation, which is usually relieved suddenly and com¬ 
pletely at the beginning of the menstrual flow. The pain sometimes 
lasts a day or two at the beginning of each period, the patient often be¬ 
ing at other times quite free from any inconvenience. The symptoms of 
retroflexion are essentially the same as those of retroversion except that 
they are all exaggerated. Pain in the back and obstinate constipation are 
the leading symptoms. The patient is also likely to suffer with pro¬ 
fuse menstruation and a considerable increase of pain at the menstrual 
periods. 

Treatment. —The same general plan of treatment recommended 
for prolapsus should be followed for flexions and all other displacements of 
the womb. In case of anteflexions, the first form of special exercise rec¬ 
ommended for prolapsus should be taken daily. In cases of retroflex¬ 
ion, as well as of retroversion, the two last forms of exercise cannot be 
too highly recommended. Hot douches, astringent injections, and fre¬ 
quent sitz-baths, are as valuable remedies in this case as in prolapsus. 

LErCOBRIHEA—WHITES. 

This is a symptom of disease rather than an independent malady. 
It is indicative of quite a variety of conditions. The discharge to which 
the term “whites” or “female weakness” is familiarly applied, varies 


1328 


DISEASES AND THEIR TREATMENT. 


considerably in character. A natural discharge of whitish mucus, 
the proper secretion of the vaginal mucous membrane, takes place for a 
short time just before and just after menstruation, and need occasion no 
concern; but when the discharge becomes continuous, not disappearing in 
the interval between the menstrual periods, it becomes a symptom of 
disease. A very profuse discharge naturally takes place also in the lat¬ 
ter part of pregnancy. 

The indication of this symptom depends largely upon the character 
of the discharge. Viscid, mucous discharges are generally from the 
womb. Curdy, mucous discharges are occasioned by catarrh of the va¬ 
gina. Clear or turbid watery discharges, especially when very offensive 
in character, are indicative of tumors or malignant disease of the womb. 
Discharges containing pus are indicative of inflammation or ulceration; 
they may proceed from the vaginal mucous membrane or from the 
uterus. Reddish or bloody discharges accompany tumors of various 
kinds, cancer, and ulceration of the womb; discharges of a very offen¬ 
sive character, especially when occasionally mixed with blood, are indica¬ 
tive of the presence of malignant disease. Offensive discharges are not 
positive evidence of the presence of cancer, however, as they may arise 
from other causes. 

In an addition to the special causes mentioned, leucorrhoea may re¬ 
sult from simple congestion of the blood-vessels of the vaginal mucous 
membrane due to improper dress. It may also be occasioned by taking 
cold, by sexual excess, and by a debilitated condition of the stomach. 

Treatment.— Hot douches and sitz baths are as effective for this as 
for other morbid conditions of the female sexual organs. The hot water 
injection should be made slightly astringent in character by the addition 
of powdered alum, tannin, and other mild astringents. Alum may be 
used in the proportion of a teaspoonful to a quart of water. Tannin 
may be used in proportion of one dram to the same quantity of water. 
When the discharge is offensive, a solution of permanganate of potash 
in the proportion of ten grains to a pint of water, or carbolic acid in 
proportion of fifteen drops to a pint of water, will generally be effective 
in correcting the fetor. 

IUFLAMM1TIOS OF TIIF VAGINA—VAGINITIS. 

SYMPTOMS.—Hot and burning pain in the vagina; aching pain in the perinceum; 
frequent urination ; profuse and purulent leucorrhoea; soreness of the externa! parts. 


I NFL A MM A TION OF THE VAGINA. 


1329 


This affection very closely resembles gonorrhoea, from which it is 
sometimes difficult to distinguish it. In a somewhat rare variety of the 
disease the -whole vaginal mucous membrane is covered with granulations, 
which renders it exceedingly sensitive. The causes of vaginitis are cold, 
irritating discharges from the womb, caustics, badly fitting supporters, 
self-abuse, and excessive coitus. 

Treatment. —An acute attack of vaginitis can generally be cured 
in ten days or two w 7 eeks by the employment of sitz baths, warm 
douches, injections of starch water, and resthig in bed. Other measures 
are seldom necessary. When the disease is chronic, longer time is re¬ 
quired for a cure. Glycerine and tannin, in the proportion of one half 
dram of the latter to one ounce of the former, is an excellent remedy in 
chronic vaginitis, to be applied to the affected part daily or every other 
day by means of cotton saturated with the solution. A solution of chlo¬ 
rate of potash, a dram to a half pint of water, is also a very useful rem¬ 
edy. Dr. Smith, of London, especially recommends a solution of half 
an ounce of alum and a dram of tannin to a quart of water, one-half 
to be used at night and the other half in the morning. 

Gonorrhoea in females is to be treated upon essentially the same plan. 

VAGIAISMIS. 

SYMPTOMS.—Pain on walking; severe spasmodic pain on touching the affected part. 

This is often a very severe affection, being the occasion not only of 
great inconvenience, but of intense mental as w T ell as physical suffering. 
It consists in an unnaturally sensitive condition of the vagina which 
causes violent spasmodic contraction of its walls from the slightest irrita¬ 
tion. The chief causes are hysteria, inflammation of the vagina, exco¬ 
riations of the mucous membrane, vascular tumors of the urethra, and 
fissure of the anus. 

Treatment.— This affection is sometimes exceedingly obstinate, re¬ 
quiring a surgical operation for relief. The patient should consult a 
competent physician without delay. 

(YSTOCEI.r. 

\ 

This is a condition in which the anterior wall of the vagina, together 
with the bladder, falls downward in such a way as to produce a bulging. 
In some cases the parts protrude. The most common cause of this con¬ 
dition is rupture of the perinjeum in childbirth. In consequence of the 

84 


1330 


DISEASES AND THEIR TREATMENT. 


falling down of the lower portion, the bladder is never entirely emptied 
of urine, and as a result, decomposition of the retained urine takes 
place, which gives rise to catarrh of the bladder, pain, heat, painful 
contractions, and difficulty in urination. The appearance of these symp¬ 
toms after an unusually hard childbirth, from which the parts have 
been exceedingly sore and long in healing, may well give rise to appre¬ 
hension of this condition, and a good surgeon should be consulted. We 
have frequently met with cases of this kind, which had been treated for 
disease of the bladder for many years without the real cause of the trouble 
being discovered, to whom we have been happy to bring relief by the 
performance of a surgical operation, by means of which the parts 
were restored to their natural condition. 

UECTOCELE. 

This is a condition similar to the preceding, occurring in the posterior 
wall of the vagina. On account of rupture of the perinaeum, the nat¬ 
ural supports of the uterus are removed, and this organ settles down, 
causing a bulging forward of the lower portion of the vagina, and with 
it the anterior wall of the rectum to which it is attached. This pouch¬ 
like extension of the rectum gets filled with the contents of the bowels, 
producing much pain, tenesmus, local irritation, and mucous discharges 
from the bowels. Rectocele, like the preceding condition, can only be 
cured by a surgical operation, a proceeding which we have often found 
necessary in patients who have suffered for many years without being- 
aware of the nature the difficulty. 

ITCnmG OF THE GENITALS—PRURITFS. 

This is a most annoying affection which .sometimes renders the life of 
a person suffering from it almost intolerable. It may be caused by irri¬ 
tating discharges from the uterus or vagina, or it may be due to an ex¬ 
tension of a disease of the skin to these parts. It is quite likely to oc¬ 
cur in women suffering from diabetes. It is also one of the miseries at¬ 
tending upon cancer of the uterus, arising from the irritation caused by 
the acrid discharges characteristic of this disease. Thread-worms are also 
said to be a cause of this affection. It occurs most frequently at the 
time of the menopause, or “ change of life.” 

Treatment. —When caused by an acrid discharge, keep the parts 
thoroughly cleansed by frequent vaginal injections. The intolerable 
itching will generally be relieved by the use of one of the following solu- 


INFLAMMATION OF THE E HE A ST. 


i:«i 


tions : Sulpho-carbolate of zinc two drams, dissolved in eight tablespoon - 
fuls of water, to be applied to the affected parts twice a day, and al¬ 
lowed to dry upon the surface; carbolic acid, ten to twenty drops, gly¬ 
cerine and water each a tablespoonful; powdered borax or sulphite of 
soda a teaspoonful, desolved in a pint of water. When there is much 
irritation of the parts, some soothing ointment should be applied, as vase¬ 
line. Hot injections are also recommended. 

IMPERFORATE HYM13A. 

This is a condition in -which the vaginal orifice is closed by an excess 
ive development of the hymen. When complete, it causes a retention 
of the menses. Although the patient has all the other symptoms of 
menstruation, the menstrual flow does not appear. Though not suffi- 
cient to occasion an obstruction to menstruation, it may be sufficient to 
render the sexual act impossible. The difficulty is not usually discovered 
until after marriage, and may give rise to a great amount of unneces¬ 
sary distress. As the difficulty can be very easily remedied by a compe¬ 
tent physician, such an one should be at once consulted on the discovery 
of grounds for suspicion of the existence of this congenital deformity. 

INFLAMMATION OF THE BREAST—MASTITIS. 

SYMPTOMS. — Deep, throbbing, burning pain ; restlessness; fever; hard and tender 
swelling of the breast. 

The most frequent cause of inflammation of the breast is taking cold 
while nursing. Inflammation may also be excited by a blow upon the 
breast; it sometimes occurs without apparent cause. 

Treatment. —On the appearance of the first symptoms, hot fomenta¬ 
tions should be vigorously and continuously applied for some hours. In 
many cases, the disease can be arrested when promptly treated in this way. 
Alternate hot and cold applications may be tried when fomentations do 
not accomplish the desired result. When the breast is swollen very large, 
it should be supported by means of adhesive straps carefully applied. 
If an abscess forms, it should be opened promptly and should afterward 
be treated by fomentations or poultices. 

ii AEACTO RRIKEA. 

This is a peculiar condition of the breast in which a continuous flow 
of milk occurs either between the intervals of nursing, or after the in¬ 
fant has been weaned. It is chiefly due to a relaxed condition of the 


1332 


DISEASES AND THEIR TREATMENT. 


nipple, abnormal activity of the gland, or to debility. It is often a very 
intractable affection, but can generally be relieved by astringent appli¬ 
cations to the nipple, as of glycerine and tannin in proportion of a 
dram of tannin to an ounce of glycerine, or a decoction of oak bark ; 
gentle friction of the nipple ; drawing out of the nipple by means of 
the breast pump; or application to the breast of a solution of belladonna 
in glycerine, in proportion of a dram of the extract to an ounce of 
glycerine. Cold applications to the breast are also in many cases very 
effective. Ice compresses may be employed, or, better, rubber bags con¬ 
taining iced water or pounded ice. 

OVERGROWTH OF TI1E BREAST. 

This condition may be due to an over-accumulation of fat or to an 
actual overgrowth of the gland itself. The causes of the first condition, 
are obesity, and masturbation and other sexual excesses. Overgrowth of 
the gland itself is due to the organ not diminishing in size after lactation. 
In the first form, the breast is large and soft. In the second, it contains 
nodular masses which are portions of the enlarged gland. Proper treat¬ 
ment of the first form consists in removal of the causes; hot and cold 
applications in the second form of the affection. 

ATROPHY OF THE BREAST. 

This is a much more frequent condition than the preceding. The 
breast is flat and the nipple small. This condition is sometimes due to 
deficient development of the ovaries, in which cases it is accompanied by 
amenorrhoea. The more frequent cause is compression of the breast by 
means of stays, corsets, or artificial forms. This difficulty is very obsti¬ 
nate, frequently yielding to no method of treatment that can be 
employed. 

CRACKER If IPPLE. 

This affection frequently occasions a great amount of inconvenience 
to a nursing mother. Slight fissures which at first appear on the nipple 
develop into serious excoriations which may become so extensive as to 
destroy the nipple. The chief causes are too frequent suckling, and 
failure to carefully dry the parts. The best treatment is prevention. 
The nipple should be hardened by bathing in cool water daily for some 
time before its use is required. Equal parts of alcohol and water with 


CANCER OF THE BREAST. 


1333 


glycerine, a weak solution of tannin, or a decoction of oak bark, and 
similar lotions, are excellent means of hardening the skin, and thus 
preventing the occurrence of fissures. Thorough cleansing of the breast 
is a matter of great importance. Bad excoriations should be treated 
with a solution of ten or fifteen drops of carbolic acid in an ounce of 
glycerine, the fissures being treated two or three times a day after being 
cleansed. When all remedies are ineffective, it is sometimes necessary to 
suspend nursing. 

CANCER OF THE R It EAST. 

SYMPTOMS. — Throbbing, darting pains, and a sense of weight in the breast; sometimes 
little or no pain ; a hard swelling in the substance of the breast which is first movable, after¬ 
ward becoming fixed; nipple drawn in ; tenderness to the touch ; skin over tumor reddish, 
afterward becoming purple; in some cases the whole breast is moderately hard, there 
being no distinct tumor. 

Treatment. —The intractable nature of malignant disease in any 
part of the body, when well developed, makes it important that prompt 
measures should be taken upon the first discovery of any symptom af¬ 
fording ground for suspicion of cancer of the breast. The patient 
should not hesitate and temporize until the chances for a permanent 
cure are lost. The opinion of the best pathologists at the present day is 
that the disease is wholly a local affection in its early stages, so that if 
the diseased part is removed before other parts of the body become in¬ 
fected, the patient has a chance to recover. There is only one method 
of treatment for use and recommendation in these cases, and that is, 
thorough removal of the diseased part as soon as suspicious symptoms 
occur. The earlier the removal can be effected, the better. Of the va¬ 
rious methods which have been employed, the removal by the knife is 
in the majority of cases the best, as it is a thorough operation, and it 
can be made painless by means of anaesthesia; it also possesses the advan¬ 
tage of giving the parts an opportunity for healing immediately, thus 
affording less opportunity for the disease to return. We have removed 
a number of cancers by this method, and have thus far heard of no re¬ 
currence of the disease. No remedy is a positive cure however, since 
the same depraved condition of the system which gave rise to the dis¬ 
ease in the first place may cause a new outbreak, even though the first 
be entirely cured. 

The public cannot be too frequently and earnestly warned against 
patronizing the numerous horde of cancer doctors who thrive upon the 


1334 


DISEASES AND THEIR TREATMENT . 


ignorance of the masses, landing the virtues and advantages of so- 
called specifics which are warranted to cure every case. These wonder¬ 
ful (?) specifics, when of any value whatever, are standard remedies which 
are well known to the regular profession and have been for years. The 
apparent success which many of these quacks achieve is due to the fact 
that they do not hesitate to pronounce all forms of tumors to be cancers, 
notwithstanding the fact that the great majority of tumors are wholly 
benign. A person finding a small painful lump in the breast should 
consult a skillful surgeon at once, especially if there is any history of 
malignant disease in the family. In cases of cancer of the breast which 
are already very far advanced, ulceration having begun and infection of 
the system having taken place, as shown by the debilitated condition of 
the patient and enlargement of the glands under the arm, etc., removal 
of the breast may still be of advantage in prolonging the life of the pa¬ 
tient and adding to his comfort, although there may be no hope of ef¬ 
fecting a cure. The application of ice to the affected part in the form 
of iced compresses, or better, by means of rubber bags filled with iced 
water or small pieces of ice, is an excellent means for relieving the se¬ 
vere pain which characterizes the disease, and also for delaying its prog¬ 
ress. Frequent freezing of the diseased parts by means of a mixture of 
salt and pounded ice, in proportion of one part of the former to two of 
the latter, applied by means of a muslin bag, has been very highly rec¬ 
ommended for holding in check the progress of this terrible malady. 

FIBROUS TUMOR OF TOE BREAST. 

Hard, painless lumps, of the size of a filbert, are often found in the 
breast, sometimes several being present in the same individual. These 
are simply fibrous tumors, and need not give rise to any apprehension, 
as they rarely, if ever, become larger than the size mentioned, and 
usually disappear of themselves, especially if the breast is frequently 
called into functional activity by nursing. As these growths give rise 
to no inconvenience of any sort, no treatment is required. 

IRRITABLE BREAST. 

The breast is sometimes the seat of severe neuralgic pain. In 
other cases, the pain is located in the intercostal nerves, just beneath 
the breast, particularly upon the left side. We have occasionally met 
cases in which the whole breast was very sensitive, the patient shrink- 


RUPTURE OF THE NECK OF THE WOMB. 


1335 


mg from the lightest touch. These difficulties arise from a great 
variety of causes, chief among which may be mentioned hysteria and 
spinal irritation. The most severe case of irritable breast we ever 
met, was in the person of a young woman who was grossly addicted 
to the habit of self-abuse. The left breast in this case was consid¬ 
erably swollen, pulsated violently, and was apparently so sensitive as 
to cause the patient to scream with pain, even at the slightest touch. 
The discontinuance of the habit caused an entire disappearance of the 
morbid irritability within a week, so that the patient was able to strike 
the breast a full blow without suffering any inconvenience whatever. 

RIPTIRE OF T1IF MKK OF THE WORE. 

These accidents are the result of childbirth, in consequence of 
unnatural rigidity, excessive size of the head of the infant, malpo¬ 
sition, the use of instruments, precipitate labor, and perhaps from 
other causes. - A tear may occur either in the neck of the womb, or 
in the perinseum. In case the laceration occurs in the neck of the 
womb, the patient may be wholly unaware of the accident at the time, 
and perhaps may never become conscious of it, but will suffer the 
consequence nevertheless. If the difficulty is not discovered and rem¬ 
edied, the usual result is, that, instead of making a rapid recovery 
after childbirth, the patient remains weak for a long time, and is 
perhaps confined to bed on account of the pain and inconvenience 
occasioned when she attempts to get upon her feet and walk about. 
She suffers with all the symptoms of congestion of the womb, and 
after a time suffers with prolapsus, or some form of displacement. 
Menstruation is likely to be very profuse. This condition often goes 
undiscovered, even when the patient resorts to a physician for exami¬ 
nation and advice. , The majority of cases of laceration of the cervix, 
or neck, of the womb, are treated for ulceration. When the physician 
makes an examination, he finds the lips of the womb enlarged, gaping, 
rolling outward, congested, and often covered with granulations. Too 
often these symptoms are mistaken for inflammation or ulceration of 
the womb, and the case is accordingly treated with caustics and vari¬ 
ous other routine remedies. In consequence of the laceration, dense 
cicatricia tissue forms upon the raw surfaces, which increases with 
the lapse of time, especially if the patient is subjected to a course of 
cauterization. We have met many of these cases in which laceration 
had existed for periods varying from live to fifteen years, the patients 


1336 


DISEASES AND THEIR TREATMENT. 


having been invalids during all of this time; and in scarcely a single 
instance had the real nature of the difficulty been previously discov¬ 
ered. They had been treated for “ prolapsus,” “ inflammation,” “ ulcer¬ 
ation,” “elongation of the neck,” various displacements, and, in fact, 
almost everything but the real difficulty. 

Treatment. —The proper remedy for this accident is the restora¬ 
tion of the torn parts to their natural condition as nearly as possible. 
In order to accomplish this, it is necessary to carefully remove all of 
the products of inflammation and long-continued irritation. The 
dense, cartilage-like substance which is nearly always present, and 
which produces a great amount of reflex irritability, such as severe 
headache, pain in the spine, obstinate dyspepsia, etc., must first be 
carefully removed; then the parts are brought together and secured, 
by means of a fine silver wire. In the course of nine or ten days, 
nature cements the torn parts together again, and the organ is restored 
to its normal condition. The satisfaction we have felt in being able 
to relieve by this simple operation patients who have come to us after 
having “ suffered many things from many physicians,” as well as from 
their diseases, has been only exceeded by the gratification and relief 
afforded the patients themselves. We have just received a visit from 
a patient upon whom we performed this operation a few weeks ago. 
She had been out of health for several years, ever since the laceration 
occurred, and had sought relief in vain by traveling, by medication, 
by local treatment, by every means that could be secured for her by 
a fond husband, and yet was not improved. After a few weeks of 
proper treatment, she submitted to the necessary operation, soon after 
which she returned home, and recently returned for a very brief visit 
for the purpose of showing us what a wonderful change had taken 
jdace. Her thin, pale cheeks, and bloodless lips, were now plump and 
ruddy with the glow of health. She had gained twenty pounds of 
flesh within a little more than six weeks. Instead of being compelled 
to spend most of her time in bed, upon the sofa, or in an easy 
chair, her step was elastic and buoyant, and she had within a few 
days walked four miles in a single day without feeling at all fatigued, 
and none the worse the next day for the exertion. We might men¬ 
tion numerous other cases in which the change was equally great. 


LASCEBA TION OF THE PERIN2E TJM. 


1337 


LACER ITIO.Y OF TI1F PEBIU^OI. 

Judging from the large number of cases of this sort which have 
come to our notice, laceration of the perinseum is an accident which 
probably occurs fully as frequently as the form of laceration just de¬ 
scribed. A slight degree of laceration almost always occurs at the 
birth of the first child. When this is very slight, no harm results; 
hut when it extends into the muscular tissue, serious injury is done. 
The laceration may be so extensive as to bring the two passages 
together in one, as we found in a case which came under our care a 
few weeks ago. A complete laceration of this sort is usually discov¬ 
ered at the time of its occurrence; but when it is smaller in extent, 
the rupture is most frequently overlooked. The symptoms of rupture 
of the perineum are, an unusual amount of soreness and long delay m 
healing. When the patient attempts to get upon her feet, she soon 
begins to suffer from the various symptoms of prolapsus, or retrover¬ 
sion. She is unable to walk but a short distance, suffers with pain in 
the back, weakness, and various other local disturbances. If the rup¬ 
ture is complete, there will be a loss of power to retain the contents of 
the bowels, especially when the bowels are loose. 

Treatment. —The proper treatment for this accident, as well as 
the preceding, is a surgical operation, whenever the laceration is 
more than very slight. When the laceration is discovered, the oper¬ 
ation should be performed within five or six hours of its occurrence. 
If not attended to then, it should be at a subsequent period, when the 
patient has so far as possible recovered her usual strength. The oper¬ 
ation consists in making raw the surfaces which have been drawn 
apart, and then bringing it together with silver wire. This operation 
requires not a little mechanical ingenuity, but when properly per¬ 
formed in a case requiring it, affords a degree of relief which in some 
cases seems almost marvelous. In the case of a lady upon whom we 
performed this operation a few months ago, the improvement was so 
rapid that within a very short time she was able to perform a large 
amount of physical labor and could walk long distances without the 
slightest fatigue, although she had been a wretched invalid since the 
birth of her child some eight or nine years previous. 

Juda'ino- from the lar^e number of these cases which have come 
under our observation in the treatment of several hundred cases of 
diseases peculiar to women, at the Medical and Surgical Sanitarium, 


1338 


DISEASES AND Til Dili TREATMENT. 


we have no doubt that there are at the present time thousands of 
women who have been suffering for many years from the effects of lac¬ 
eration of this sort, which might readily be cured by a proper surgical 
operation. We have dwelt at some length upon this class of cases for 
the purpose of calling special attention to them. On account of the 
general neglect with which they are treated, we urge upon every lady 
who has borne children and who has any reason to suspect that any 
difficulty of this sort may exist, the importance of consulting a sur¬ 
geon at the earliest possible moment, selecting the most competent and 
reliable surgeon who has had experience in such cases, who may be 
accessible. , 

Change of Life. —The change of life, or menopause, the cessation of 
the function of menstruation, usually occurs between the ages of forty 
and fifty. It sometimes occurs a little later, and sometimes as early as 
between thirty and forty. We have met one case in which it occurred 
before the age of thirty. The usual symptoms are irregularities in the 
times and quantity of the menstrual flow, various nervous symptoms, 
sudden flushing of the head and other parts of the body, congestion of 
the head, and disorders of the digestion, etc. During this critical period 
of her life a woman should have abundance of rest, freedom from care, 
frecfuent recreation, plenty of out-door exercise of a gentle character, 
and mental diversion. Special attention should be given to the general 
health, and all the laws of hygiene should be regarded carefully. 

Coccyodynia—Painful Sitting .—This is an occasional accom¬ 
paniment of pregnancy, though it often occurs in other conditions as 
well, and is not confined exclusively to the female sex. The disease con¬ 
sists of a painful affection of the coccyx, or terminal portion of the spinal 
column. The proper treatment consists in applications of cold, alternate' 
heat and cold, galvanism, and in bad cases, the performance of a surgical 
operation. 

Enlarged Abdomen. —In women who have borne several children 
in rapid succession, the abdominal walls often become flaccid and pend¬ 
ulous. The only remedies for this condition are cool bathing, the appli¬ 
cation of faradic electricity, and the employment of the abdominal band- 


MIDWIFRY. 


1339 




OBSTETRICS, OR. MIDWIFRY. 


We shall not attempt to enter into the technicalities of this subject, 
as this is forbidden both by the object of this work and the space 
which can be properly devoted to it. We wish especially to empha¬ 
size, however, the fact that the art of midwifry is one which is 
worthy of the very highest skill and ability that can be brought to it. 
The once popular notion that it is something which should be left 
to nurses and old women is in the highest degree pernicious. While 
childbirth is a function which when naturally performed is attended 
by little risk to either mother or child, and requires but a very mod¬ 
erate amount of skill or knowledge to meet all the necessary require¬ 
ments, it should he borne in mind that various accidents, irregularities, 
unnatural conditions, and sundry other deviations from the natural 
course of events, are likely to occur at any time, and without previous 
warning, being often of so serious a nature as to threaten the life of 
both mother and child. To meet some of these emergencies, the very 
highest skill and the fullest knowledge are often required. Hence this 
essential art should not be left in the hands of the ignorant: and it is 
important that the public should be sufficiently informed upon the 
subject to at least appreciate the necessity for, and the full value of, 
skill and experience in this department of medical science. 

The anatomy, physiology, and general hygiene of the reproductive 
system, have been considered in the earlier oortion of this work, and 
hence need not be recapitulated here. 

SKiA’S OF PKi:(i\i.\( Y. 

The first indication of pregnancy likely to attract attention is the 
cessation of menstruation. When this occurs, without other sufficient 
cause, as taking cold at the menstrual period, or as the result of dis¬ 
ease, there are good grounds for suspecting that conception has taken 
place, and the period of gestation or pregnancy begun. It should be 
remarked, however, that pregnancy may occur without the menstrual 
function ever having made its appearance. It should also be remarked 
that a periodical flow resembling menstruation, though probably really 



1340 


DISEASES AND THEIR TREATMENT. 


different in character, is occasionally present during the whole period 
of pregnancy. 

A very early symptom is morning sickness, which may occur the 
first week after conception, and frequently continues for six or eight 
weeks. Some do not suffer at all from this symptom. Others suffer 
with extreme severity. Cases occasionally occur in which the vomit¬ 
ing continues without interruption in spite of all remedies which can 
be employed, sometimes wearing out the life of the patient before the 
pregnancy is completed. The vomiting at this period is considered to 
be sympathetic. 

At the end of six or eight weeks the breasts begin to enlarge, the 
nipple becomes more prominent, and the dark ring about it becomes 
much more distinct, especially in persons of dark complexion. The 
little protuberances about the nipple also become much more promi¬ 
nent. In some cases, dark spots appear upon the face, hands, and 
other parts of the body. At this time, the womb, having become ab¬ 
normally heavy on account of its increasing size, settles down in the 
pelvis, causing the abdomen to appear flat. 

Between the third and the fourth month the fetus becomes devel¬ 
oped to such an extent that its heart-beats may be distinguished by plac¬ 
ing the ear to the abdominal walls. It is recognized by its very rapid 
character and the fact that it does not agree with the pulse of the 
mother. The pulse will generally be found to be 120 to 140 per min¬ 
ute. In male infants the heart-beat is less frequent than in females. 

Quickening. —Motions of the child, popularly known as quickening, 
are generally felt at about four or four and a half months. The suppo¬ 
sition that at this time the fetus acquires individual life is a popular 
error. The fetus makes movements of various sorts long before this 
period; but they are not usually strong enough to be felt by the mother, 
and hence are not noticed. The motions are sometimes so strong as to 
be exceedingly disagreeable, especially to patients of a nervous tempera¬ 
ment. They can generally be readily felt by placing the hand upon the 
abdominal wall. If they do not happen to occur in a short time, they 
may be excited by dipping the hand into cold water and laying it upon 
the abdomen. 

This is one of the best signs of pregnancy, and yet it is not an inva¬ 
riable indication, as women often imagine that they have felt motions, 
when none at all have been experienced, or nothing more than the move- 


HYGIENE OF PREGNANCY. 


1341 


ments of the intestines from indigestion and moving of gas in the how- 
els. On the whole, however, this may be considered as a very good 
indication of pregnancy. 

At the end of four months the enlargement can be easily distin¬ 
guished through the abdominal walls. As the uterus increases in size, 
it rises out of the pelvis, and often inclines toward the right side. 

In the latest stages of pregnancy, vomiting again returns in conse¬ 
quence of the pressure upon the stomach. Toward the conclusion, 
there is profuse leucerrhcea, and at the very last the uterus settles 
down into the pelvis again as much as possible. 

During this process the uterus increases to more than twenty times 
its normal size. When fully developed, the fetus generally weighs 
about seven pounds. The usual variation is from four to ten pounds. 

HIGIESE OF PBEG1SMC1’. 

Parturition without Pain. —According to the Bible, the pains of 
childbirth constitute a part of the curse pronounced upon woman in 
consequence of the transgression of mother Eve in Eden. We are 
thoroughly convinced, however, that the curse of fashion, and the 
long list of preventing influences which have for ages been telling 
upon the human constitution, are far more responsible for the terrible 
agony frequently attendant upon the bringing of a human being into 
the world, than the original curse. But regarding pain as a penalty 
for sin, some over-conscientious people have thought it not only useless 
but even irreverent and sinful to make any attempt to mitigate the 
sufferings of childbirth. We do not regard this objection of sufficient 
force to be worthy of serious attention, and are thankful to be able 
to say to the thousands of mothers who often go so near to death’s 
door for the purpose of bringing into life another, that it is possible, 
in a very great degree, to ameliorate their sufferings. We have known 
of some cases indeed, in which by proper care and treatment during 
pregnancy the pain was almost entirely banished. In one instance, 
the lady declared that she suffered no pain whatever. We will now 
call attention to a few of the most important points to be observed for 
obtaining this desirable end. 

Exercise. —Moderate and regular excerise should be taken during 
the whole period of pregnancy, even to the last. The habit many 
women have of sitting or lying most of the time for several months 


1342 


DISEASES AND THEIR TREATMENT. 


is a very injurious one, as the muscles become weak, while the general 
health is seriously impaired. Childbirth is a process which is chiefly 
due to muscular action. In the performance of this act, the muscles 
of the abdomen and other parts of the trunk, as well as the womb, 
are involved, and hence anything which weakens or strengthens the 
muscles will materially affect the parturient process. Some of the 
easiest childbirths we have ever known were in the cases of poor wo¬ 
men who were obliged to do their own house-work, and continued to 
do so up to the very time of confinement. 

When the patient is for any reason too feeble to walk, ride, or take 
much vigorous exercise of any kind, daily passive exercise should be 
given in the form of massage and Swedish movements. Care should 
be taken never to over-do the matter, however, so as to occasion ex¬ 
haustion. 

At certain periods, as about the third or seventh month, special 
care to secure rest and quiet should be observed, owing to the liability 
to miscarriage at the former period, and premature birth at the second. 

Diet.— The food should be nourishing, but simple and unstimula¬ 
ting. Tea, coffee, beer, ale, porter, and stimulants of all kinds, should 
be avoided. Little if any meat should be taken. Inflammation or de¬ 
generation of the kidneys is a not very infrequent occurrence in preg¬ 
nancy, and is encouraged by the use of meat. The “ longings ” for 
various articles of food (many of which are of an unwholesome char¬ 
acter) experienced by many women when in this condition, should not 
be considered an imperative indication of what should be allowed. 
The idea that the infant will be “ marked ” or possess some deform¬ 
ity if “ longings ” are not satisfied, is an error. The patient should 
be denied unwholesome articles, no matter how strong the craving for 
them, as the desire for them cannot change their character or their re¬ 
lations to the body. Such food as oatmeal, cracked wheat, and other 
whole grain preparations, together with an abundance of fruit, should 
be freely used, not only as a means of securing proper activity of the 
bowels, but because these foods furnish the elements most essential to 
nourish the developing infant. 

Dress. —The dress should be suitable to the season, the body being 
clad in such a manner as to secure thorough and equable protection. 
It should not constrict the body of the wearer in any part, particularly 
about the waist. The Grecian lawgiver Lycurgus made a law re- 


HYGIENE OF PREGNANCY. 


1 343 


quiring all women when pregnant to wear very loose clothing. The 
ancient Romans enacted laws to the same effect. When the enlarge- 
ment of the abdomen becomes very great, the wearing of a wide band¬ 
age cut to fit the abdomen and applied in such a way as to support it 
somewhat, will be found very conducive to the comfort of the patient. 

Bathing. —General baths should be taken as often as necessary for 
cleanliness, as from one to three times a week. Sitz baths are especially 
advantageous. They should be taken all through the period of gesta¬ 
tion, two or three times a week, and during the last few weeks of preg¬ 
nancy should be taken daily. This is a most excellent means for relieving 
many of the local ailments from which women suffer during this period, 
especially those who are also subject to chronic disease of the womb. We 
do not know of any one means by which so much suffering at the period 
of childbirth may be obviated as by the persevering employment of sitz 
baths. We have often recommended this measure to those who were ac¬ 
customed to suffer very severely at childbirth, and never without very 
satisfactory results. 

Care of the Breasts. —Attention should be given to the breasts 
during the period of pregnancy, as by this means much trouble and in¬ 
convenience may be avoided after childbirth. They should be carefully 
protected from the pressure of tight clothing, and if painful may be 
soothed by means of anodyne liniments. When the nipples are sunken 
and retracted, they should be frequently drawn out by means of a breast- 
pump. When the skin of the nipple and of the breast in the immediate 
vicinity is tender, it may be hardened by applying twice a day a strong 
solution of alum or borax in whisky, or a solution of sulphate of zinc 
in the proportion of five grains to the ounce of water. 

Mental Conditions. —The mind should be kept in a cheerful frame 
bv kind and cheerful surroundings which will be conducive to evenness 
of temper. Although a woman in this condition is often in a very un¬ 
natural mental state, being fretful, petulant, and peevish, without any¬ 
thing more than an imaginary cause, she should be treated with the ut¬ 
most kindness, and her mind should be, so far as possible, diverted from 
the event to which she may look forward with very great apprehension, 
<‘specially if she has ever suffered a severe labor. The importance of con¬ 
trol of the mind on account of the effect of the mental status of the moth¬ 
er upon the impressible mind of the infant has been fully considered else¬ 
where. See pages 341-344. Another point which should be men¬ 
tioned in this connection is the propriety of sexual continence during 


1344 


DISEASES AND THEIR TREATMENT. 


this period. This is the invariable rule in lower animals, and should be 
with human beings; a disregard of it is a frequent cause of abortion. 
An eminent gynecologist remarks that “ if any obstetric authorities give 
their passive or implied consent to intercourse in pregnancy, it is like the 
story of Moses’ concession to the hardness of human hearts.” 

LABOR, OR CniLDBIRTH. 

The duration of pregnancy is generally from 278 to 300 days. At 
the end of this period, labor or parturition occurs, the process by which 
the new human being is brought into the world. This process some¬ 
times begins suddenly, but generally gives indications of its approach 
for some days or at least hours beforehand. 

The symptoms of the approaching conclusion are gradually increased 
irritability of the bladder, with much difficulty in standing or walking, 
and a change in form of the abdomen which results from the settling 
down of the womb, leaving the waist smaller, but increasing the prom¬ 
inence of the lower portion of the abdomen a short time before the 
labor is to begin. Also the external parts become swollen, and there is 
a leucorrhceal discharge of a thick, clear matter somewhat resembling 
the white of an egg. Uterine contractions, quite painless in character, 
are also indicative of the approaching crisis. These contractions at 
first occur at irregular intervals. When they become regular, the 
labor has begun. The pains usually begin in the back and sacrum, 
and extend to the front part of the abdomen. What are termed false 
labor pains arise from colic, constipation, or irritation of the bowels. 
They differ from labor pains in being irregular. The term pain, as 
used in obstetrics, is applied to the spasmodic uterine contractions which 
take place, together with the pain incident to the same. 

Presentation and Position. —The term presentation has reference 
to the particular part of the body which presents at the mouth of the 
womb. The term position has reference to the location of the pre¬ 
senting part in the passages of the mother. The most usual presenta¬ 
tion is the head. Occasionally the other extremity of the trunk takes 
precedence, forming what is termed a “ breech presentation.” In still 
other cases the body lies crosswise of the outlet, a presentation which 
must be modified in some way, before the infant can be born. 

There are various modifications of each of these classes of presen¬ 
tation, that is, 6ther parts of the head may present. In a perfectly 
natural labor, the vertex of the head is the presenting part. But vari- 


MANAGEMENT OF LABOR. 


1345 


ous other parts of the head may be presented, more or less complicat¬ 
ing the process. 

Stages of Labor. —The labor is divided into three stages. 

1. Dilation of the mouth of the womb. This is indicated by cut¬ 
ting pains felt mostly in the back, contractions taking place in the 
womb only, and gradually growing more and more frequent until the 
neck of the womb is fully dilated. 

2. Expulsion of the child, by means of stronger contractions in 
which the abdominal muscles contract, as well as the uterus. 

3. The expulsion of the after-birth. 

The average length of labor in women who have previously borne 
children is about six hours, the first four of which are occupied in 
the first stage, and the latter two in the second stage. The after¬ 
birth is often expelled at once after the expulsion of the child, but is 
more often retained five to thirty minutes. 

The first and second stages of labor are generally considerably 
prolonged. Some women, especially those who have broad hips and 
are well adapted to childbirth, pass through the process of labor in a 
much shorter space of time, in some cases not more than thirty min¬ 
utes or an hour being occupied. In women who have not borne chil¬ 
dren before, especially those who are somewhat advanced in life, labor 
is often very greatly prolonged. 

Various obstacles frequently arise to delay the process; such as, 
inactivity of the womb, rigidity of the neck of the womb or of the 
perinasum, and contracted pelvis. 

Management of Labor. —In the first place, the services of a com¬ 
petent attendant should be secured. The attendant should, if possi¬ 
ble, be a thoroughly trained physician. This is a field in which 
woman as a physician can fill a very useful sphere. Under no cir¬ 
cumstances, except in emergencies, should the important process of par¬ 
turition be placed wholly in the hands of a midwife whose qualifica¬ 
tions, such as she may possess, are wholly derived from experience at 
the bedside, no matter how large may be the number of cases she 
may have attended. No one person could by practical experience 
alone in a life-time acquire all the knowledge necessary to meet the 
urgent emergencies which are liable to arise at any time in childbirth. 
The science and art of obstetrics have been developed by a very slow 
process, and as they exist at the present day, are the result of the 

85 


134G 


DISEASES AND THEIR TREATMENT. 


■combined experience of physicians during the last two thousand years. 
Thorough theoretical knowledge is indispensable as a foundation for 
practical skill. This, of course, must be supplemented by actual ex¬ 
perience. 

As soon as the first labor pains make their appearance, the physi¬ 
cian should be promptly notified, and also the nurse, if the latter is 
not already in readiness. The room in which the patient is to be con¬ 
fined should be a large, light, airy, and pleasant one. But few per¬ 
sons should be allowed to be present, and these should be such as are 
desired by the patient, and no others. 

So far as consistent, all her wishes should be complied with, so that 
■she may be in as pleasant a state of mind as possible, and that no 
mental influence may present an obstacle to prevent the completion 
of the process in which her physical and nervous powers will be taxed 
to the uttermost. No remark of a discouraring nature should be ut- 
tered in the presence of the patient, but hope and confidence should 
be inspired. 

During the first stage the patient need not go to bed. In fact, it 
is better that she should sit up, as the sitting posture favors the prog¬ 
ress of labor. This need not be required, however, if the patient 
prefers to be in bed. During this stage the patient should qui¬ 
etly allow nature to carry on the work without any attempt to 
hasten matters by “ bearing down,” as she may often be encouraged to 
do by ignorant friends. These voluntary efforts are of no consequence 
until the neck of the womb is fully dilated. The patient should be 
allowed to drink cold water, or weak lemonade, as freely as desired; 
but stimulants should not be given, as they will produce a feverish 
state of the system without giving any real strength. Hot teas are 
•also better withheld. If the bowels have not moved freely, they 
.should be relieved by a full enema. 

During the first stage, the bed should be made in readiness. The 
feather bed, if in use, should be removed and replaced by a moderately 
hard mattress. Over this should be placed a large rubber cloth three 
or four feet wide and six feet long. This should be covered with a 
■comfortable, and a sheet placed over all. 

At the beginning of the second stage the patient should go to bed, 
and her clothing should be drawn up under her arms so that it will 
not be soiled, the lower portion of the body being protected by a sheet 
<or petticoat. The patient may lie on the left side or on the back. If 


MANAGEMENT OF LABOR. 


1347 


the fetus is strongly inclined toward the right side, it is better for 
the patient to lie upon the left side. During the severe pains which 
characterize the second stage of labor, the back of the patient should 
be supported by firm pressure with the hand. The knees should be 
drawn up, and fixed in such a position as to give them support dur¬ 
ing the pains. The nurse should take hold of the hand or wrist of 
the patient to give her an opportunity to make firm traction during 
the pain. In the intervals between the pains, if the patient is ex¬ 
hausted, she should be allowed to sleep, if possible, in order to recu¬ 
perate her strength. When the face becomes hot and flushed, it should 
be bathed with cool water. As the termination of labor approaches, 
as indicated by the increasing severity and frequency of the pains 
which at this time often become almost continuous, a supply of hot 
water should be got in readiness, a large pailful being brought to 
the bedside, together with a large pan, to be ready for any emergency. 
A syphon syringe should also be filled with hot water and held ready 
for use. A bottle of camphor should also be at hand, and a strong 
cord, made of silk or linen thread twisted and well waxed, with a 
pair of scissors, should be in readiness for prompt use. 

As the head of the child presses severely upon the perinseum, the 
efforts of the patient should be restrained, to avoid rupture by giving 
the tissues time to dilate. As soon as the head passes out, the cord 
should be felt for, as it is sometimes wound around the neck in such a 
way as to interrupt the circulation as the strain is brought to bear 
upon it. It also sometimes happens that knots are tied in it, which 
being tightened by the strain may cut off the supply of blood from 
the child too soon. If the body is not speedily expelled, the child may 
be withdrawn by making traction with the finger placed in the armpit. 

As soon as the child is born, the hand of the nurse should be placed 
upon the abdomen of the mother in such a way as to grasp the upper 
part of the womb, firm pressure being made for the purpose of secur¬ 
ing contraction of the organ. This pressure should be kept up until 
the after-birth is expelled and the bandage applied. 

The child should be brought to the edge of the bed as soon as it is 
born and examined Generally it at once utters a cry, which indi¬ 
cates that its lungs are filled with air. In case it does not cry and 
breathes feebly, or only gasps, the hand should be dipped in cold water 
and plac.d upon its chest, or the chest may be slapped with the hand. 
This will generally be sufficient to start the respiration. If the child 


1348 


DISEASES AND THEIR TREATMENT. 


is limp and pale, and makes no efforts whatever at respiration, it 
should be immediately inverted, being held with the head downward, 
and hot flannels should be wrapped about it. Efforts should be made 
to excite respiration by compressing the chest at intervals of a few 
seconds Care should also be taken to see that the mouth is cleared 
of mucus, though this is not likely to be necessary unless the child has 
begun to breathe just as the head is being born and has drawn mucus 
into the throat. If the face has a purplish appearance, the child should 
he placed at once in a warm bath of a temperature of 105°, or as hot 
as can be safely used without injury to the skin, and cold water should 
be dashed upon the chest. Artificial respiration may also be employed 
at the same time. These measures should be continued for some time 
and should not be abandoned so long as any evidence whatever of the 
action of the heart can be obtained. Some cases are recorded in which 
infants have been resuscitated after apparent death had continued for 
fully an hour. 

As soon as it breathes freely the cord should be tied in two places ; 
the first about two inches from the body, the other about three inches. 
The child should then be laid upon its side, not on the back, as the 
side position favors the escape of mucus from the throat. If there 
should be much rattling in the throat, indicating the presence of con¬ 
siderable mucus, the infant should be laid with its head downward 
and to one side, so as to allow the mucus to escape. 

Washing and Dressing the Child. —If the birth is a premature 
one, having occurred before the infant was fully developed, the child 
will be smaller than usual and less well developed; its movements 
will be slight and feeble, and its cry will be very faint, and the coun¬ 
tenance will have a peculiarly old expression. Such a child requires 
extra care and warmth. It should be carefully wrapped in soft cot¬ 
ton. Very great care will be required in rearing it, as it will at first 
be too weak to nurse and must be fed with a spoon. It should not be 
washed and dressed for some time, and should be kept very warm. 
Care should be taken in washing the child not to expose it to cold so 
as to produce blueness of the surface, as is often done. It should be 
recollected that the infant has all its life thus far been accustomed to 
a temperature of nearly 100°, and being wholly without protection 
when born, and keenly susceptible, it must suffer quite severely from 
cold. 


WASHING AND DRESSING THE CHILD. 


1349 


The best plan is to place the child in a warm bath, the tempera¬ 
ture of which is about blood heat, and then rub it gently with a 
sponge dipped in warm, weak suds made of castile soap. If the sur¬ 
face is covered with curd-like matter, as is sometimes the case, it 
should be smeared with a mixture of equal parts of egg and sweet oil 
beaten up together. After the bath, the surface of the skin should be 
anointed with a little olive oil or vaseline. If some portions of the 
curdy matter seem to be firmly adhesive to the skin, no violent efforts 
should be made to remove them, as they will dry up and disappear in 
a short time without further attention. After being thoroughly 
washed, the child should be carefully examined to see that it pos¬ 
sesses no deformity. The outlets of the body should receive particular 
attention, as in some cases the anus or urethra are closed. 

The best method of dressing the cord is this: Grasp the cord with 
the thumb and finger close to the body, cutting it off at the ligature. 
Squeeze out all its contents by pressure with the thumb and finger of 
the other hand, keeping a firm grasp upon it with the thumb and 
finger first applied so as to prevent hemorrhage. Now apply another 
ligature about an inch from the end of the stump. By this means 
the cord will be very greatly reduced in size and may be much more 
easily dressed than when treated in the usual way. In dressing, 
apply a soft thin muslin bandage, about as wide as the first joint of 
the thumb, wrapping it around the cord three or four times. Now 
apply another ligature outside of the bandage, and the dressing is 
complete. Some prefer to apply for a bandage a soft linen cloth four 
or five inches square smeared upon the under surface with mutton 
tallow and having a hole in the center through which the cord is 
slipped. The cloth is generally scorched, but not much is gained by 
this practice. By dressing the cord in this way, much offensiveness 
which arises from decomposition is avoided. It is generally custom¬ 
ary to next apply what is termed the belly-band. This is not so im¬ 
portant as many suppose, if indeed it is needed at all, which we very 
seriously doubt. If applied, it should not be drawn too tight, and 
should be fastened with tapes instead of pins. The best material to 
use is very soft flannel. When the dressing is completed, the infant 
should be placed in a warm bed; but it should not have its head cov¬ 
ered, as it needs an abundance of air, as well as adults. The infant 
when thus properly dressed, generally sleeus several hours. When it 
awakes, it should be applied to the breast. Although the milk is not 


1350 


DISEASES AND THEIR TREATMENT. 


yet formed, the efforts of the child to nurse will promote the secretion 
and will also benefit the child, as the first secretion furnished by the 
breast, a watery fluid known as colostrum, has a slightly laxative ef¬ 
fect upon the bowels of the infant, freeing them from their dark green 
contents, which is termed meconium. 

The Binder. —After the child has been born and its immediate 
wants attended to, the binder or abdominal bandage should be applied 
to the mother. The binder consists of a double thickness of strong 
muslin cloth or a large linen towel. It should be applied in such a 
way as to give the mother the least possible amount of inconvenience 
in the application. In fastening, it should be drawn so as to fit the 
body snugly and should be pinned from before downward. The band¬ 
age is generally applied more tightly than is necessary, the serious 
consequence of which is not infrequently prolapsus of the womb. In 
case there is any marked tendency to hemorrhage after the birth, a 
folded towel should be laid over the womb beneath the bandage. The 
soiled clothing should next be removed. The patient should be 
washed and wiped dry, and a dry clean sheet with old cloths for ab¬ 
sorbing the discharges should be placed beneath the patient. Care 
should be taken that the patient is warmly covered. A slight shiver¬ 
ing will often occur, but this is generally from nervousness. If the 
patient has lost much blood or is very weak, the head should be placed 
low ; only a very small pillow or none at all should be used. The pa¬ 
tient should now be allowed to rest. Simple drinks may be allowed 
at pleasure, but stimulants are rarely called for. The patient will 
generally fall to sleep if allowed to do so, and will awake after two or 
three hours very much refreshed. Food may be taken at regular 
times, but should be simple and unstimulating. Milk, toast, oatmeal 
porridge, and occasionally soft boiled eggs, should constitute the chief 
diet. Beefsteak and other meats are better avoided. 

Attention should be given to the bowels and bladder. If the bow¬ 
els do not move by the second day, an enema should be administered. 
Either tepid water or flaxseed tea may be employed. The bladder 
should be emptied within a few hours after labor. If there is inability 
to urinate, a warm fomentation may be applied over the bladder be¬ 
tween the thighs, or a warm douche administered. This will usually 
bring relief, especially the latter measure, the patient being directed to 
urinate while the douche is being given. If these simple measures do 


MILK FEVER. 


1351 


not succeed, it will be necessary to use a catheter. The bladder should 
be relieved two or three times a day. 

For the first day, the discharge from the womb is of a bloody 
character; after this, it gradually becomes watery, and in from three 
to five days it becomes thicker. This is termed the lochicil discharge, 
and generally continues from one to three weeks. It is often checked 
for a day or tw T o at the time when the milk secretion begins. In or¬ 
der to prevent the discharge from becoming offensive, as is sometimes 
the case, the vaginal douche should be taken at least twice a day; and 
when the discharge is very profuse, more frequently. The water em¬ 
ployed should be quite warm, and should contain a teaspoonful of car¬ 
bolic acid dissolved in a tablespoonful of glycerine or alcohol to the 
quart of water. The injection of hot water not only cleanses the parts, 
but stimulates complete contraction of the tissues, and thus prevents 
danger from hemorrhage, and hastens the process by which the organ 
returns to its natural size. A solution of permanganate of potash in 
the proportion of a teaspoonful of the crystals to a quart of w T ater, is 
also an excellent injection for use when the discharge is offensive. 
The carbolic acid solution should be thoroughly shaken before it is 
used. When blood reappears in the discharges after a few days, it is 
an indication that the process referred to is not taking place regularly 
and satisfactorily. This is generally the result of the patient’s getting 
up too soon. 

Milk Fever. —This is a term applied to the feverishness which is 
sometimes present on the third day after confinement. The fever 
may be introduced by a slight chilliness. The patient has thirst, head¬ 
ache, and frequent pulse. The breasts are generally somewhat swollen, 
harder than natural, and sensitive; throbbing and darting pains are 
sometimes felt in them. It is probable that the fever is not the result 
of the milk secretion, but is due to the absorption of decompos¬ 
ing discharges through the raw surfaces of the vagina and womb. 
The thorough use of disinfectant injections will generally prevent a 
recurrence of this fever. 

Allowing the child to suck the breast soon after birth, and at reg¬ 
ular intervals afterward, is also an excellent means of prevention. 
The treatment at this time should consist in giving the patient lit¬ 
tle fluid to drink, feeding her chiefly with solid food, and quenching 
the thirst by means of pieces of ice. Hot fomentations should be ap¬ 
plied to the breasts, and they should be emptied by means of the 


1352 


DISEASES AND THEIR TREATMENT. 


breast-pump, unless the child is able to withdraw the secretion by nurs¬ 
ing. Sometimes the swelling is so great that the nipple is partly bu¬ 
ried, thus interfering with the nursing. In this case the breast-pump 
should be employed to draw out the nipple, or a nipple shield with a 
rubber teat should be employed. In the absence of either one, an 
adult may act as a substitute for the child. 

Care of the Breasts. —If the breasts have been properly cared 
for during pregnancy, little inconvenience will be experienced after 
childbirth. Care should be taken to wash the nipples carefully with 
cold water both before and after nursing. If the breasts are large, 
flabby, and pendulous, it is well to support them by means of bandages 
properly applied, passing under the breasts and over the neck. This 
precaution will often prevent inflammation of the breasts. 

Sore Nipples will rarely occur when these precautions are ob- 
served. If the nipples should become cracked and tender, especial at¬ 
tention should be given to cleansing, both before and after nursing, 
and an ointment of carbolated vaseline, ten drops to the ounce, should 
be used, care being taken to remove the ointment before the nipple is 
given to the child. A solution of tannin in glycerine, fifteen grains 
to the ounce, is also an excellent application for sore nipples. It should 
be used twice a day. Another excellent remedy is the following lo¬ 
tion, which should be applied twice a day with a camel’s hair brush : 
Carbolic acid twenty drops, glycerine two teaspoonsful, water a table¬ 
spoonful and a half; mix thoroughly. Care should also be taken to give 
the nipple as much rest as possible, by using the breasts alternately, and 
making the intervals between nursing as long as possible without doing 
injury to the child. One of the greatest causes of sore nipples is com¬ 
pression of the breast by improper dressing before and during preg¬ 
nancy. In some cases, severe pain may be felt whenever the child is 
taken to the breast, in consequence of neuralgia of the part. This 
should be carefully distinguished from soreness of the nipple by a 
critical examination of the breast. 

Inflammation of the Breast. —If swelling of the breast occurs, 
accompanied by redness, pain, and tenderness, the breast should be given 
entire rest at once. Hot fomentations should be applied until the pain 
is relieved. The fomentations should not be simply warm, but they 
should be as hot as can be borne. If relief is not obtained in this way, 
ice-compresses or an ice-pack should be used. We generally obtain better 


SECRETION OF MILK. 


1353 


results by means of alternate hot and cold applications than by the 
use of either one alone. If one alone is used, the packs or compresses 
should be removed once in a half-hour for fifteen or twenty times, 
in order to prolong the good effect. At the very beginning of the dif¬ 
ficulty, before inflammation has really begun, relief may frequently be 
obtained by carefully withdrawing the milk from the breast and rub¬ 
bing it gently with the hand. If suppuration occurs, as indi¬ 
cated by the softening of the hard cake which forms when the 
inflammation rises high, poultices should be applied. It is also 
best to call a physician in this case, as it is frequently necessary 
to lance the abscess which has formed. Blisters, mustard plasters, 
leeches, and other irritating applications, are of no value whatever- 
Inflammation of the breast may almost always be prevented by care 
on the part of the mother to avoid allowing the breast to become too 
full. On this account, regularity in nursing is of great importance. 

To Glieck the Secretion of Milk. —In some cases it becomes de¬ 
sirable that the secretion of milk should be checked. This is espe¬ 
cially important in cases of still-birth. The most effective measure 
for checking the secretion of milk is to require the patient to abstain 
from the use of fluids of any sort. The food should be of a solid 
character. The thirst may be relieved by taking small quantities of 
ice. This should be continued until the fourth or fifth day, when there 
will usually be no further difficulty. The breasts should be partialh' 
relieved of their contents by the breast-pump or other means, but 
should not be entirely emptied. The application of the ice-pack or 
cold compresses to the breasts, is also an excellent means for diminish¬ 
ing the secretion. It is also a good plan to apply to the breasts two or 
three times a day a mixture of equal parts of sweet oil and spirits of 
camphor, and to keep the breasts constantly covered with a cloth sat¬ 
urated with spirits of camphor. 

To Promote the Secretion of Milk. —This must be accomplished 
chiefly by regulation of the diet and attention to the general health, 
especially to the improvement of the digestion. The patient should 
make free use of liquid food, particularly fresh milk, sweet cream, oat¬ 
meal porridge, graham gruel, and other whole-grain preparations. Teas 
of various kinds are of little consequence and do not increase the quan¬ 
tity of milk except by the addition of water. Tim use of wine, beer, 
ale, and other alcoholic stimulants is a practice to be in the highest de- 


1354 


DISEASES AND THEIR TREATMENT. 


gree condemned, as it not only deteriorates the quality of the milk, 
but makes the child liable to various diseases. An eminent physician 
declares that in many instances in which beer and ale are used, the in¬ 
fant is not sober a moment from the time it begins nursing until it is 
weaned. 

Gentle manipulation of the nipple in imitation of the act of milk¬ 
ing is in many cases very efficacious in promoting the secretion of 
milk. By this means, the secretion has been produced in women who 
had never borne children, and often in young girls and men in such a 
quantity as to enable them to perform the part of wet-nurse with 
entire success. 

It is said the function of lactation is possessed by many men in 
Russia. Some years ago a negro slave appeared before the class in 
a Southern medical college, who had a profuse secretion of milk from 
one breast, and had acted as wet-nurse for all the children of his mis¬ 
tress. 

Getting Up. —No definite time can be set at which it would be safe 
for every woman “ to get up.” Some are as able to be up in three or 
four days, as others at the end of two weeks. The traditional “ nine 
days for lying in,” has no substantial foundation. As a general rule, 
the woman should remain recumbent in bed for a week or ten days. 
If she has been getting along nicely, she may be permitted to sit up a 
few minutes after the fourth or fifth day while the bed is being changed 
and aired; but if the lochial discharge becomes bloody after being up, 
it is an indication that she should remain in bed some time longer. 
Getting up too soon after confinement is a frequent cause of some of 
the most troublesome chronic ailments from which women suffer. The 
worst of these is enlargement of the womb, due to sub-involution, a 
condition in which the organ fails to return to its natural size, remain¬ 
ing permanently enlarged. When everything progresses well, this proc¬ 
ess generally takes place in six or eight weeks. During this time the 
patient should exercise very great care to avoid exposure of any kind. 
Getting the feet wet, being chilled, overexertion of any kind, either 
mental or physical, and anything which has a prostrating effect, will 
be likely to check the natural retrograde process, the prompt and thor¬ 
ough performance of which is very important. Special care should be 
taken so long as the lochial discharge is still present. Care during; 
this period will often save the patient from many years of suffering.. 


HEMORRHAGE. 


1355 


Hemorrhage after Labor. —Sometimes the womb does not con¬ 
tract so firmly as it should after childbirth, in consequence of which 
its greatly dilated blood-vessels remain open, and frightful hemorrhage 
is the result. This is also sometimes caused by only partial separa¬ 
tion of the after-birth, the remainder of the after-birth being attached 
so firmly that it cannot be expelled by the contractions of the organ. 

Treatment .—When the hemorrhage is due to partial attachment 
of the placenta, the after-birth should be removed as quickly as pos¬ 
sible. In order to effect this, it is sometimes necessary for the phy¬ 
sician to pass his hand into the womb. The necessity for this meas¬ 
ure may almost always be obviated by the employment of the hot- 
water douche at as high a temperature as can be borne by the patient. 
Where hemorrhage is due to failure of the uterus to contract, the best 
remedy known is the hot-water douche. The syphon syringe, or some 
other efficient instrument of the kind, should be in readiness for use 
in an emergency of this sort. The water employed should be as 
hot as can be used without burning the tissues. This remedy is gen¬ 
erally quite promptly effective. 

Uterine contraction may also be stimulated by alternate hot and 
cold applications to the abdomen over the womb, and to the breast. 
Care should be taken by the nurse to examine the patient frequently 
after childbirth to see that there i-s no unusual hemorrhage. 

Retention of the After-Birth. —The condition referred to in the 
preceding paragraph sometimes occurs in consequence of failure of the 
uterus to contract properly after the child has been born, or in conse¬ 
quence of an unusually firm attachment of the placenta to the internal 
walls of the uterus. As previously remarked, the after-birth is gen¬ 
erally expelled from five to thirty minutes after the child is born. 
When the uterine contractions suddenly cease after the child is born,, 
so that the placenta is not expelled, the remedies suggested for inactiv¬ 
ity of the womb should be applied, one of the most effective of which 
is the hot-water douche. In case these are not effective, it becomes 
necessary for the physician to pass two or more fingers into the womb 
and by gradually working them under the placenta loosen it and 
bring it away. This is a frequent cause of hemorrhage after child¬ 
birth, the treatment for which has already been given. 

Inactivity of the Womb.— When labor is delayed in any of its 
stages in consequence of failure of the uterus to contract with suffi- 


1356 


DISEASES AND THEIR TREATMENT. 


cient vigor, it is necessary to adopt means for the purpose of stimulat¬ 
ing the contractions. Among other simple measures which may be 
applied with advantage are the application of cold water to the breast 
and over the abdomen. Sometimes alternate hot and cold applica¬ 
tions are more effective than cold alone. Sometimes the inactivity is 
due to exhaustion, and rest is needed. In such cases, the patient 
should be allowed to sleep, if possible, and should be given food. In 
case of very great weakness, a small quantity of some form of local 
stimulant may be taken without detriment, and probably with 
advantage. 

Electricity is a very useful agent in cases of this sort. The posi¬ 
tive pole should be applied to the back and the negative over the 
womb. The hot vaginal douche is one of the most effective measures 
for use in these cases. 

Rigidity of the Womb .—In some cases labor is delayed by a 
failure of the neck or mouth of the womb to dilate with sufficient ra¬ 
pidity. This is sometimes due to an early rupture of the membranes, 
in consequence of which the “ bag of waters,” which precedes the child 
as it passes downward, does not perform its usual and important func¬ 
tion of dilatation. It is also sometimes due to an unnatural condi¬ 
tion of the tissues of the neck of the womb. In these cases the pains 
are very severe and acute, being felt mostly in the sacrum. The pa¬ 
tient is feverish and very restless, the pulse becomes very frequent, 
and the patient suffers great distress. By internal examination, the 
os, or mouth, of the womb is felt like a hard ring. 

Treatment .—The best remedies for this condition are the hot sitz 
bath and the hot vaginal douche. They may be continued for several 
hours if necessary without detriment. Large hot enemas are also very 
useful in this condition. They should be retained as long as possible. 

Rigidity of the Perinaeum. —In this condition, the perinseum, or 
portion of the tissue between the vagina and rectum, does not dilate 
as it should, but the central portion bulges forward while the upper 
edge remains hard and unyielding. This is the most frequent cause 
of rupture of the perinaeum. The best remedies are the hot sitz bath 
and hot fomentations to the parts. A very excellent way of applying 
moist heat is by means of a large sponge dipped in hot water, and 
applied as hot as it can be borne. The hot-water douche and the hot 
enema are remedies of very great value. The employment of daily 


TWINS. 


1357 


sitz baths during the later months of pregnancy is a very excellent 
means of preventing this complication. 

After-Pains. —In some cases, contractions of the uterus continue 
for a longer or shorter period after labor is completed. When these 
contractions are so severe as to give the patient great discomfort, hot 
fomentations should be applied over the abdomen. The hot vaginal 
douche is also an excellent means of relieving after-pains by produc¬ 
ing firm contraction of the womb. 

The Use of Ergot. —This drug, once very popular, indeed thought 
to be almost indispensable in all cases of childbirth, is now charged 
by many of the most eminent obstetricians with being the cause of 
much increase of suffering during childbirth, and serious subsequent 
disease. It has often been the cause of ruptures of the neck of the 
womb and of the perinaeum by producing too rapid labor. If used at 
all, it should be only in difficult labor. It is probable that its use 
can be dispensed with in nearly, if not all, cases, without detriment 
to any, and with benefit to many. 

The Use of Anaesthetics. —The employment of anaesthetics in 
childbirth is a practice of very recent date. When it was first intro¬ 
duced, many fears were expressed that harm would result to either 
mother or child, or both. Some opposed the measure on moral 
grounds, claiming that the pains of child-birth were part of the curse 
pronounced upon Eve, and that the use of anaesthetics for the pur¬ 
pose of mitigating the pain was preventing execution of the penalty. 
Notwithstanding the opposition, however, some form of anaesthetic, 
generally chloroform, is now very largely used, especially in prolonged 
and unusually painful labors. If the patient is strong and vigorous, 
and the labor is not unusually severe, there is no occasion for the use 
of the anaesthetic; but if the contrary of this is true, there is no ques¬ 
tion but benefit, as well as comfort, may be derived from the judicious 
use of chloroform. It is unnecessary to produce profound anaesthesia, 
or to bring the patient fully under the influence of the drug, and hence 
there is little or no danger of immediate injury to the patient. Neither 
have those opposed to the use of chloroform been able to show that 
injury results to the child. It should never be used, however, with¬ 
out the advice and constant supervision of the physician. 

Twins. —Twin pregnancy may be suspected when the mother is 
unusually large, or when there is a double appearance of the enlarged 


1358 


DISEASES AND THEIR TREATMENT. 


abdomen. Twin birth occurs in proportion of about one to seventy 
or eighty single births. The usual unpleasant symptoms which occur 
during pregnancy are greatly exaggerated in twin pregnancy. 
Complicated labors are also somewhat mor-e frequent in twin births. 
The birth of the second child generally succeeds that of the first very 
quickly, but cases have been observed in which several hours and even 
days have elapsed before the birth of the second child. 

Abdominal Pregnancy. —It sometimes happens that the impreg¬ 
nated ovum finds its way into the abdominal cavity and there under¬ 
goes development; fortunately, occurrences of this kind are very rare. 
In many cases, the fetus becomes surrounded with a cyst, by means 
of which it is separated from the rest of the body, and sometimes may 
be thus preserved for years in a degenerated condition. 

In other cases, the different portions of the fetus gradually work 
out through the bowels, or even through the abdominal wall. In still 
other cases, decomposition and suppuration take place, the system be¬ 
comes infected with the products of decomposition, and the patient dies 
of blood poisoning. Cases have occurred in which, by the performance 
of a surgical operation, a fully developed child has been removed from 
the abdominal cavity, the lives of both mother and infant being saved. 


DISORDERS OF PREGNANCY. 


1359 


DISORDERS OF PREGNANCY, 

Constipation. —Can generally be relieved by regulating the diet, 
which should consist chiefly of fruits and grains. Drinking a glass of 
cold water before breakfast is an excellent means of securing a regular 
evacuation of the bowels. In case these measures are insufficient, the 
enema may be resorted to. As small a quantity of water should be used 
as will secure the desired movement. It is also better to employ water 
at a moderately low temperature, so as to keep the blood-vessels of the 
part well closed, as a means of preventing hemorrhoids. A very ex¬ 
cellent plan by which the dependence upon the enema may be some¬ 
what avoided, is to inject into the rectum at night, just before retiring, 
two tablespoonsful of water containing ten drops of spirits of camphor. 
This will often provoke a movement of the bowels at once. If the 
fluid is retained over night, it will be quite certain to secure a prompt 
movement. Figs, stewed prunes, and other fruits of a laxative char¬ 
acter, if freely used by the patient, will generally obviate the necessity 
for other means. It is very unwise to become dependent upon the use 
of the enema, and hence a persevering effort should be made to secure 
healthy activity of the bowels by regulation of the diet. 

Piles, or Hemorrhoids. —This troublesome difficulty is a very fre¬ 
quent accompaniment of pregnancy. It is generally the result of con¬ 
stipation of the bowels. When this is the case, the bowels should be 
kept loose by means of enemas of linseed tea, or soap-suds. In case 
there is a tendency to hemorrhage from the rectum, an ointment con¬ 
taining a dram of tannin to an ounce of vaseline should be used after 
each movement of the bowels. 

Morning Sickness. —Nausea and vomiting in the morning soon 
after getting up, is one of the early symptoms of pregnancy, and is 
also characteristic of its later stages. The best method of treatment is 
to give the patient something to eat before getting up in the morning, 
as a bowl of brown bread and milk. The patient should eat at least 
fifteen or twenty minutes before attempting to get up, and upon aris¬ 
ing should dress quickly and go out in the open air for a walk, unless 
the weather forbids. 

The abdominal bandage is a very excellent means of relieving this 
unpleasant symptom. It should be worn constantly for a week or two, 


1360 


DISEASES AND THEIR TREATMENT. 


and then omitted during the night. Daily sitz baths are also of great, 
advantage. In many cases, electricity relieves this symptom very 
promptly. When nearly all kinds of food are rejected, milk and lime- 
water may be employed in very urgent cases in which the vomiting 
can not be repressed, and the life of the patient is threatened. The 
stomach should be given entire rest, the patient being nourished by 
means of nutritive injections. See Page 737. Fomentations over the 
stomach and swallowing of small bits of ice, are sometimes effective 
when other measures fail. 

Various other disturbances of digestion occur, due to the develop¬ 
ment of various forms of dyspepsia. Severe pain in the stomach is 
often a very ominous symptom. When present, the attention of the 
physician should be called to the fact. 

Disorders.of the Bladder and Womb. —Various disorders of the 
bladder and urine are frequent during the pregnant state. Irritability 
of the bladder, or painful micturition, incontinence of urine, retention 
of urine, are the most common troubles of this sort. Irritability of the 
bladder is most generally due to neglect to empty the bladder of its 
contents with frequency and regularity. In some cases, the bladder 
troubles are due to displacements of the womb existing before pregnan¬ 
cy occurred. This is especially true of incontinence of urine, which 
generally results in these cases from pressure upon the bladder by the 
enlarged womb. Prolapsus of the uterus and retroversion are difficul¬ 
ties which sometimes complicate pregnancy and require the attention 
of the physician. The irritability of the bladder is generally relieved 
by copious water-drinking, the free use of fruit, and relieving the or¬ 
gan regularly once in five or six hours. The recumbent position is the 
best remedy for incontinence of urine. Sometimes this difficulty may 
be prevented by the use of the abdominal bandage for the purpose of 
holding the uterus in place. 

Itching Genitals. —This difficulty should be treated according to 
directions given elsewhere. See Page 1330. It is almost always ac¬ 
companied by leucorrhcea, which should also receive proper treatment. 

Vaginal Discharges. —The discharges which take place from the 
vagina during pregnancy are quite various. The most common is a pro¬ 
fuse mucous discharge, or leucorrhoea, the best remedy for which is the 
daily use of vaginal injections administered with the syphon syringe. 
The water should be at the temperature of the body, and little force 


VARICOSE OR ENLARGED VEINS. 


1861 


should be employed. Various remedies elsewhere ecommended for 
leucorrhcea are useful in this form of the difficulty. 

Occasionally strong gushes of a watery fluid occur, followed for 
some time by a dribbling of the same. The remedy for this difficulty is 
complete rest. Fluid discharges occurring during pregnancy should 
receive prompt attention, as they may indicate a liability to miscarriage. 

Varicose or Enlarged Veins. —Varicose veins of the lower ex¬ 
tremities are of very frequent occurrence in pregnancy, being produced 
by the pressure of the enlarged womb upon the veins which return the 
blood from the lower extremities. Sometimes a similar enlargement of 

O 

the veins of the external organs of generation on one or both sides also 
occurs. 

Treatment .—The limbs should be supported bv means of an elastic 
bandage, or elastic silk stocking, whenever the patient is on her feet. 
A flannel bandage made of strips of flannel torn across the web so as 
to give some elasticity may be used in place of the rubber bandage 
The bandage should be applied evenly, from the toes upward, as high 
as necessary, even extending to the body in some cases. When the pa¬ 
tient is sitting or lying down, the feet should be elevated a little higher 
than the hips if possible. If the labia becomes very much swollen, the 
patient should remain as much as possible in a horizontal position, in 
the meantime pressing out the blood from the distended veins by steady 
compression with the hand. A pad and bandage can be adjusted in 
such a way as to answer the same purpose. 

Dropsical Swelling of the Feet and Limbs. —General dropsy, in¬ 
dicated by swelling of the limbs so that pitting is produced by press¬ 
ure with the finger, and puffiness of the face, is a very serious compli¬ 
cation of pregnancy, indicating inflammation of the kidneys. This 
condition should receive prompt attention. The most useful remedies 
are such as will induce active perspiration. The patient should be al¬ 
lowed no animal food except milk, the diet being made up chiefly of 
fruits and grains. When the swelling is confined to the feet and limbs, 
it may be treated by means of the bandage, or the elastic silk stocking. 

Difficult Respiration. —Shortness of breath or difficulty of breath¬ 
ing, are frequently among the most prominent inconveniences of the 
latter stages of the pregnant state. Patients subject to asthenia, and 
suffering with organic disease of the heart, suffer much more than do 
others. The interference with respiration is produced in most cases by 

86 


1362 


DISEASES AND THEIR TREATMENT. 


crowding upward of the abdominal organs against the diaphragm, 
thus preventing its descent, and making it impossible for the patient to 
take a full inspiration. Shortness of breath is sometimes due to pov¬ 
erty of the blood. 

The first class of cases can be relieved but little, as the cause can¬ 
not be removed. Some advantage may be derived, however, by the 
application of faradization to the chest, for the purpose of strength¬ 
ening the respiratory muscles. In cases in which the difficulty arises 
from debility, the patient should receive such treatment as will se¬ 
cure improvement of nutrition. 

Fainting in some cases occurs quite frequently during the first few 
months of pregnancy. This is simply due to the morbidly suscepti¬ 
ble condition of the nervous system during this period, very slight 
disturbances being sufficient to occasion intense mental excitement and 
profound disturbance of the circulation. 

Headache and Disturbance of Sight. —Severe continuous head¬ 
ache and various disturbances of vision, such as blurring, double sight, 
etc., are sometimes of quite serious import. These cases should be in¬ 
vestigated by a competent physician. Whenever these symptoms oc¬ 
cur, a careful examination of the urine should be made, to determine if 
albumen is present. The headache may generally be relieved by cool 
or hot compresses and derivative measures. 

Neuralgia.— The neuralgia of pregnancy is sometimes one of the 
most disagreeable features. It may assume a great variety of forms. 
It most frequently affects the face. Very often the teeth are the seat 
of the pain. 

Treatment .—Hot fomentations, hot poultices, electricity, and other 
measures elsewhere recommended for neuralgia, are equally useful in 
these cases. 

Miscarriage and Abortion. —These terms are applied to cases in 
which the fetus is discharged before the seventh month. Mis¬ 
carriage occurs most frequently in fleshy persons and those who are 
subject to menorrhagia, or profuse menstruation. Nearly all the se¬ 
vere acute diseases may give rise to miscarriage. Violent excitement 
or exertion, either mental or physical, displacements of the uterus^ 
together with chronic inflammations and tumors of. the organ, falls, 
and other violent accidents, severe vomiting or coughing, bad hygiene, 
and sexual indulgence, may be enumerated as the principal causes of 
abortion. 


PREMA TURE LABOR. 


1363 


The symptoms of abortion within the first two weeks do not dif¬ 
fer very greatly from those attending menorrhagia. Not infrequently 
miscarriages occur at this period without the woman being conscious 
©f the fact. In the third or fourth month, there is considerable hem¬ 
orrhage, and some portion of the fetus is likely to be retained in the 
womb, where decomposition not infrequently takes place, imperiling 
the patient’s life. Criminal abortion is very frequently attended by 
fatal results. The moral aspect of this question has been fully consid¬ 
ered elsewhere, page 355. Miscarriage occurring as late as five or six 
months, very closely resembles labor. 

Treatment .—In cases in which abortion habitually occurs at a 
certain time, complete rest should be enjoined upon the patient. She 
should not be upon her feet at all until the dangerous period is past. 
Sexual excitement should also be strictly prohibited. In case flooding 
occurs, or other symptoms of abortion, the patient should at once go to 
bed and apply cold compresses over the bowels, and tepid injections of 
tannin or a decoction of white-oak bark into the vagina. Abortion or 
miscarriage is much more likely to be followed by diseases of the 
womb than natural labor, and hence every possible precaution should 
be taken to prevent exposure in these cases. 

Premature Labor. —This term is applied to all cases of premature 
childbirth occurring after the beginning of the seventh month. The 
causes are essentially the same as those which produce abortion. The 
rules already laid down for the management of labor at full term, are 
equally applicable to premature labors. It should be remarked that 
extra preparations should be made, to give the feeble infant likely to 
be born in these cases, the best possible chances for life. 

Death of the Fetus.—When many symptoms of pregnancy which 
have been distinctly present disappear, there are grounds for suspicion 
that death of the fetus has been occasioned by some cause. The causes 
which occasion death of the fetus are essentially the same as those 
which give rise to abortion and premature labor. The fetus is gen¬ 
erally expelled a week or ten days after it dies. 

Molar or False Pregnancy. —Two forms of false pregnancy occur. 
In one of these, after the usual symptoms of abortion, and with con¬ 
siderable pain and hemorrhage, a fleshy body of varying size is expelled, 
which may be shown by a close examination to be an undeveloped 
fetus. This form of false pregnancy is attended by little danger. 


1364 


DISEASES AND THEIR TREATMENT. 


In the other form, the symptoms of pregnancy continue up to the 
fourth or fifth month, though no fetal movements are ever felt. The 
abdominal walls are generally extended more than at the same time 
in true pregnancy. After a time, a large quantity of bloody serum 
is discharged, along with severe hemorrhage, the escaping fluid con¬ 
taining small bladder-like bodies resembling grapes. This is known as 
the hydatidi-form. This form of false pregnancy is by no means free 
from danger. 

O 

Flooding. —The patient should at once go to bed. Cold compresses 
should be applied over the lower part of the bowels. She should be 
given an abundance of cold water to drink. Cold water may also 
be injected into the rectum with advantage. In case of a severe hem¬ 
orrhage after miscarriage or premature labor, the best known remedy 
is the prolonged hot-water vaginal douche. 

Puerperal Convulsions. —This is a very serious disease which 
may occur during pregnancy, or during or after labor. It generally 
occurs in patients who have suffered with disease of the kidneys dur¬ 
ing labor, as shown by swelling of the feet and limbs, puffiness of the 
face, and the presence of albumen in the urine. Among the first 
symptoms are disorders of vision, as blurred sight, double vision, etc. 
The attack generally begins with strong muscular contraction, in which 
the muscles of the limbs become rigid, and respiration ceases through 
rigidity of the muscles of the chest. This is followed in a short time 
by spasmodic twitching of the various muscles. Sometimes the con¬ 
tractions of patients suffering with this affection are frightful. The 
most common, and probably the sole cause of true puerperal convul¬ 
sions, is poisoning of the blood by the elements of the urine which are 
not eliminated on account of congestion or inflammation of the kid¬ 
neys. Sometimes the attacks assume a character resembling that of 
epilepsy. These cases are probably due to some other cause. 

Treatment .—The preventive treatment of this disease is by far the 
most important. It consists, first, in thorough attention to the laws of 
hygiene relating to the pregnant state. The diet should be chiefly fruit, 
and farinaceous articles of food. Sugar and meat should be carefully 
discarded. As soon as the swelling of the feet and puffiness of the face 
are observed, the patient should take frequent warm baths with wet- 
sheet packs, vapor baths, and other treatment which will induce active 
sweating. Considerable quantities of water should be daily drank,—in 


PUERPERAL FEVER. 


1365 


fact, the general course laid down for Bright’s disease of the kidneys 
should be carefully followed. 

At the time of the attack, vigorous efforts should be made to relieve 
the system of the noxious elements by which the brain and nervous 
system is being poisoned, through the medium of perspiration. If pos¬ 
sible, the patient should be given a hot blanket pack, hot bottles being 
packed around her to induce copious sweating. If the bowels are con¬ 
stipated they should be relieved by a warm enema. A spoon handle 
wrapped with cloth should be placed between the teeth to prevent the 
tongue being bitten. The patient should not be violently restrained, 
but should be gently prevented from injuring herself. When coma 
is present, as is frequently the case, cold or iced compresses should be 
applied to the head. Hot and cold applications should be made to the 
spine. If these measures do not bring relief, chloroform may be used 
to subdue the spasms. This remedy is generally effective. When the 
contractions have ceased, energetic measures should be taken to prevent 
their occurrence, by exciting activity of the kidneys and skin. 

Puerperal Fever.— This disease is responsible for a large number 
of deaths following confinement, and a great multitude of chronic, dis¬ 
eased conditions, by which women who have suffered from it are crip¬ 
pled and maimed, many times for life. It is now pretty generally 
conceded that severe fever following confinement is generally the re¬ 
sult of absorption into the system of some of the products of the de¬ 
composition taking place in the generative passages. Having gained 
access to the blood, the diseased germs multiply in great numbers and 
soon pervade the whole system. In addition to the general fever, in¬ 
flammations of the womb or its surrounding tissues and the ovary and 
other organs are very likely to occur, leaving adhesions, consolida¬ 
tions, abscesses, indurations, etc. 

Treatment .—The best treatment of this disease is prevention. If 
the parts are thoroughly washed out two or three times a day with a 
disinfectant lotion, by means of a syphon syringe, the thorough cleans¬ 
ing being kept up continuously until the lochial discharge has entirely 
ceased, there is little chance for the germs of disease to find an entrance 
into the system, and puerperal fever w r ill not be likely to occur. A 
physician attending one case of the disease will be very likely to con¬ 
vey it to other patients whom he may visit. The fever should be 
treated on the general principles laid down for the treatment of fever 
elsewhere. 


1366 


FEEDING AND CARE OF INFANTS. 


FEEDING AND CARE OF INFANTS. 


The fact that fully one-third of the human family perish before the 
age of live years is sufficient apology for devoting a brief section to the 
consideration of this subject. Notwithstanding the immense number of 
physicians, nurses, and mothers, who have had much experience in the 
rearing of children, the amount of accurate information on the subject 
of infant care and feeding possessed by the general public is very meager. 
We shall endeavor to summarize as precisely as possible the most relia¬ 
ble information to be gathered from experience and research on this sub¬ 
ject. 

INFANT DIET, 

Carefully collected statistics show beyond room for reasonable doubt 
that the most active cause of infantile disease is improper feeding. This 
cause is particularly active during the warm season of the year, which 
occasions the immense number of deaths from various digestive disor¬ 
ders at this period. The careful observance of the following sugges¬ 
tions will rarely fail to secure immunity from disorders of the digestive 
organs :— 

1. Milk is the natural and proper food for children from infancy to 
the age of twelve or eighteen months. Starchy foods cannot be di¬ 
gested, owing to the fact that the digestive element of the salivary 
secretion is not formed in sufficient quantity during the first few months 
of life to render the child able to digest farinaceous foods, such as pota¬ 
toes, rice, fine-flour bread, and the like. 

2. As a general rule, an infant should be fed once in two or three 
hours during the daytime and once at night until one month old 
After this time it should not be fed at night, and it should take its food 
no more frequently than once in three hours during the daytime until 
four months of age. Between four and eight months, the intervals 
should be gradually prolonged to four hours. After this time the fourth 
meal should be gradually dropped off, so that at twelve months the child 
will take its food but three times a day. 

3. If the child is deprived of its natural food, a healthy wet-nurse 
should if possible be secured,—at least until the child is two or three 



INFANT DIET. 


13G7 


months old. When a suitable wet-nurse cannot be secured, milk from 
a healthy cow constitutes the best food. Care should be taken in the 
selection of cow’s milk, that being preferred which is obtained from a 
cow which has calved two or three months previously. The health and 
care of the cow, particularly the character of her food, are matters of 
importance which should receive attention, as there is no doubt but that 
consumption is frequently communicated to infants from cows whose 
lungs have become diseased through confinement in close stalls with 
foul odors, and deficient and improper food. Cow’s milk should be di¬ 
luted at first to - one-half, the proportion being gradually increased 
as the child’s stomach is strong enough to bear it. Pure water, 
lime-water, barley-water, and thin well-boiled and strained oatmeal 
gruel, may be used to dilute the milk. The object of the dilution is, 
first, to render it more nearly like mother’s milk in the proportion of 
nutriment which it contains, and second, to render it less liable to form 
hard curds in the stomach, which are very likely to occur when the milk 
is taken undiluted. 

4. Cow’s milk, or other fluid food, is best given to an infant with 
a proper nursing bottle. The best forms of nursing bottles are those 
which are furnished with rubber caps such 

as are shown in Figs. 350 and 351. The 
cap should be removed and well cleansed 
with warm water in which soda or saleratus 
has been dissolved in proportion of a tea¬ 
spoonful to a pint each time the bottle is 
used. Both the nursing bottle and the rub¬ 
ber nipple should be kept immersed in a 
weak solution of soda when not in use. 

They should also be cleansed the second time 
just before the child is fed. Neglect to ob¬ 
serve this precaution is one of the most common causes of stomach 
disturbances. 

5. The diet of the mother while nursing is of very great impor¬ 
tance, as anything that will disturb the system of the mother will af¬ 
fect that of the nursing infant more or less. Her food should be nour¬ 
ishing, simple, and wholesome. Stimulants of all kinds, whether in 
the form of alcoholic drinks or irritable condiments, should be care¬ 
fully avoided. Pastry, desserts, ice-cream and confectionery, and all 
similar articles, should be wholly avoided. Oatmeal porridge or milk 








1368 


FEEDING AND CARE OF INFANTS. 


and the various whole-grain preparations, eggs, and, with those accus¬ 
tomed to its use, a moderate allowance of meat, together with an 
abundance of ripe fruits, constitute the best diet. With reference to 
increasing and diminishing the supply of milk by regulation of the 
diet, see paragraph on this subject elsewhere. Vegetables, such as 
cabbage, turnips, and carrots, together with peas, beans, and onions, 
which are very likely to produce colic in the child should be care¬ 
fully avoided. 

6. Feeble, infants, especially those who are born prematurely, will 
need to be fed a little more frequently than others,-and will require 
extra care. 

7. The interior of a child’s mouth, as well as its lips, should be care¬ 
fully wiped free from milk or other food after feeding, a moist cloth 
being used for the purpose. 

CAUTIONS RESPECTING INFANT FEEDING. 

1. Too frequent feeding is a very common practice, and is one of 
the most active causes of colic and various other forms of indigestion 
in children. Many mothers wonder why the children do not grow 
fleshy notwithstanding they have a voracious appetite and eat nearly 
all the time, when the simple reason is that the food taken is not 
digested and assimilated on account of the weakened and disordered 
state of the digestive organs. Frequent feeding at night is not only 
unnecessary, but exceedingly harmful. After the first month or two, 
infants require no food at night. If they are properly educated upon 
the matter of diet from the start, they can be managed without any 
difficulty. 

In order to break children of the habit of eating in the night when 
the mothers have been in the habit of nursing them at all hours of 
the night as well as the daytime, a little warm water may be given in 
the nursing bottle instead of allowing food. This will often satisfy 
the child’s cravings so that it will go to sleep. 

2. Overfeeding is a much more frequent error than the opposite. 
Very frequently children are allowed to take too much at a time. 
This is the most common cause of vomiting in infants. Fortunately 
their stomachs are so constructed that the surplus of food may be 
easily expelled ; but sometimes this is not the case, and often very seri¬ 
ous disorders of digestion result. The child should be removed from 


CAUTIONS RESPECTING INFANT FEEDING. 


1369 


tlic breast when its hunger has been satisfied, and should not be urged 
to take more when it is evidently satisfied. 

3. The child should never be allowed to sleep at the breast, or with 
a nursing bottle to its mouth. 

4. The child should never be put to the breast to stop its crying. 
Children cry in consequence of disturbances of the stomach much 
more often than from hunger. The child will often nurse as though 
hungry when the stomach is already full of undigested food, being 
permitted to do so by the pain or discomfort which it suffers. Chil¬ 
dren often cry in consequence of the irritation of pins, but no matter 
whether any other cause for crying should be found or not, the child 
should not be nursed except at its regular hours. 

5. No other food but milk, except such fluids as are used to dilute 
■cow’s milk, should be used until after several teeth have made their 
appearance. As a general rule, bread and other farinaceous food cannot 
be digested before the age of seven or eight months. Meat should 
never be given to children until after they have acquired a sufficient 
number of teeth to masticate it thoroughly, and then should be allowed 
only in very small quantities once a day. Young children are very much 
better off without meat as a general rule. 

6. Children should never be given sugar-teats, candies, sweetmeats 
cheese, nor pastry. The habit many nurses have of feeding an infant 
sugar and water every hour or two, during the first one or two days of 
its life, is a practice which cannot be condemned too strongly. The 
same may be said to be the cause of colic and other disturbances. 
Catnip tea and similar other decoctions used at this time, are exceed¬ 
ingly harmful, not only disturbing the stomach and giving the child 
discomfort, but preventing the natural desire for food and depriving 
the mother of the benefit to be derived from suckling the child. Plac¬ 
ing the child early to the breast is one of the best means of prevent¬ 
ing “ gathered breast ” and securing a plentiful supply of milk. The 
practice that many people have of taking young children to the table 
and feeding them bits of almost everything on the table cannot be too 
strongly discountenanced. It is one of the most prolific causes of di¬ 
gestive disturbances in children. 

8. As a general rule, menstruation and pregnancy, either of which 
may occur during nursing, are likely to affect the child injuriously, 
and it requires weaning. As a general rule, a woman should discontinue 


1370 


FEEDING AND CARE OF INFANTS. 


nursing upon the occurrence of conception or pregnancy. Three lives; 
may be affected injuriously by a neglect of this rule. 

9. Special care must be taken in the warm season of the year of 
children that have been weaned or that have been raised on the bottle, 
to avoid feeding sour milk or milk that has become slightly changed 
by standing. In very hot weather, milk sometimes begins to sour in 
a very short time. This is especially the case when milk pans or cans 
have not been cleansed as thoroughly as they should be. If either 
the mother or nurse in charge of an infant would obtain a “ test pa¬ 
per,” which can be found at any drug store, and always test the child’s 
milk when there is any possiblity of its being sour, many cases of ill¬ 
ness and death would be avoided. The process of testing is a very 
simple one, it only being necessary to observe that when the milk is 
acid the blue paper will be turned red, and when it is sweet, no change 
will occur. 

10. Another danger to which children are exposed is the use of 
milk which has been poisoned by standing in pans made of tin adul¬ 
terated with lead. This danger is now becoming quite a serious one. 
Infants are more susceptible to injury than adults on account of their 
weakness and little vitality. 

11. Many mothers have sacrificed their children by attempting to 
rear them upon the various patented baby foods sold in the stores. A 
majority of these foods are starchy preparations, which contain little 
or no nourishment valuable for infants. Some of them, particularly 
the various preparations made according to the directions of the emi¬ 
nent German chemist. Prof. Liebig, are useful, but not more so than 
well boiled oatmeal or graham gruel with the addition of cow’s milk. 
Directions for feeding infants whose digestive organs are very badly 
disordered, are considered in connection with the diseases in the treat¬ 
ment of which they are specially necessary. 

12. Sexual excesses have a very damaging influence upon the nurs¬ 
ing infant. 

13. A nursing mother should never give way to fits of anger or de¬ 
pressing emotions of any sort, but endeavor to improve and sustain her 
general health in every possible way by proper diet, daily exercise in 
the open air, abundance of sleep, avoidance of overwork, etc. 

Weaning. —Under this head it is important to call attention to 
the following points:— 


GENERAL CARE OF INFANTS. 


1371 


1. The proper time for weaning a healthy infant is at about one 
year of age. Very weakly children sometimes require longer nursing. 
The custom practiced by some women of prolonging the nursing pe¬ 
riod to two years or more is injurious to both mother and child. 

2. The process of weaning should be conducted gradually. At the 
age of eight or ten months the child may be fed bread and milk, or 
oatmeal porridge once a day, this article being substituted for 
mother’s milk. As it grows older, the preparation of these articles 
of food may be increased, and some other articles, as perfectly ripe 
fruit, with now and then a portion of a baked potato, simple soups, 
etc., may be given. Graham bread should be invariably used in pref¬ 
erence to fine flour bread. If necessary, the coarsest of the bran may 
be sifted out. By the adoption of this plan, at the end of twelve 
months nursing may be discontinued altogether without the child suf¬ 
fering any serious consequences. 

From this time, the diet of the child should still consist chiefly of 
graham bread and milk, baked potatoes, ripe fruit, and equally simple 
articles of food. Meat, coarse vegetables, butter, tea and coflee, mus¬ 
tard, pepper and other condiments, pastry, preserves and sweets of all 
kinds, rich puddings and sauces, dessert, and all articles difficult of di¬ 
gestion, should never be given to young children; indeed, the world 
would be vastly better off if these articles were rarely if ever taken 
either by older children or adults. When the child is costive, oatmeal 
porridge as a principal article of diet is an excellent means of regulat¬ 
ing the bowels. In making oatmeal porridge the milk should not be 
boiled, but should be added after the porridge is done. 

3. As a general rule, children should not be weaned in hot weather, 
as slight changes in diet are often sufficient to produce serious disturb¬ 
ances at this season of the year. 

GEIERAL CARE OF I\ FIATS. 

The Bowels and Bladder. —The first movement of the bowels 
of a newly boim child is of a green color. After this, the 
discharges should be uniformly of a bright yellow color. If 
the bowels have a slight tendency to constipation, they should be 
thoroughly kneaded several times a day, especially while the child is 
taking its morning bath. The cold compress worn about the bowels 
is also an advantageous measure. Giving the child one or two tea- 


1372 


FEEDING AND CARE OF INFANTS. 


spoonsful of cold water half an hour before nursing is also a useful 
measure. Care should be taken that the bowels and bladder move 
properly; and if there is any interruption of the functions of these 
organs, proper measures for relief should be resorted to at once. 

Clothing. —The legs, arms, and neck, as well as the trunk, should 
be thoroughly clad with a soft flannel gown, in addition to which a wool¬ 
en bandage should be placed about the trunk. Care should be taken in 
placing the binder not to draw it too tight, as this is one of the most com¬ 
mon causes of prolapsus of the rectum, a not infrequent condition in 
young children. The child should not be clothed too warmly, as debili¬ 
tating perspirations may be induced. The temperature of the room 
should be kept at about 68° or 70°, and a proper degree of moisture 
should be supplied by keeping a vessel of water upon the stove, or 
keeping the water-pan of the furnace supplied with water. Too much 
clothing should not be worn upon the head nor about the neck, as these 
parts are thereby rendered unnaturally sensitive and more liable to cold. 

Bathing. —The daily bath is of great advantage to children, and 
soon comes to be much enjoyed by them. As a general rule, there is 
no danger that the child will be weakened in the slightest degree by 
taking a tepid bath every morning before its breakfast. The temper¬ 
ature of the water employed should first be about that of the body, 
but it should be gradually lowered, so that after a few weeks it will 
not be over 80° to 90°. Many physicians recommend a still lower 
temperature. It may be said that the cooler the water employed the 
more thorough is the protection against taking cold. No fears what¬ 
ever need be entertained that the child will contract a cold by taking 
a cool bath. The whole surface of the body should be thoroughly 
rubbed. It is also well to anoint the skin as often as every other day with 
some fine unguent, as olive or cocoanut oil, or vaseline. Fine castile 
soap should be used in the bath every day or two. 

Sleeping .—A healthy child, during the first few weeks of its life, 
sleeps nearly five-sixths of the time. The infant should be taught to go 
quietly to sleep while lying in its crib, without rocking, petting, or carry¬ 
ing in the arms. If the child is taught correct habits at the start, it 
will give much less trouble than if humored and petted until it makes 
unnecessary demands. The face of a child should never be covered dur¬ 
ing sleep, as it needs an abundance of fresh air as well as older persons. 
As a general rule, it is better that the infant should not sleep in the 


EXERCISE—TEETHING. 


1373 


same bed with an older person, even its mother. In cold weather, when 
it needs additional warmth, one or two large bottles tilled with warm 
water may be laid beside it. Its crib should be well padded upon the in¬ 
side, so as to protect it from receiving injury from the hard frame-work. 

Exercise. —Although it is unnecessary that infants should be con¬ 
stantly carried about, and is injurious to them as well, it is important 
that young children should be taken up several times a day and carried 
about for a few moments. This is especially true in the case of very 
feeble children. If allowed to lie too long upon the back, congestion of 
the lungs may be occasioned. After an infant is a month old, it may be 
safely taken out in pleasant weather at any season of the year, provided 
it is properly protected. In cold weather it is better that the child should 
be carried in the arms instead of being drawn in a cart, as there will be 
less liability of its getting chilled. It should also be exposed to the sun 
daily, or as often as possible. Care should be taken to protect the infant’s 
eyes from the glare of sunlight. 

Nurses should use caution in carrying infants not to hold them al¬ 
ways upon the same arm. The neglect of this rule sometimes results 
in deformity. Children should not be urged to walk too early, or before 
the limbs are sufficiently strong to support the body well. Bandy-legs, 
knock-knees, and other deformities are the result of inducing children to 
learn to walk too early. As a general rule, the child should not be urged 
to walk until it shows a manifest disposition to do so. 

Teething. —During this troublesome period children require special 
care, as the digestive organs are more liable to become disordered than at 
any other time. The child is often fretful and restless; and if it es¬ 
capes being treated for worms half a dozen times, although innocent 
of harboring any such vermin, it is unusually fortunate. Teething is 
generally held responsible for every disease which occurs during the 
period of the eruption of the teeth. It is probable, however, that the 
process of teething is really responsible but for a small part of what is 
charged to it. Lancing the gums is seldom called for. The tissue cov¬ 
ering the teeth is not sufficiently tense to require cutting to allow them 
to protrude. In fact they do not tear their way out, but the tissue cov¬ 
ering is gradually absorbed. About the only occasion for lancing the 
gums is the occurrence of infantile convulsions. Rubbing the teeth with 
very hard substances is also a questionable measure. All the rubbing 
required will generally be performed by the child itself with the finger 
or thumb. 


1374 


DISEASES OF CHILDREN. 


DISEASES OF CHILDREN. 


A large share of the diseases to which infants and young children 
are subject, arise from the ignorance of mothers and nurses respecting 
the hygiene of infancy, or how to feed, clothe, and care for human be¬ 
ings during the first years of their existence. If adults suffer for want 
of attention to the laws of health, infants suffer still more, not generally, 
however, so much through intent to neglect, as through ignorance of the 
requirements of the human system during the first years of life. Un¬ 
doubtedly, a large share of the most serious constitutional diseases from 
which adults suffer have their foundation laid in infancy by various 
injurious practices, to which attention is more particularly called else¬ 
where in this volume. 

The treatment of the diseases of infants has, until recently, been in a 
very unsatisfactory condition. Fortunately for these little ones, recent 
investigations, which have been conducted independently in all the prin¬ 
cipal civilized countries of the globe, have resulted in the development 
■of many new features and principles, by the aid of which they may now 
receive as fair a chance for recovery from illness as their older relatives. 

The treatment of the diseases of infancy is attended by difficul¬ 
ties much more serious in many respects than those met with in the 
treatment of adults. One of the first of these is the difficulty of ob¬ 
taining a full account of the patient’s symptoms. The little one is not 
able to tell how it feels, and the information must be almost wholly 
gathered from observation. Only the quick eye of the well-informed 
and anxious mother and nurse, or the intelligent physician,’is able to de¬ 
tect the evidences of disease manifested in early life. Many of the 
most serious conditions are indicated by*,slight symptoms which might 
escape detection if not well understood. 

The following facts respecting the deviations from the condition of 
health as seen in children, will be of great value in enabling the 
mother or nurse to detect the early evidences of disease, and so apply 
the necessary and appropriate treatment. 

General Appearance. —A peculiar or unnatural attitude, flush or 
pallor of the face, white or livid color of the lips, unusual dryness of 



P ULSE. —EXPRESSION. —GEST URES. 


1375 


the skin or excessive or irregular perspiration,—as of the head and 
forehead only,—a disturbed or painful expression, moaning, starting, 
muscular twitching, grinding of the teeth, strong working of the nos¬ 
trils, staring, etc., are all symptoms which should arouse suspicion of 
disease. 

Pulse. —In children under two years of age, the pulse ranges from 
ninety to one hundred and thirty beats per minute. After two years, 
it is rarely more than a hundred, though it may be as low as seventy. 
Any great deviation from these limits indicates disease. A pulse as 
low as forty or fifty in a young child is a grave symptom; for in¬ 
stance, if a child seems feverish and sick, and has a pulse of one hun¬ 
dred and twenty, it is very likely due to some indiscretion in diet. If 
the same symptoms are present with a pulse of forty or fifty, it is very 
probable that the child is suffering tubercular meningitis, a very fatal 
malady. 

Respiration. —The number of respirations in a child vary from 
thirty to fifty per minute. About forty is the usual average under 
two years. The respiration in children over two years of age should 
be about eighteen during sleep, and from twenty to twenty-five while 
awake. In children under one year of age, respiration is generally 
forty to fifty a minute. 

Expression of Countenance. —The upper portion of the face is 
affected chiefly in brain disease, which is indicated by a knitting of 
the brow, contracted forehead, and rolling, fixed, or staring eyes. In 
heart and lung affections, the middle portions of the face are affected, 
the symptoms being sharp, distended and working nostrils, a bluish 
circle around the mouth and dark rings under the eyes. The lower 
portion of the face exhibits symptoms relating to the bowels. The 
cheeks are changed in color, being either pale or flushed. They may 
be sunken or puckered, the mouth being drawn to one side. The lips 
are livid or pale, often giving the expression which the famous Sir W. 
Jenner describes as “a Yoltaire-like look.” Unnatural contraction or 
dilatation of the pupils is significant of nervous disorders. 

Gestures. —The motions of a child are often very significant. In 
brain disease the child puts its hand to its head, pulls at its ear, rolls 
its head on the pillow, and beats the air. 

In abdominal diseases, the legs are drawn up, the countenance is 
anxious, cheeks sunken, and the child picks at the bedclothes. When 


1376 


DISEASES OF CHILDREN. 


distressed for breath from diseases of the respiratory organs, the child 
tears its throat, or puts its hand in its mouth. 

The Cry. —In pneumonia, or capillary bronchitis, the child’s cry is 
labored and half suffocated, sounding as though coming from an adja¬ 
cent room. In croup, it is hoarse, with crowing respiration. In dis¬ 
ease of the brain, especially water on the prain, or hydrocephalus, it is 
sharp, shrill, and solitary, while in marasmus, or wasting disease of the 
bowels, it is moaning and wailing. Long continued crying, from which 
the child cannot be diverted, is due to either earache or hunger. A pee¬ 
vish cry, attended by a slight, dry cough, is indicative of inflammation 
of the lungs. A very loud, shrill cry produced by coughing or sud¬ 
denly moving the child, is usually due to pleurisy. 

A cry accompanied by writhing and wriggling when the bowels 
move, is due to intestinal disease. Moaning is particularly character¬ 
istic of disease of the stomach and bowels. 

As a general rule, children shed no tears before they are three or 
four months old. Some authors consider that in children under seven 
years of age the shedding of tears is a favorable symptom, while the 
absence of tears is very unfavorable. 

Posture. —When the child cannot breathe lying down, and shows a 
great desire to sit up, or to be held in an upright position, disease of the 
respiratory organs is indicated. If the child lies on the side, with the 
legs strongly drawn up, with the arms close to or on the chest, some 
serious brain affection is indicated. 

The Eye. —Squinting occurring suddenly in acute disease, is a se¬ 
rious symptom, indicating irritation of the nervous system. It may 
occur in connection with convulsions, and is likely to remain after the 
child has recovered from the fit. When a child suffering from tu- 
bercular meningitis becomes cross-eyed, it will probably die. A very 
small pupil indicates congestion of the brain. Large pupils which do 
not respond to light, indicate some disease of the nervous system. 
Inequality of pupils, that is, one contracted and the other dilated, 
when occurring in connection with acute disease, is a very serious 
symptom. Inequality of pupils is sometimes produced by the irrita¬ 
tion of worms in the intestines. 

The Tongue. —A furred tongue covered with small particles of 
whitish curd, indicates dyspepsia and intestinal irritation. A white 
fur usually indicates fever, and yellow fur, chronic derangement of 


DEVELOPMENT. 


1377 


the stomach and liver. Brown fur is present in typhoid fever,.or the 
typhoid condition. A red and dry tongue indicates inflammation of the 
mouth, stomach, and bowels. A strawberry tongue, when accompanied 
by fever and an eruption, indicates scarlatina. A glassy tongue is an 
indication of dyspepsia. The tongue of a young infant can be seen 
when it is crying, or, if it can not, it can be made to protrude the 
tongue by placing the finger on the lip. 

Development. —The child should grow from six to seven inches 
the first year. From the fourth to the sixteenth year, about two 
inches should be annually added to the height. From the sixteenth to 
the seventeenth year, the average growth is one and a half inches. In 
the next three years, the usual addition to the height is about one inch 
each year. Retarded growth is indicative of disease of the bones, rick¬ 
ets, or scrofula. Most of the diseases of youth and childhood accelerate 
the growth, which gives rise to the idea that too rapid growing pro¬ 
duces disease, which is exactly the opposite of the truth; the disease 
being the cause of too rapid growth. 

The child should be able to run alone at the end of twelve months. 
When it begins to walk, attention should be given to the manner in 
which it uses its limbs. If it walks simply on the toe of one foot with 
a limping gait, and complains of pain in the knee whenever the limb 
is handled, it may be suspected that hip disease is beginning. The 
child does not usually raise its head till it is six or eight weeks old, and 
cannot sit upright until four or five months of age. 

Careful attention should be given to the teeth. The first incisors, 
or front teeth, should appear by the seventh month; the first back teeth 
by the twelfth month; the eye teeth and stomach teeth at the end of 
a year and a half, and the second back teeth, or molars, at twenty 
months. 

Attention should also be given to the gums, to ascertain whether 
they are hot, swollen or tense, indicating the approaching eruption of 
the teeth. 

The Bowels. —The bowel passages of the infant should be yellow 
in color, and at least three or four a day. The appearance of curds in 
the bowels indicates imperfect digestion, and if the difficulty is not cor¬ 
rected, will result in intestinal catarrh or inflammation. 

General Symptoms.— The whole surface of the body should be 
carefully examined. In health, the skin should be mottled, flesh firm, 

87 


1378 


DISEASES OF CHILDREN. 


skin smooth and elastic, and not flabby. Any eruptions should be no¬ 
ticed; the anus, especially, should be carefully examined for soreness 
or eruptions. The arms and limbs should move freely. It should be 
remembered that chills seldom occur in young children; convulsions 
and delirium correspond to chills and headache in adults. Sleepless¬ 
ness or disturbed sleep is a symptom which indicates some quite serious 
disturbance, as infants naturally sleep very soundly, and when healthy, 
spend eighteen to twenty hours out of the twenty-four in sleep. A 
restless, sleepless child will be badly nourished, and dwarfed in develop¬ 
ment. 

The fontanel is the proper name for the so-called soft spot which 
is found upon the head of all young children. There are, in fact, two; 
one in the fore part of the head, and the other in the back part. The 
larger one, which is here referred to, is situated at the upper part of 
the forehead. It is familiar to all mothers. By observing the condi¬ 
tion of this spot, much can be learned of the condition of the brain. As 
the bones have not yet joined over the small space, the soft tissues fill¬ 
ing it rise and fall with the increase or decrease of blood in the brain. 
When the fontanel is very full, the brain is full of blood, and con¬ 
gested. When it is unnaturally depressed, it is in consequence of too 
little blood in the brain. The first condition exists in congestion of the 
brain, inflammation, or water on the brain. The second is found when 
the child is suffering from the effects of wasting disease. The fonta¬ 
nel constitutes an excellent means of distinguishing between true and 
false dropsy of the brain, being depressed in the latter disease, in con¬ 
sequence of the deficient blood supply to the brain, instead of being 
full and prominent as in true dropsy of the brain. 

The temperature of the body is a very important symptom as a 
means of determining the amount of fever present. It can only be 
ascertained by means of a thermometer, with which every family ought 
to be supplied. The natural temperature is 98J°. In children, the 
temperature may fall slightly in the evening just before going to 
sleep, but a rise of temperature to 100° or upward indicates fever. 
The sudden rise of temperature to 104° or 105° indicates the onset 
of some severe fever, like scarlet fever, or pneumonia. 

COjSVIJLSIOSS. 

SYMPTOMS.—Spasmodic twitching of the muscles; unconsciousness; other symp¬ 
toms too familiar to require description. 


CONVULSIONS. 


1379 


This is a very common disease in infancy. It is very likely to oc¬ 
cur during teething, either when cutting the first or the second teeth. 
As a general rule, it is due to indigestion, especially to accumulation 
of gas in the bowels. It may often be caused by taking cold. When 
it occurs periodically, several days in succession, being followed by 
fever, it is due to ague, during which the convulsion takes the place of 
the chill. The convulsion in infants represents the chill in older peo¬ 
ple. Convulsions are very frequent in measles, scarlet fever, whoop¬ 
ing-cough, and other diseases of childhood. When one convulsion 
follows another in rapid succession, some serious nervous disease is 
indicated, as dropsy of the brain. Convulsions occurring during the 
course of disease are more serious than if they occur at the beginning. 
They are most likely to occur in children having what is termed a 
nervous temperament. They are also frequent in rickety children. 
They are likely to occur in prostrating diseases, and are sometimes pro¬ 
duced by an inactive state of the liver. 

In what is termed “ inward fits,” the child lies as if asleep, only mov¬ 
ing the eyelids, the muscles of the face twitching, and the countenance 
wearing what is termed “ a sardonic smile.” Inward fits are generally 
produced by flatulence, or gas in the bowels. When the hands and 
feet twitch, and the child lies with its eyes half closed, waking with a 
sudden start and the face flushed, it is threatened with general convul¬ 
sions. A convulsion may last for a minute or two, or for one or two 
hours, at the end of which the child often falls asleep, lies in a stupor, 
or cries loudly, or slowly returns to consciousness. Sometimes the 
stupor becomes more intense, and death occurs. This is very rare, ex¬ 
cept in the convulsions which occur in whooping-cough and meningitis. 

Treatment. —Plunge the child as quickly as possible into a hot bath, 
pouring cool water upon the head and chest. When the convulsion is 
the result of indigestion, the child should be made to vomit, if possible, 
by drinking cold water or half a glass of cold water into which a tea¬ 
spoonful of mustard or powdered alum has been stirred. When con¬ 
stipation and flatulence are the cause, give an enema of soap-suds. 
When the fontanel is prominent or bulging, the cold applications to 
the head should be very vigorous; ice may be used. When there is 
considerable fever, cool sponging of the person should be employed, to¬ 
gether with cold injections into the bowels. When the fontanel is 
depressed, showing lack of blood in the brain, the convulsions may 


1380 


DISEASES OF CHILD BEN. 


sometimes be relieved by inverting the child, that is, turning its head 
downward. This is often recommended indiscriminately for convul¬ 
sions, which is a grave error, as it might produce a fatal result in con¬ 
vulsions produced by congestion. “ Inward fits ” are relieved by fo¬ 
mentations to the bowels, or giving the child a few teaspoonfuls of 
water containing a drop or two of peppermint essence. 

IMF1NTILE TBISMrS-“ MIME-DAY FITS.” 

The symptoms of this affection are similar to those of tetanus in 
adults. The mother notices that the child cries when it is placed to 
the breast, and is unable to nurse. The jaws are found to be fixed 
partly open. The infant is seized at intervals with violent convul¬ 
sions, foaming at the mouth, thumbs drawn into the palm of the 
hand, jaws locked, face livid. The disease is generally fatal in from 
one to three days; death sometimes occurs within a few hours. 

Causes. —A careful investigation of the cases of this disease in all 
parts of the civilized world have shown that the principal causes are 
impure air, filthiness, improper diet, the use of alcoholic liquors by the 
mother, and improper dressing of the cord. Just one hundred years 
ago, according to Ellis, from whose excellent work we have drawn 
largely in our account of the symptoms of disease in infants, one-sixth 
of all the children born in the Dublin lying-in hospital died within 
two weeks of birth, nineteen out of twenty dying of this disease. 
When the ventilation and hygienic management of lyingin cases were 
improved, only thirty-seven cases occurred out of nearly seventeen 
thousand births. Probably the direct cause of the disease is an irri¬ 
tation of the navel. 

Treatment. —Continuous application of ice to the spine is un¬ 
doubtedly the best remedy in this disease, but with the very best 
treatment many cases will be fatal. 

TETAME. 

SYMPTOMS.—Thumbs drawn into the palms with fingers flexed over them; hands 
bent at wrist; toes contracted; feet extended; arms and legs rigid; muscles of the 
jaws and back not affected; often spasm of the glottis, causing croupy symptoms; at¬ 
tacks intermittent, attended by severe pain ; spine not affected. 

This disease in some respects resembles tetanus, but it is by no 
means so grave an affection. It is unattended by fever, and the con¬ 
tractions are not continuous, which distinguishes it from inflammation 


NIGHTMARE. 


1381 


of the brain. The principal cause of this disease is irritability of the 
nerve centers, induced by a nervous organization, and the irritation of 
indigestion. It is most apt to occur in the first three years of life. 

Treatment. —The disease is rarely fatal, is almost always relieved 
by a long-continued warm bath. A hot blanket pack may be used 
instead of a warm bath, with advantage. 

KIGnT TERRORS—NIGHTMARE. 

SYMPTOMS.—Child wakes suddenly, screams, does not recognize its mother; sees 
very small animals, and is much agitated; sometimes has pleasing hallucinations ; an 
abundance of pale colored urine is generally passed during the attack. 

This is a somewhat alarming, but by no means a serious, affection, 
although it may be a precursor of grave disease. It does not indicate 
the presence of disease of the brain. It is almost always due to disor¬ 
der of digestion, resulting from late suppers, overeating, eating sweet¬ 
meats, candies, etc., the use of too much meat and of tea and coffee. 

Much of the nervousness of children is due to the use of meat. In 
the majority of cases, children would be much better off if they had 
none at all before ten or twelve years of age, and we have seen very 
vigorous and healthy children of twelve and fourteen who have never 
tasted a particle. Nightmare is a mild form of this affection. 

Treatment. —All the exciting causes just mentioned should be 
avoided. The child should have regular meals, not oftener than three 
times a day after two or three years of age; and should never take 
food within two or three hours of retiring. Food should be simple 
and unstimulating. All measures should also be adopted for improve¬ 
ment of the general health, as daily exercise in the open air, exposure 
to the sun, etc. Children who are old enough should be encouraged to 
take sufficient exercise to become somewhat fatigued, as sound, re¬ 
freshing sleep will be secured by so doing. For immediate relief, 
give a hot bath, with cold to the head, an enema of soap-suds or warm 
water, an emetic when the stomach is loaded with undigested food, 
and fomentations to the bowels when distended by gas. A teaspoon¬ 
ful of powdered alum or mustard in half a glass of water will produce 
prompt emetic effects, if the child can be made to take it. If the 
child is suffering with night terrors, he should not be allowed to sleep 
alone, and should be allowed to have a light at night if he desires. 
He should never be scolded or punished, but should receive sympathy 
and encouragement. 


1382 


DISEASES OF CHILDREN. 


Nightmare occurs very often in grown people as well as in chil¬ 
dren. The causes and general indications for treatment are essentially 
the same as stated above. 

ACUTE HYDROCEPHALUS—TUBERCULAR MEMIGITIS. 

SYMPTOMS. —FIRST STAGE: Irritability of disposition ; headache, shown by the 
child often putting hand to head; drowsiness; after the child is old enough to walk, 
dragging of one leg; little or no appetite; vomiting; constipation; fever; disturbed 
sleep; bowel discharges pale and offensive; tongue moist, red at tip and edges, furred 
in center; pulse quick and irregular; eyes sensitive to light; child sleeps with eyes 
partly open, grinds its teeth, often wakes in alarm; slight cough; pinched, haggard 
expression ; sighing; yawning. 

SECOND STAGE: Increased irritability; child wants to be let alone; delirium at 
night; pulse unnaturally slow; stupor; countenance frowning; head hot and fontanel 
pulsating ; increased stupor; convulsions, which may leave paralysis; pupils large and 
motionless; eyes staring and sunken; pulse small and rapid; clammy sweats; labored 
breathing ; purging; just before death, cessation of pain, purging, and difficult breathing, 
with apparent improvement. 

This is a very insidious and deceptive disease. It begins very stealth¬ 
ily, and the second or third stage is frequently reached before the real 
nature of the affection is discovered. It is a very fatal malady. It gen¬ 
erally occurs under five years of age. A symptom ©f some importance 
not mentioned above is the appearance of a reddish line remaining when 
the finger is drawn over the skin. This symptom is not a positive one, 
but should excite strong suspicion of the disease. In some cases, the 
patient dies very suddenly from a rapid accumulation of water in the 
brain, known as water-stroke. For these cases, there is no help. The 
symptoms differ more or less in all cases, ordinary cases continuing for 
from ten to twenty days. 

Causes. —The principal causes are depression of the vital powers, 
improper diet, especially encouraging precocity. Children early inclined 
to remarkable manifestations of intelligence and mental power, are more 
subject to this disease than others. There is a strong suspicion that the 
use of meat by children is a cause of this disease, it being a well known 
fact that the tubercles which are found in the membranes of the brain 
after death are highly nitrogenous in character. 

Treatment. —The treatment should be, first, preventive, by avoid¬ 
ance of all known causes of disease in children whose temperament 
makes them subject to it. The disease is curable only in its first stage. 
The essential measure of treatment is the application of cold to the 


WATER ON THE BRAIN. 


1383 


head and warmth to the extremities. Compresses wrung out of ice- 
cold water, frozen compresses, ice hags, and bags filled with iced water, 
are the best means of applying cold in these cases. The hair should be 
cut short so that the brain may be more thoroughly cooled. The 
patient should be kept in a dark and quiet room. The diet should be 
very plain, and no stimulants should be given. When one case of this 
kind has occurred in a family, especial pains should be taken to ward 
off the disease in the other children by proper precautionary measures. 

CHROMIC HlDBOCEPnALUS-WATER THE BRAIN. 

SYMPTOMS.—Gheat enlargement of the cranium, face and lower part of the head 
remaining of natural size ; cry harsh ; rolling of eyes; squinting ; legs doubled on the 
body and feet crossed, feet and hands cold. 

This affection iqay exist before birth to a greater or less degree, or 
it may come on afterward, often appearing ten or twelve months after 
birth. The head continues to enlarge until in some cases it becomes 



Fig. 352. 



Fig-. 353. 


Fig. 354* 


Side, Vertex, and Front View of Head of Hydrocephalus Child. 


enormous in size, giving the child a very unnatural appearance. Figs. 
352 to 354. The child suffers with frequent convulsions and increas¬ 
ing paralysis. Death generally occurs within a year or two, but the 
patient may linger for many years. 

Causes. —The causes of chronic hydrocephalus operate chiefly 
through the mother. They are those agents which affect the nutrition 
of the mother. 





1384 


DISEASES OF CHILDREN. 


Treatment. —Patients occasionally recover from this disease, but in 
the majority of cases no treatment is successful. Tapping the head 
has succeeded better than any other method of treatment, but it is, 
nevertheless, rarely successful. Bandaging the head by means of elas¬ 
tic bandages or straps of adhesive plaster has been practiced, but with¬ 
out any very encouraging results. 

FALSE DROPSY OF THE BRIO. 

SYMPTOMS.—Child restless, peevish, feverish ; sighing, moaning, screaming during 
sleep; a sharp cry upon being touched; bowels loose, discharges green and offensive; 
husky cough; eyes wandering; stupor; pulse and respiration feeble. 

The principal cause and characteristic of this disease is debility from 
Avant of proper food or any other debilitating cause. There is no in¬ 
flammation, although the symptoms closely resemble those of tubercular 
meningitis. A very common cause of the disease is leeching and 
blistering the head for inflammation of the brain, by which the oppo¬ 
site condition is produced. It frequently occurs in exhausting diseases, 
ns cholera infantum, typhoid fever, long-continued indigestion, etc. 

Treatment. —The opposite treatment is required in this disease 
from that necessary in inflammation of the brain. Cold, and other de¬ 
pressing agents, should be carefully avoided. 

It is very important that the mistake should not be made of treating 
this disease for inflammation of the brain, as very opposite remedies 
are required. The best means of distinguishing betAveen this disease 
and acute dropsy of the brain is the depression of the fontanel present 
in false dropsy, while the fontanel is bulging in the graver affection. 
Warmth should be applied to the body, and occasionally to the head. 
Hot baths to the extremities, however, are not indicated, as they would 
diminish the amount of blood in the brain, which is already too lit¬ 
tle. Rubbing the back of the neck with a sponge dipped in ice water, 
or a piece of ice inclosed in thin muslin, may be employed three or four 
times a day with advantage. The patient should be kept in a horizon¬ 
tal position, preferably with the head loAver than the feet. One of the 
most important measures of treatment is proper diet. The child 
should be fed with beef tea, well boiled oatmeal gruel, egg beaten with 
milk, chicken broth, etc. In case the digestion is very feeble, and the 
debility great, the white of an egg dissolved in a glass of water may 
be used to advantage. In some cases, some improvement seems to take 


INFANTILE PARALYSIS. 


1385 


place from the addition of a few drops of brandy to the egg and water. 
Food should be given in small quantities and at short intervals. As 
the strength is increased, the quantity of food and length of the intervals 
should be increased. In many cases, nutritive enemas may be em¬ 
ployed with advantage. The offensive character of the discharges can 
generally be made to disappear by the addition of a little lime-water 
to the food. A teaspoonful of lime-water with a couple of teaspoonsful 
of milk may be given with advantage each time the child eats. 

I* Alt JULY SIS OF TIIE SOFT PALATE. 

SYMPTOMS.—Nasal tone of voice ; liquids enter the nose on attempting to swallow. 

This affection occurs most frequently after severe cases of diphtheria, 
coming on generally as the patient is recovering from the disease. 
Other muscles in various parts of the body are also likely to be affected 
at the same time. 

Treatment. —When this difficulty is the result of diphtheria, recov¬ 
ery usually takes place within a few weeks without treatment of any 
sort. Recovery is greatly facilitated, however, by the local application 
of faradic electricity. Applications may be made externally with 
sponges, and internally by means of electrodes adapted to the purpose. 
Ganrlino- hot and cold water alternately is also of some advantage. 


OFAATILE PARALYSIS. 

SYMPTOMS.—Sudden paralysis of the 'muscles of one or more limbs, or of a single 
group of muscles ; subsequent wasting of the affected muscles. 

This disease is a form of inflammation of a certain portion of the 
spinal cord; and it often occurs during teething, frequently also during 
an attack of measles, scarlatina, or other acute disease. Sometime 
only a single muscles is affected. The muscles of the leg are more likely 
to suffer than any other part of the body. After the paralysis occurs, 
rapid wasting of the muscle takes place. The limb does not entirely 
cease to grow, but its growth is greatly retarded. After a time, the 
affected muscles undergo fatty degeneration. 

Treatment.— When fatty degeneration has occurred, little or no 
improvement can be obtained. The satisfactory treatment of infantile 
paralysis depends upon early attention to the disease. During the first 
few weeks after paralysis first occurs, ice should be applied to the 


1386 


DISEASES OF CHILDREN. 


spine several hours each day, for the purpose of limiting the inflamma¬ 
tion as much as possible. The patient should also be kept quiet. 

After the inflammation is subdued, electricity should be applied to 
the affected muscles, together with massage. In severe cases, the fara- 
dic current will not cause contraction of the muscles and galvanism 
must be used first. Very strong currents are sometimes necessary. 
The current should be frequently interrupted by withdrawing and re¬ 
placing one of the electrodes, as contraction occurs only at the beginning 
and breaking off of the current. In curable cases, contraction may be 
produced by the faradic current, after galvanism has been employed 
for some time, and it should be used when this stage is reached. Cases 
in which contraction cannot be produced by either form of electricity 
are hopeless. Besides the use of electricity, the affected muscles should 
be vigorously rubbed and kneaded daily, and should be exercised, by the 
Swedish movements, while the patient is requested to make efforts to use 
them. Alternate hot and cold sponging, applied daily, is also a valua¬ 
ble measure of treatment. For incurable cases, apparatus of various 
sorts have been devised, by means of which elastic bands in some de¬ 
gree supply the place of the affected muscles. 

SPIXA-BIFID.4—CIEFT SP1AE. 

This is a singular congenital defect in development, in which the 
spinal canal is not completely closed. It generally occurs in the lower 
part of the spine. In consequence of the defect referred to, the soft 
part becomes stretched. A cystic tumor is formed, the cavity of 
which connects with the spinal canal, and is filled with the fluid 
which always exists in small quantity in the spinal cord and brain. 
Pressure upon the tumor will generally cause convulsions, by the 
pressure upon the brain. As the sac enlarges, it gradually becomes 
thinner, and in many cases ruptures. Generally, however, the patient 
dies of inflammation of the brain. 

The causes of this affection are not well understood, but are un¬ 
doubtedly ante-natal influences of some sort. This condition is an 
almost hopeless one; but a few cases of recovery have been reported. 

Treatment. —The most successful treatment has been the employ¬ 
ment of continuous pressure, made by means of bands or adhesive 
straps, and withdrawal of the fluid by means of aspiration. In a few 
cases, a cure has taken place after the injection of iodine and other sub¬ 
stances into the sac. 


RICKETS. 


1387 


CONSUMPTIVE CONSTITUTION. 

It is important to be able to detect the peculiarities which charac¬ 
terize a child with marked consumptive tendencies, so as to take such 
measures as may, possibly, ward off the disease. Sir William Jenner 
describes the appearance of a child with consumptive tendencies, as fol¬ 
lows : “ Thin skin, clear complexion, the surface veins distinct, eyes 
bright, pupils large, eyelashes long, hair silken, face oval, ends of the 
bones small, shafts thin, limbs straight.” Dr. J. considers freckles a 
symptom of value. Children subject to tuberculosis are precocious. 
They cut their teeth early, and learn to run alone and talk before 
others. The chest is generally long and round. In some cases it is 
long and pigeon-breasted, a condition resulting from repeated attacks of 
catarrh, and bronchitis. 

Treatment. —The most important means of combating and over¬ 
coming the consumptive tendency in a child, are proper diet and exer¬ 
cise. A child of consumptive parents should be submitted to the most 
careful regimen from the earliest infancy. If the mother is consump¬ 
tive, the child should be weaned, and a healthy wet-nurse employed. 
Great care should be taken to follow carefully all the directions given 
elsewhere for the care of infants in health. These children should not 
be given candy and sweetmeats of any kind, and should not be allowed to 
take tea or coffee. At the proper time, graham and oatmeal prepara¬ 
tions should be introduced into their dietary. But little meat should 
be employed. As a general rule, the less meat used by these patients 
the better, since tubercle is a nitrogenous product, closely resembling 
meat in its composition, and is very likely to be produced by an excess 
of nitrogenous elements in the food. 

RICKETS—RACHITIS. 

SYMPTOMS.—At first, profuse perspiration, especially of the head; feverishness at 
night, with disposition to kick off the clothes; tenderness of the whole surface of the 
body ; child dreads to be touched; excessive quantity of urine, with copious deposits; 
child has an old, careworn look; eyes unnaturally brilliant; soon head enlarges; long 
bones become curved and the joints enlarged, as seen in wrists and ankles; curvature of 
the spine ; teeth slow in coming ; abdomen large and tumid; head flattened on top; bad 
smelling bowel discharges; capricious appetite. 

In addition to the above long list of symptoms the child may suffer 
with a variety of others arising from bronchitis, acute or chronic pleu¬ 
risy, enlargement of the spine and liver, hydrocephalus, convulsions, 


1388 


DISEASES OF CHILDREN. 


diarrhea, and spasmodic croup. When no teeth appear before the ninth 
month, the child should be carefully examined, as there are grave 
grounds for suspicion of rickets. When improvement does not occur, 
all the symptoms given above increase until death takes place from ex¬ 
haustion. When improvement does occur, under proper treatment or 
changed conditions, the enlarged joints become smaller, but the curva¬ 
tures of the spine and limbs are not corrected. The muscles generally 
undergo changes which render them weak and feeble, so that the chil¬ 
dren are often unable to use them, although they may still retain con¬ 
siderable size. This difficulty can be but partly overcome in advanced 
cases. 

Causes. —The chief causes of rickets are improper food, bad air, 
and a general lank of proper care. The use of food which does not con¬ 
tain a sufficient supply of phosphates and other organic elements, on 
the part of the mother, is one of the predisposing causes. This may 
affect the child not only before birth, but after birth, through nursing. 
The affection is to be attributed to the use of superfine flour bread, 
more than to any other one cause. In order to prevent its occurrence, 
expectant mothers should make free use of oatmeal, graham, and 
other whole-grain preparations. The same principle applies to the diet 
of children after they have been weaned. Little, if any benefit can be 
expected from the use of phosphates as they are generally administered 
hr medicine. Ground malt, maltine, and Trommer’s Extract of Malt, are 
useful nutritive medicines, as they present the phosphates in a natural 
condition. Every possible measure should be employed to improve the 
general health of the patient, by means of daily sponge baths and fric¬ 
tion to the whole surface of the body, out-door exercise, sun baths, etc. 
Particular attention should be given to keeping the stomach and bow¬ 
els in good condition. Electricity is a valuable tonic agent, and may 
be used in all cases with good advantage. 

O G 

CEPHALHEMATOMA—BLOOD TIMOR OF TOE SCALP. 

Cephalhsematoma is a swelling on the head, generally caused by 
the rupture of a blood-vessel beneath the scalp from pressure during 
labor. As a general rule, absorption takes place without any partic¬ 
ular attention. There is generally left, after absorption, a bony ridge, 
marking the edges of the tumor, which will also disappear after a time. 


PAIN IN THE BOWELS.—VOMITING. 


1389 


PAIN O THE BOWELS. 

Pain in the bowels in young infants is indicated by moaning cries, 
pallor, peculiar drawing of the corners of the mouth, twitching of the 
face during sleep, sometimes supposed to be due to “ angel whispers ; ” 
the abdomen is usually bloated ; infant kicks and frequently passes 
wind. The principal cause is indigestion. If the feet are allowed to 
get cold, pain in the bowels will generally result. It is also occasioned 
by the irritation of worms. Infants often manifest great eagerness to 
nurse. 

Treatment. —Regulate the diet carefully, apply fomentations to 
the bowels, and warmth to the feet. A drop or two of peppermint 
essence in a few teaspoonfuls of water, will generally relieve the pain 
from gas in the bowels. 

VOMITING. 

Vomiting in infants is usually the result of overeating, or of eat¬ 
ing too fast. It is frequently occasioned by sickness which results 
from rocking in the cradle or tossing in the arms, both bad practices. 
Acidity of the stomach also frequently occasions vomiting. In these 
cases, the curds thrown up are sometimes very large, especially when 
cows’ milk is used without dilution. 

Severe coughing generally induces vomiting in children. Sudden 
vomiting, in which the food is expelled from the stomach with a good 
deal of force, is characteristic of hydrocephalus, or dropsy of the brain. 
Vomiting from overeating is really nothing more than regurgitation of 
food from the over-full stomach, which takes place very easily on ac¬ 
count of the shape and position of the stomach in infants, which differ 
from that in adults. Nurses generally consider easy vomiting a good 
symptom, and the opinion has good foundation in fact, since in chil¬ 
dren who do not vomit easily, overeating results in fermentation of the 
food, which is likely to be followed by catarrh of the stomach and 
bowels. 

Treatment. —Vomiting will usually be checked by regulating the 
quantity and quality of food. If it comes from sour stomach, a little 
lime-water should be used after each meal, one or two teaspoonfuls 
being taken in double the quantity of milk. When the child seems to 
suffer considerable distress, hot fomentations or a hot flannel should be 
applied over the stomach. 


1390 


DISEASES OF CHILDREN. 


IM AMIIJ' DYSPEPSIA. 

SYMPTOMS .— Vomiting; constipation; diarrhea; green or clay-colored stools, 
bowel discharges sour or fetid; appearance of curds in the bowel discharges; loss of 
flesh; irritability; moaning cry; capricious appetite; feverishness; symptoms of worms. 

Disorders of digestion constitute a very large share of the causes of 
illness in children. A careful study of the causes of death among chil¬ 
dren shows that derangement of digestion of various kinds, either di¬ 
rectly or indirectly, are the cause of by far the greater share of deaths 
occurring in the first years of life. Vomiting is the most common 
symptom of indigestion. When the matters vomited are very sour, the 
child is suffering with acidity of the stomach, which may be the result 
of overeating or of the use of sugar or starchy food. Green, offensive 
bowel discharges indicate decomposition of the contents of the intes¬ 
tines in consequence of imperfect digestion. The green discharges are 
generally preceded by discharges in which lumps of curd are seen, in¬ 
dicting that digestion- is imperfectly performed. After awhile, an irri¬ 
tation of the intestinal canal arises from the contact of hard, undigested 
curds which should have been digested in the stomach, and the dis¬ 
charges become more offensive in character, and are likely to con¬ 
tain considerable mucus from catarrh of the bowels. Clay-colored 
stools indicate an inactive condition of the liver, or an obstruction of 
the bile ducts, probably in consequence of the extension of the intestinal 
catarrh into the bile ducts. When the stools continue greenish, sour or 
fetid, sometimes the child shows marked symptoms of wasting, becom¬ 
ing thin and wrinkled,—the countenance wearing an old look,—weak, 
peevish and restless. In many cases, convulsions come on in conse¬ 
quence of the weakened state of the child, in one of which the child 
dies. In other cases, the child dies from exhaustion. When vomiting 
is the principal symptom, the difficulty seems to increase until the little 
sufferer is unable to retain anything upon the stomach. 

Causes. —The principal causes of derangement of the digestion in 
children are improper food, too frequent feeding, overfeeding, the use 
of nursing-bottles which have not been properly cleansed. For direc¬ 
tions with reference to feeding, see section on “ Feeding and Care of In¬ 
fants.” Mental excitement, as care, anxiety, and particularly anger on 
the part of the mother, is a frequent cause of indigestion in nursing in¬ 
fants. Menstruation, pregnancy, sexual excesses, also exert a pernicious 
influence upon the infant through the milk. The ill health of the mother 


INFANTILIi D YSPEPSIA . 


1391 


is a frequent cause of laying the foundation, during the nursing 
period, of constitutional weakness in the child, as well as occasioning 
immediate disorders of nutrition. The practice that many mothers 
indulge in, of feeding the child every time it cries, is a most perni¬ 
cious one, but we will not dwell upon this point, as it has been fully 
considered elsewhere. Nursing-bottles, especially those with long tubes, 
are responsible annually for a large number of deaths among children. 
It is so difficult to keep bottles perfectly clean, as milk rapidly under¬ 
goes decomposition when warm, that probably the nursing-bottle is not 
free from danger in one case out of twenty in which it is used. A 
slight degree of sourness in a bottle or tube will communicate fermen¬ 
tation to the fresh milk taken by the child, so that the food will very 
soon sour and decompose in the stomach, producing all the results of 
indigestion or dyspepsia. The use of milk from unhealthy cows, from 
farrow cows, or that which has been allowed to slightly “change” before 
using, is very sure to disturb the sensitive digestive organs of the in¬ 
fant. 

Treatment. —The child should be fed at regular intervals, the 
length of which should be determined by its age. It should be fed a 
proper quantity, and at proper times. The habit of feeding children as 
frequently during the night as during the day, is a mistaken and in¬ 
jurious one. (See section on “Feeding and Care of Infants.”) 

When the child shows symptoms of indigestion, careful inquiry 
should be made respecting the nature of its food, the manner of feed¬ 
ing, etc. If the cause is ascertained to be in the mother, either a 
healthy wet nurse, whose child is about the same age as that of the 
patient, should be employed, or, when this cannot be done, as is often 
the case, cows’ milk should be used. The milk should be taken as fresh 
as possible. It ought not to be more than six or eight hours old, when 
fresher can be obtained. Attention should also be given to the length 
of time since the cow has calved. The milk of cows, being richer in 
caseine and in fat than human milk, should be diluted with pure 
water, or, as we prefer, with barley water, or thin oatmeal gruel, 
well boiled, and strained through a coarse cloth. For a very young 
child, milk should be diluted one-half. As a child grows older, and its 
digestive powers increase in strength, the quantity of water may be 
diminished. 

In cases in which there is much acidity, and the discharges from 
the bowels are very fetid in character, lime-water may often be used 


1392 


DISEASES OF CHILDREN. 


with advantage, one part lime-water being added to three or four parts 
of milk. In some cases it is sufficient to give the infant one or two tea- 
spoonsful of lime-water in double the quantity of milk after other food 
has been taken. In severe cases in which the digestive organs of the child 
seem to be unable to digest milk in any form, strong beef tea, white of 
egg dissolved in water, barley-water, or thin oatmeal gruel may be em¬ 
ployed, either separately or combined. We have succeeded in cases 
which seemed utterly hopeless, in restoring children by beginning with 
egg water, made by dissolving the white of an egg in a glass of tepid 
water, and gradually adding a little milk, oatmeal gruel, beef tea, or 
other food, as the child became able to bear it. In many cases, it is 
necessary to give food in very small quantities, sometimes not more 
than a tablespoonful or two at a time, and at intervals of an hour or 
two. When there is evidence that the nursing-bottle is at fault, and 
the evidence may be considered good whenever the nursing-bottle is em¬ 
ployed, the bottle should be discarded at once, and the child should be 
fed with a spoon. Nursing-bottles with long tubes should be avoided 
as in the highest degree dangerous. We have never yet found one which 
was not in a condition unfit for use. In extreme cases, in which the 
stomach rejects food altogether, it should be allowed to rest for a time, 
the child being nourished in the meantime by means of nutritive 
enemata of beef tea, egg and milk, and other preparations suitable for 
such use. 

Diarrhea, dysentery, colic, and other diseases of the digestive organs 
in children, should be treated upon the same principles, and essentially in 
the same manner, as recommended for these diseases in older persons. 

WORMS. 

Many children are rendered dyspeptic, and not infrequently made 
very ill, by constant treatment for worms. In the great majority of 
cases the symptoms which are supposed to be those of worms are 
really nothing more than symptoms which will only be aggravated by 
the use of the various worm medicines generally employed in such 
cases. When there is any suspicion that the child is troubled with 
worms, the bowel discharges should be carefully examined daily, for 
several days in succession. If no worms or segments of worms are 
found in the stools, it may safely be concluded that the symptoms ob¬ 
served arise from some other cause. At any rate, a physician should 
be consulted before any active measures of treatment are adopted. 


SKIN ERUPTIONS. 


1393 


We are sorry to say that many physicians are in the habit of adopting 
the suggestions of mothers and nurses, and consenting to treat infant 
patients for worms without sufficient grounds for so doing. Much 
harm is often done in this way. 

SliO ERUPTIONS. 

Slight eruptions of the skin are very common in children. A form 
of eruption known as strophulus which appears in two forms, red and % 
white gum, is most peculiar to small- children. This eruption affects 
chiefly the face and arms, other portions of the body being occasion¬ 
ally affected. The eruption consists in little elevations about the size 
of a pin-head, which, when red, are known as red-gum, and when 
white, are called white-gum. Nettle-rash, an eruption which resem¬ 
bles the result of a nettle sting, is also one of the most common skin 
eruptions in children. The principal cause of eruptions of this char¬ 
acter is indigestion. 

Treatment. —Remove the cause by improving the child’s digestion 
Bathe the affected parts with a solution of bi-carbonate of soda, tea¬ 
spoonful to a pint of water. This generally relieves the intense burn¬ 
ing. In severe cases, the parts affected may be covered with cloths 
wrung out of the solution. 


88 


ACCIDENTS AND EMERGENCIES. 


ILOESS. 

In many cases of sudden illness, it is often of vital importance to 
know just what should be done at once, as prompt measures will often 
prevent serious consequences which otherwise might follow. 

Fainting.— Fainting, or syncope, is due to sudden failure of the 
heart’s action. At the moment a person faints, the heart nearly or quite 
ceases to beat, so that a sufficient amount of blood is not sent to the 
brain, and the person falls unconscious. The action of the lungs is also 
checked. Fainting may be occasioned by loss of blood, by violent men¬ 
tal emotion,—as joy, fear, or grief,—a blow upon the pit of the stomach, 
a violent electric shock, or anything which arrests the action of the 
heart. Many persons will faint at the sight of disagreeable or unusual 
objects. The sight of blood or a serious wound causes some people to 
faint. When a person faints, the face is pale, pupils dilated, breathing 
suspended or gasping, pulse very feeble or not perceptible. Just before 
fainting occurs, the patient is dizzy and becomes weak and limp. 

Treatment. —Although fainting is a condition which approaches 
very near actual death, it is not often fatal. When a person faints he 
should be immediately laid on his back with the head lower than the 
rest of the body if possible, so as to encourage the flow of blood to the 
brain. The dress should be loosened about the neck and chest, and cold 
water should be dashed upon the face with the hand. Slapping the 
chest, especially over the region of the heart, is also a useful measure. 
If necessary, a handkerchief upon which a few drops of spirits of harts¬ 
horn have been sprinkled, should be placed to the nostrils of the patient. 
He should be kept in a horizontal position until the breathing and 
pulse are fully restored and color returns to the cheeks. The upright 
position is an exceedingly dangerous one for the fainting person. When 
the attack is prolonged, or shows a disposition to recur, alternate hot and 
(1394) 



Poison Ivy. (Rims Toxicotlentlri 



Stramonium. 
Pf.ATK XVII. 





CONVULSIONS—APOPLEXY—VERTIGO. 


1395 


cold applications should be. made to the spine and the patient should be 
given hot drinks of some kind. 

Convulsions. —If coming on soon after eating, give an emetic con¬ 
sisting of a teaspoonful of powdered alum or ground mustard dissolved 
in three or four tablespoonsful of warm water. If the extremities are 
cold, warm them. If the whole body is cold, give a hot bath. If the 
head is hot, apply ice. If there is violent jerking and clinching of the 
teeth, endangering the tongue, place between the teeth a cork or a piece 
of wood, or the handle of a spoon wound with cloth. If the patient does 
not recover quickly, send for a physician. 

Apoplexy. —When a patient falls suddenly, becoming unconscious, 
with flushed face and full pulse, elevate the head and shoulders, and ap¬ 
ply ice to the head. A physician should be sent for at once. For fur¬ 
ther treatment, see page 1078. 

Sun-stroke. —For the treatment of sun-stroke, see page 108G. 

Yertigo. —When a person is suddenly seized with vertigo or dizzi¬ 
ness, he should lie down at once. If it occurs in a position in which there 
is danger from falling, as in looking over the edge of a precipice, looking- 
down from a tower, and similar situations, the individual should at once 
withdraw to a sufficient distance from the point of danger to secure 
safety, and should lie or sit down and close the eyes until the symptom 
disappears. If a person feels dizzy in climbing, he should look up. 

Sudden Mauia. —Although violent mental derangement is generally 
preceded by symptoms of a premonitory character, it sometimes occurs 
very suddenly, making it necessary to take prompt measures. Mania may 
occur in consequence of disease of the brain or some temporary disorder 
of which delirium is a symptom,—as fever, delirium tremens, etc. As 
soon as signs of mental derangement occur, the patient should be put 
under careful watch. If the head is hot and the pulse full, relief will 
generally be obtained by the application of ice to the head. Most cases 
also require hot applications to the extremities at the same time. A 
physician should be called at once, and if there are evidences of real dis¬ 
ease of the brain, the patient should be put under careful medical treat¬ 
ment, with proper supervision, or sent to an insane asylum. 

Shock. —This term is applied to the condition which usually follows 
severe injury of any sort. It also frequently follows severe surgical 
operations. The patient generally becomes cold and complains of faint¬ 
ness. There Is general tremor, pulse is small, speech and thought are 


1396 


ACCIDENTS AND EMERGENCIES. 


confused, there is little or no appetite, perhaps nausea and vomiting, and 
there may be involuntary discharges from the bladder and bowels. A 
shock is generally followed by reaction, in which the patient has more 
or less fever according to the intensity of the shock. 

Hot bricks or bottles should be applied about the patient. If the in¬ 
jured part is painful, it should be soothed by hot applications. The 
hands and feet, and the whole surface of the body, should be rubbed un¬ 
til warm. Hot drinks of some kind should be given. Great harm may 
be done by the free use of stimulants, as is quite customary in these 
cases. By their employment the reaction, or fever, which follows may 
be greatly increased. 

Hemorrhage. —The principal means to be employed for arresting 
hemorrhage are, pressure, ice or cold water, hot water, and the ligature. 
The means to be employed differ somewhat according to the part in 
which the hemorrhage occurs. As a general rule, the bleeding part 
should be elevated, and pressure applied at the point of injury. Hot or 
cold applications should also be made. Pressure acts by closing the bleed¬ 
ing vessels and allowing the blood to coagulate. Cold at first causes the 
blood-vessels to contract; but if applied continuously for a long time, 
the blood-vessels are paralyzed and become relaxed. Hot applications 
cause more permanent contraction of the vessels than cold. 

The ligature is applied by a surgeon to the bleeding vessel itself; 
but when used by a person not skilled in surgery, should be applied ei¬ 
ther above or below the injury if it occurs in a limb, according as the 
bleeding comes from an artery or a vein. If an artery is wounded, the 
blood will flow in jets and will be of a bright red color. If the wounded 
vessel is a vein, the blood will be dark in color and will flow in a steady 
stream. If the vessel is an artery, the ligature or pressure should be ap¬ 
plied between the wound and the heart; if a vein, it should be applied 
upon the opposite side. A slight hemorrhage from a wound may gen¬ 
erally be very easily controlled by pressure upon the injured part with 
the fingers, or a compress of folded linen which may be held in place by 
the hand, or a bandage tightly applied. This method is particularly ap¬ 
plicable to wounds of the scalp and upper portions of the face. A 
hemorrhage from superficial injuries may generally be controlled quite 
readily by applying freely dry plaster-of-Paris or a mixture of equal parts 
of flour and salt. These are excellent remedies for bleeding from the 
navel in young infants. 


HEMORRHAGE. 


1397 


Bleeding from the Nose may generally be checked by holding the 
head erect, snuffing cold, water up the nostrils, and holding one arm as 
high as possible. Other remedies are mentioned on page 988. Severe 
hemorrhage occurring from the trunk of the body must generally be 
controlled by pressure with the finger until the services of a surgeon 
can be secured. 

Hemorrhage from a Cut Throat, may be slight or severe, according 
to the size of the vessel cut. When the large arteries are cut, death 
. may occur in a few minutes. The head should be elevated, and cold 
applied until a surgeon can be called. When the hemorrhage is severe, 
pressure with the fingers may be required. 

Hemorrhage from the Arm or Leg may be controlled by pressure 
upon the principal artery of the limb, made as follows:—Tie a knot in 
the center of a handkerchief or 
strip of cloth, of sufficient length 
to reach around the limb, in¬ 
cluding in the knot a small Stone, 
a large marble, or in the absence 
of anything better, a small po¬ 
tato or other hard substance. Tie 
the bandage around the limb in 
such a way that the knot will 
come just over the course of the 
wounded vessel as shown in fig¬ 
ure 355. It should be noticed 
that most of the large arteries 
run along the inside of the limbs. 

After tying the bandage, pass 
underneath it, on the side opposite 
the knot, a stout roller or rod. 

By means of this, the bandage 
should be twisted so as to tight¬ 
en it, thus compressing the ar¬ 
tery. Compression should be gradually increased until the hemor¬ 
rhage is controlled. A bandage of this kind should not be retained in 
place too long, as the parts beneath it and below may be injured. 
Properly, its object is to control the hemorrhage until the bleeding 
vessel can be secured and tied by a surgeon or other competent person. 





1398 


ACCIDENTS AND EMERGENCIES. 


An injury occurring in the upper part of the arm may be controlled 
by pressure above the collar bone of the same side, made by means of 
the thumb, or better, the ring of a key. See Fig. 356. 

Hemorrhage from the Palm 

troublesome. It can generally be 
relieved by pressure. If the 
bleeding is not checked by ele¬ 
vation of the limb, a proper pad 
should be applied over the wound 
and firmly secured in place by 
means of a bandage, and the 
hand should also be bound fast 
to a splint placed upon the back 
side of the arm. The two arter¬ 
ies at the wrist may be com¬ 
pressed by applying over each a 
piece of rubber tubing, or in the 
absence of anything better, pieces 
of a lead pencil an inch or two 
in length. It should be secured 
in place by a rubber bandage 
firmly applied. 

Bleeding from the Gums, from the extraction of teeth, will be best 
relieved by very hot or very cold water. 

In severe Hemorrhage form the Hand or Fingers, the arm should be 
tightly bandaged. It is also well to have the hand elevated to the 
opposite shoulder and held in place by a properly adjusted sling. 

Hemorrhage from the Arm below the Elboiv, or the Leg below the 
Knee, may be greatly lessened, and sometimes entirely checked, by bend¬ 
ing the limb upon itself as strongly as possible. 

Hemorrhage from the Stomach, indicated by vomiting of blood, re¬ 
quires perfect rest, the application of ice over the stomach, and swallow¬ 
ing small bits of ice in rapid succession. 

Hemorrhage from the Lungs requires heat at the extremities; re¬ 
straint from coughing; the application of cold to the chest; ice pills; 
and the inhalation of an atomized solution of tannin, or the vapor of 
turpentine. See page 1011. 


of the Hand, is sometimes very 



of the Arm. 



WOUNDS. 


1390 


Hemorrhage from the Bowels generally results from hemorrhoids, 
or piles. Cold water should be injected into the rectum, and the patient 
should be kept quiet in a horizontal position. See page 914. 

Bleeding from a Rupture of Varicose Veins in the lower limbs is 
sometimes very severe. It may be relieved by the application of a 
tight ligature a little belo^v the point of rupture. 

WOUXDS. 

Wounds are generally divided into the following classes: Incised 
wounds, or cuts usually made with cutting instruments or with glass; 
lacerated, or torn wounds; contused, or bruised wounds; punctured, or 
penetrating wounds, and poisonous wounds. Wounds require differ¬ 
ent treatment, according to their character. Cuts generally heal up 
quite readily, if properly dressed soon after the wound is inflicted. 
After the hemorrhage has been stopped, the wound should be care¬ 
fully washed with pure water, or better, with a solution of carbolic 
acid, five or ten drops to the ounce of water. When the wound is 
thoroughly cleansed of blood and all foreign matters, the edges should 
be brought together and held in position by means of stitches, adhesive 
plaster or bandages, or all combined. Silk, silver, or iron wire, cat¬ 
gut, and horse-hair are the most suitable material for sutures. If 
stitches are employed, they should be removed after three or four 
days, or as soon as the parts have become united. If retained too 
long, they are a source of irritation. If adhesive plasters are used, 
narrow strips should be employed, so in case there should be any dis¬ 
charge, there will be an opportunity for it to escape between the 
strips. When the cut is a long one, adhesive strips will generally re¬ 
quire to be reinforced by a bandage. Simple water-dressing, or cloths 
wet in a solution of carbolic acid, five or ten drops to the ounce, con- 
stitues the best dressing for most wounds. 

If the end of the finger or toe has been cut off by a sharp instru¬ 
ment, it should be at once replaced, even though it may have been en¬ 
tirely severed. We have known several instances in which the por¬ 
tion replaced in this manner has grown fast. If the severed part is 
frozen or badly bruised, an attempt to secure union will of course be 
useless. 

Punctured Wounds. —Punctured wounds, when inflicted with a 
clean, sharp instrument, generally heal quite readily. When the 


1400 


ACCIDENTS AND EMERGENCIES. 


wound is made by rough, blunt, dirty, or rusty instruments, healing 
occurs much more slowly, violent inflammation sometimes being pro¬ 
duced. In cases in which a nerve is injured, but not completely sev¬ 
ered, as in a punctured wound produced by stepping upon a rusty 
nail, lockjaw is likely to occur; hence, wounds of this character should 
receive prompt attention. 

Punctured wounds quite often heal quietly at the surface, while 
union does not take place in the deeper tissues. • .This gives rise to the 
formation of an abscess, making it necessary to make an outlet by open¬ 
ing the wound with a penknife or lancet. When the wound is made 
by a thorn or splinter, the foreign body should be removed by means 
of a pair of tweezers. It is useless to pick at the splinter with a needle, 
as it will be likely either to be driven farther-in or to be broken off. 
When a fish-hook is caught in the flesh, if it is imbedded beyond the 
barb, no attempt should be made to withdraw it, but the point should 
be pushed forward until it emerges from the skin, when it may be cut 
off by means of a file or pair of pliers, and the balance of the hook with¬ 
drawn, or the line may be detached and the whole hook pushed through 
the tissues. If a crochet hook has been thrust into the flesh, a not un¬ 
common accident, the attempt should not be made to withdraw it 
directly, but a large knitting or darning needle should be introduced 
along side of it and placed against the hook, when both may be drawn 
out together without inflicting further injury. 

Not infrequently punctured wounds are made by needles which 
may either be broken off in the tissues or entirely imbedded. In these 
cases the parts should be kept perfectly still, as the movements of the 
muscles of the part may bury it in deeper. If the needle cannot be 
readily got out, it may be left without any very great danger of doing 
harm, as it will probably work out of itself. Punctured wounds should 
be treated by means of hot fomentations or poultices, or compresses of 
tepid water or cai'bolic acid lotion. 

Torn and Contused Wounds. —These wounds heal much more 
slowly, as a general rule, than either incised or punctured wounds, 
never uniting by what is termed dry or primary union, in which no 
pus is formed, the parts adhering together at once, leaving no scar. 
These wounds heal by a process known as granulation, or secondary 
union, which is accompanied by more or less profuse discharge of pus. 
When the granulations which are formed in the process of healing 
grow so rapidly as to fill up the wound and aperture above the sur- 


TORN AND CONTUSED WOUNDS. 


1401 


rounding tissues, we have what is known as proud flesh. The new 
skin destined to cover the wound is gradually formed about the outer 
edge, extending inward until the whole is covered. The new tissue 
formed by this process of healing contracts after the healing process is 
complete, and forms what is known as scar or cicatricial tissue. Scar 
tissue becomes after a time like the tissue in which it is produced. 

Still another method of healing which is sometimes illustrated in 
this class of wounds, as well as others, is that known as scabbing. 
This is a process by which the repair of the injured part takes place 
very rapidly in a manner similar to that seen in primary union. No 
granulations are formed, but a protective substance is thrown out 
which when dry forms what is known as scab, beneath which the re¬ 
pair of the injured parts takes place. Artificial scabs may be formed 
in a clean fresh wound by moistening a bit of lint in fresh blood and 
placing it over the injured part. 

The wound should be thoroughly cleansed as in other cases, and the 
injured part should be drawn together by means of plasters and band¬ 
ages. Care should be taken not to employ too ^trong compression. 
Either water-dressing or lint saturated with sweet oil containing ten 
drops of carbolic acid to the ounce, may be employed. If the parts 
have been badly bruised, hot fomentations should be applied. Heat is 
especially essential in cases in which considerable portions of tissue have 
been nearly severed from the body, but have retained a sufficient 
amount of attachment to justify the attempt to secure union. 

For contused wounds, carbolated vaseline, containing ten drops of 
carbolic acid to the ounce, constitutes an excellent dressing. It should 
be spread upon a piece of thin cloth and then applied to the injured 
parts. 

If considerable sloughing occurs through the death of the tissues, 
the parts should be thoroughly cleansed two or three times a day with 
fine castile soap and water, followed by a one per cent solution of car¬ 
bolic acid. Portions of the limbs are sometimes so badly torn and 
mangled that healing cannot take place. In this case the injured 
part must be removed by amputation. It should be borne in mind, 
however, that nature’s resources are often much greater than might be 
considered possible, parts apparently irreparably injured being restored 
to a very useful condition. Hence, when there is even the barest pos¬ 
sibility of saving the inj ured part, amputation should not be performed. 
We have known instances in which individuals have resisted the advice 


1402 


ACCIDENTS AND EMERGENCIES. 


of the surgeon who urged amputation, and have recovered with useful 
arms and legs, who otherwise would have been maimed for life. Re¬ 
covery is especially likely to occur from severe injuries of the hands and 
feet. 

Dr. Frank Hamilton, of Bellevue Hospital, New York City, has se¬ 
cured some remarkable results in these cases by continuous immersion of 
the injured part in warm or hot water, the temperature being maintained 
at 100° or a little above. When there is a marked disposition of the 
injured parts to become gangrenous or to slough, hot fomentations should 
be applied, or the parts should be immersed in water as hot as can bo 
borne. Some surgeons have ridiculed this process of “maceration,” as 
they are pleased to term it, but Dr. Hamilton has so thoroughly demon¬ 
strated its utility that it is now recognized as one of the most useful 
means of treating badly lacerated limbs. It is of course necessary that 
the water should be changed frequently; three or four times a day is 
none too often. 

Dissection Wounds. —The tissues and fluids of animals become 
very poisonous after decomposition has begun, and are sometimes ex¬ 
tremely poisonous in character independent of decomposition, on account 
of disease—as in the case of death from malignant pustule, glanders, etc. 

Medical students, physicians, butchers, veterinary surgeons, and 
hunters, are the most likely to suffer from wounds of this character. 
It is said that some barbarous tribes render their arrows and spear 
points poisonous by smearing them with the fluids of decomposing 
flesh. It is also claimed by eminent authorities that poisons of this char¬ 
acter may be carried by the flesh-fly. The local symptoms of a wound 
of this character are those of a very painful boil. 

The hands should never be exposed in dissecting a decomposing body, 
especially if any portion of the skin is inj ured by a scratch or other ex¬ 
coriation. “Hang-nails,” or “ag-nails,” on the fingers, are frequently 
means of inoculation in dissection. Touching all suspicious points with 
nitrate of silver or lunar caustic and smearing the hands with oil or 
vaseline, are excellent preventive measures. If an abraded surface 
has been accidentally exposed or a wound inflicted with an infected 
instrument, the parts should be at once touched with nitrate of silver or 
pure carbolic acid. When the first symptoms of a poisoned wound ap¬ 
pear, as mentioned before, the boil should be freely opened, and nitric 
acid, pure carbolic acid, or a white hot iron should be applied. A large 



Black Hellebore. 



Plate XVIII. P0IS0N01 












HYDROPHOBIA. 


1403 


nail or three-cornered file heated to a white heat and applied to the dis¬ 
eased part is a less painful remedy than the application of caustics. 
If the iron is only heated to a red heat, however, the pain is very great. 

Bites of Animals. —Dogs, cats, horses, hogs, rats, squirrels, and 
polecats, frequently inflict bites upon human beings. When these an¬ 
imals are not suffering from rabies these bites generally heal quite 
readily, though much laceration may result in continued and violent 
inflammation. If the animal is in a state of rage at the time the 
bite is inflicted, the wound is likely to assume some of the character¬ 
istics of a poisoned wound. We have met several instances in which 
wounds inflicted by the bite of human beings gave rise to very serious 
inflammation. In one instance, a surgeon on probing a wound which 
was inflicted upon the hand, made a diagnosis of dead bone. After 
making an incision, what was supposed to be a dead bone was removed, 
which upon examination proved to be an incisor tooth of the individual 
by whom the bite was made. 

Whenever there is the slightest ground for suspicion respecting 
the condition of the animal inflicting the bite, it should be treated 
as a poisoned wound, both immediately after the bite is inflicted and 
subsequently. 

Hydrophobia—Babies. —The symptoms of this disease are itching, 
burning, smarting, numbness of the part bitten, slight shivering, rest¬ 
lessness, no appetite for food, headache, frightful dreams, distress 
occasioned by the sight of water or any bright substance, spasm 
of the throat and shivering on attempting to drink, heat and contrac¬ 
tion in the throat, great thirst, spasms of the whole muscular system, 
secretion of great quantities of viscid saliva, hoarseness, some fever, dif¬ 
ficulty in breathing, great debility, death from exhaustion in two to 
six days. Cases are recorded, however, in which individuals have lin¬ 
gered a longer time, though in a state of such intense suffering that 
death would have been a grateful release at any moment. 

This disease seems to have increased rapidly in modern times. 
This is probably due to the increasing number of dogs which are kept 
and allowed to run at large. The disease may be produced by the bite 
of a dog, wolf, polecat, or any other animal suffering with the disease. 
The period of incubation varies from a few days to a number of years. 
Cases have occurred in which the disease made its appearance ten or 
twelve years after the patient was bitten. The disease does not occur 
more frequently in hot weather, or the season known as “ dog days,” 


1404 


ACCIDENTS AND EMERGENCIES. 


than at other seasons of the year, as is generally supposed. Statistics 
show that cases are fully as frequent in cold weather as in the summer 
season. It is probable that the disease may be developed spontaneous¬ 
ly in the dog, but the tnost common way is by contagion through a 
bite. Human beings almost always contract the disease through the 
bite of a rabid dog; but experiments which have been made seem to 
show quite clearly that the saliva of a person suffering with hydropho¬ 
bia will communicate the disease as well as the saliva of a mad dog or 
any other rabid animal. Fortunately but a small proportion of those 
who are bitten by rabid dogs are inoculated with the poison. No 
more than one person in twenty-five suffers. It is necessary that the 
saliva should be introduced into the blood. This can only be done 
through abrasion of the skin. Cases have been reported in which 
horses have been inoculated by eating straw upon which a mad dog has 
lain. Another case is cited in which a man died of hydrophobia, having 
contracted the disease by using his teeth in untying a knot in a rope 
with which a mad dog had been tied. 

It is probable that in some cases all the symptoms of hydrophobia 
may occur wholly through fear and without the individual having been 
infected. This is of course most likely to occur in persons who have 
been bitten. 

Treatment .—Owing to the almost hopeless character of this affec¬ 
tion, prevention of the disease is of the utmost importance. This can 
only be effected by the enforcement of stringent laws against keeping 
all dogs. The practice of raising dogs as pets is really a reprehensible 
one. Cases are known in which persons have contracted hydrophobia 
through the licking of the hand by a dog afterward shown to be mad. 
There is a popular belief that certain species of dogs, particularly the 
variety known as the Spitz, are especially liable to this affection. A 
gentleman said to us not long ago that he would as soon have a rattle¬ 
snake in his house as a Spitz dog. 

About the only treatment which is at all effectual is that which can 
be administered immediately after the bite. A strong ligature should 
be applied between the part bitten and the heart. It should be drawn 
sufficiently tight to obstruct the circulation. The bitten part should 
then be cut out, including a little of the sound flesh about it. An iron, 
as a poker, may be heated to a white heat and applied to the part in¬ 
stead of using a knife. Nitrate of silver or lunar caustic may also be 


HYDROPHOBIA. 


1405 


used for the same purpose, the part being first dried before it is applied. 
Probably the safest way is, first to wash and dry the body, and then 
apply lunar caustic or caustic potash. When caustic potash is used, it 
may be neutralized by washing the part with vinegar after a sufficiently 
energetic action has been obtained. 

Whether treated in this manner or not, the wound itself generally 
heals kindly at first, but as already pointed out, is likely to become sore 
and irritable at some subsequent time just before the other symptoms of 
the disease make their appearance. It is unsafe to employ the mouth 
in sucking the poison from the wound as has often been recommended, 
as infection may take place through some slight abrasion in the mucous 
membrane, which may be so small as to escape the attention of the 
individual. 

A person who has been bitten should adopt the measures recom¬ 
mended instantaneously, if possible, and should then look forward to the 
future with hopefulness, consoling himself with the fact that a very 
small proportion of those who are bitten are actually poisoned, and still 
further with the thought that if inoculation has taken place, it has un¬ 
doubtedly been rendered inert by the prompt treatment applied. Sev¬ 
eral thousand cases are recorded in which persons who have been bitten 
have had the bite treated in this manner, and in no case hydrophobia 
appeared subsequently. The pain attending the removal of the bitten 
part by a knife may be prevented by freezing the tissues with ice and 
salt mixed together in a thin muslin bag and held over the part four or 
five minutes. 

When the characteristic symptoms of the disease are fully developed, 
very little can be done, except t® palliate the patient’s sufferings. The 
vapor bath and the inhalation of oxygen gas are more highly recom¬ 
mended than any other measures of treatment. A physician practicing 
in India claims to have obtained success by cutting out the scar as soon 
as an attack is threatened by pain, tenderness, or other peculiar symp¬ 
toms, thus dividing the nerves which are connected with it, and then 
inducing free perspiration by the hot-water or vapor bath. Opium, 
Indian hemp, and chloroform, are useful for the purpose of relieving the 
patient’s sufferings. The severe thirst which sometimes gives patients 
great distress, on account of their inability to drink, may be relieved in 
some degree by injecting a considerable quantity of water into the 
bowels and retaining it as long as possible. The patient may also be 


1406 


ACCIDENTS AND EMERGENCIES. 


nourished by the employment of nutritive injections when unable to 
swallow any kind of food. 

Snake Bites. —Fortunately venomous snakes are much less com¬ 
mon in this country than in many others, especially the tropical por¬ 
tions of the globe. The most common of the poisonous snakes which 
are found in this country are the rattlesnake, the chickensnake, water 
moccasin, or cotton-mouth, and the copperhead, all of which are 
about equally poisonous. The bite of the rattlesnake is inflicted by 
means of two fangs which are used only when the snake is irritated. 
At the same instant that the fangs are inserted by a striking movement 
upon the part of the snake, the poison is injected through a little canal 
which runs along the side of the fang. Not every person who is bitten is 
poisoned, as if the snake bites through clothing, the poison may be ab¬ 
sorbed by the clothing, or the fangs may not penetrate the skin suffi¬ 
ciently far to inject the poison into the circulation. 

The first symptoms which occur after a person has been bitten, are 
vomiting, coldness, lividity or yellowness of the skin, nosebleed, weak 
and irregular pulse, fainting, and perhaps convulsions and delirium. 
The bitten part swells rapidly and very extensively, and is generally 
very painful. If life continues for a few days, abscesses form in the 
swollen parts. Death has been known to occur in less than thirty min¬ 
utes after an individual was bitten. Life sometimes continues for five 
or six weeks. A very curious observation which has been made is that 
hogs do not appear to be injured by the bites of rattlesnakes. It is a 
well-known fact that they frequently attack reptiles, kill and eat them. 
It is a popular error to suppose that snakes poison themselves. This is 
also true in reference to other reptiles. 

Treatment .—When a person has been bitten by a rattlesnake or 
any other venomous serpent, the following measures should be adopted. 
1. Place around the limb, a short distance above the wound, a cord, 
tying it as tightly as possible. A whip-cord, shoe-string, neck-tie, strap, 
or anything which can be made to answer the purpose of a ligature, 
may be used. It should be sufficiently tight to cut off the circulation. 
This may be accomplished by placing a small stick beneath the cord and 
twisting it as is shown in Fig. 355. 2. If possible, cut out the bitten 

part, being sure to include all of the poisoned tissue. 3. If there is no 
sore, ulcer, or abrasion in the mouth, it will be safe and proper to next 
proceed to suck the wound, as the poison will do no harm if not re- 


BITES AND STINGS OF INSECTS. 


1407 


Ceived into the circulation. 4. As soon as possible the wound should be 
cauterized with a hot iron or live coal, or pure carbolic or nitric acid may 
be applied. To combat the coldness, the patient should be surrounded with 



Fig-. 357. Centipede. Fig. 358. Scorpion. 


hot bottles and warm blankets. Hot tea should also be given to drink. 
When the heart becomes weak, galvanism over the heart and hot and 
cold applications to the spine should be employed. There are no known 
antidotes for the poison after it has been introduced into the sys- 



Fig. 361. Tick, a, &, c, Jaws of 
the Insect. 



Fig. 359. Jigger, a , Fe¬ 
male, natural size. 



bug. 



Fig. 362. Flea. 


tem. Alcohol in the form of brandy or whisky has been very fre¬ 
quently shown to be no antidote for the poison. It is possible, how¬ 
ever, that in some cases life may be saved by the employment of stim- 






















1408 


ACCIDENTS AND EMERGENCIES. 


ulants as a temporary means of combating the tendency to collapse. If 
the patient is too weak to swallow hot liquids, stimulants should be in¬ 
jected into the rectum. It should be recollected that many of those 
bitten are not poisoned, to which fact may be attributed the supposed 
efficacy of many remedies which have been recommended. 

When there is great stupor and numbness, the patient should be en¬ 
couraged to exercise. When too feeble to exercise, the muscles may be 
kneaded and manipulated. If the breathing becomes greatly impeded, 
artifical respiration should be employed. Hot fomentations over the 
stomach and cold applications to the head are also useful. Drinking 
considerable quantities of fluid to stimulate the action of the kidneys, 
and the hot water bath, are measures worthy of recommendation. 

Bites and Stings of Insects.— The principal insects which are 
capable of inflicting painful or poisonous bites or stings are fleas, 




Fig. 364. Tarantula. 


bed-bugs, bees, wasps, musquitoes, the midge or buffalo fly, the jigger, 
ticks, spiders, the scorpion, and the centipede. Figs. 357 to 364. 

Treatment. —The bites of such insects as the musquito, flea, bed¬ 
bug, and midge are generally relieved by bathing the parts with a weak 
solution of ammonia water, salt and water, or a solution of saleratus 
or baking soda. The same measures are useful for the relief of bee 
stings. When the sting is left in the wound, it should be carefully 
withdrawn. When a person is stung upon the inside of the month, a 
hot solution of salt and water should be used as a mouth-wash or gar¬ 
gle. Hot vinegar is useful for the same purpose. If the parts become 
very much swollen, so as to produce suffocation, they should be lanced 
and allowed to bleed freely. The bites of the spider and scorpion are 






BRUISES. 


1 401 ) 


to be treated upon the same principles. If abscesses or boils form, they 
should be lanced and treated as other boils. 

The bite of the centipede is a much more serious matter, and should 
receive attention the moment it is inflicted, or as soon as possible, as death 
has sometimes occurred within a few hours.' The part bitten should be 
incised with a sharp knife and encouraged to bleed freely by sucking 
or soaking in hot water. The treatment should be the same as recom¬ 
mended for bee stings and the bites of other insects, unless severe symp¬ 
toms should develop, when the directions given for treatment of snake 
bites should be followed. 


BRIISES. 

For severe contusions in consequence of a blow received on any 
of the soft parts of the body, apply at once fomentations as hot as can 
be borne. The hemorrhage beneath the skin which frequently occurs 
in consequence of a severe bruise, may generally be prevented by firm 
compression immediately after the injury. It is a custom among 
German mothers when a child falls, striking its head severely, to apply 
the convex surface of the bowl of a teaspoon immediately upon pick¬ 
ing it up. The compression can be kept up by means of a pad and 
bandage as long as desired. 

Much of the discoloration which results from bruises, which is par¬ 
ticularly undesirable when the eye is the part injured, may be pre¬ 
vented by the continuous application of hot fomentations for some time 
after the accident. The sooner the hot applications can be made, the 
better. The object of this treatment is to cause contraction of the 
blood-vessels and thus diminish the amount of hemorrhage. Cold is 
very efficient for the same purpose, but it should not be applied for more 
than half an hour without removal for a few minutes, as the blood ves¬ 
sels become paralyzed. Alternate hot and cold applications are better 
than either hot or cold alone. An additional advantage in the use of hot 
applications is the removal of the soreness of the parts. Hot fomenta¬ 
tions are also one of the best means for relieving the pain which ac¬ 
companies fractures of bones occasioned by a blow or fall. 

Lotions of various kinds are recommended for the prevention of 
discoloration. Probably water alone, equal parts of alcohol and water, 
or a lotion of common salt and vinegar, are as efficient as any that can 
be employed. A favorite remedy with some, for bruises and contusions, 
is tincture of bryonia. We do not think, however, that any of these 

80 


1410 


ACCIDENTS AND EMERGENCIES. 


remedies are better than hot water faithfully applied. When there is a 
marked tendency to inflammation, as indicated by heat, redness, swell¬ 
ing, and much pain, cold applications should be vigorously applied. 
When suppuration has taken place, poultices should be employed. If the 
patient has high fever and chills, the abscess should be lanced. 

Arnica is a popular remedy for bruises, but its use is of doubtful 
propriety, as it frequently produces local symptoms of poisoning, and 
often gives rise to disease of the skin of parts to which it is applied. 
When a person has been much jarred, as by a considerable fall, or more 
or less bruised all over, a hot full bath, or a hot blanket pack will give 
more relief than any other remedy. This measure should not be 
employed, however, when the patient is faint. 

In case a person has been bruised about the trunk, or body, by hav¬ 
ing a tree fall upon him or being run over by a wagon wheel, the servi¬ 
ces of a skillful surgeon should be obtained as soon as possible. Hot 
fomentations or a hot full bath may be employed in the meantime. 

Bruises upon the head in consequence of severe blows or a fall, often 
give rise to serious symptoms on account of fracture of the skull and com¬ 
pression of the brain, or from simple concussion, or jarring, of the brain. 
If a person is insensible or partially paralyzed in consequence of an ac¬ 
cident in which the head is injured, surgical advice should be secured 
at once. As a general rule, continuous cold is the best application for 
injuries resulting from severe blows upon the head. Fomentations may 
be applied at intervals to relieve soreness, but the application should be 
not longer than five or ten minutes at a time. 

Injuries to the joints require perfect rest and the application of 
cold to the*injured part, until danger of inflammation is past, when the 
joint should be carefully moved daily to prevent its becoming stiff. 

STISAIAS. 

In consequence of severe exertion, some of the fibres of a muscle or 
of its tendon may be ruptured. This is what is termed a strain. Hot 
fomentations should be applied, and the injured part kept at rest. If 
necessary, large adhesive straps should be applied over the injured part 
to keep it quiet. Sometimes complete rupture of the tendon occurs. 
This is most likely to occur in the largest tendon of the body, that 
known as the tendo Achillis, which connects the muscles of the calf 
to the heel bone. 


SPLAIXS-BUBXS AND SCALDS. 


1411 


In treating this accident, a slipper should be placed upon the foot, to 
the heel of which a strap is attached. The upper end of the strap 
should be attached above the knee in such a way as to extend the 
foot completely and partly Hex the leg. 

SPRAINS. 

A sprain consists of a laceration or rupture of the ligaments sur¬ 
rounding and supporting the joints, in consequence of unnatural strain 
brought to bear upon them. To relieve the pain, apply fomentations; to 
prevent inflammation, apply cold after the pain is relieved. The joint 
should be kept at perfect rest until the inflammation has subsided. A 
person should never attempt to walk with a sprained ankle or to use a 
joint that has been injured in this way until the inflammation has been 
entirely subdued, as permanent injury to the joint may result unless 
rest is secured. In some cases, the application of a pasteboard splint 
upon either side of the joint, secured in place by the bandage, is a use¬ 
ful measure. 

BURNS AND SCALDS. 

If possible, immediately immerse the injured part in water at about 
the temperature of the body. Very extensive burns in which consider¬ 
able portions of the skin are destroyed, are best treated by the contin¬ 
uous bath, the patient remaining immersed in water until the new skin 
is formed. Patients have been kept immersed in this way for months, 
in some instances with the result of securing recovery when no hope was 
afforded by any other means. No harm results from prolonged immer¬ 
sion, provided the water is changed as it should be, once or twice a day. 
An excellent means of relieving the pain of an extensive burn, is the 
application of common baking soda. This generally relieves the pain to 
a very great extent in a short time, and seems to promote the heal¬ 
ing process wonderfully. Portions of charred clothing and other foreign 
matter should be removed by a stream of warm water, or immersion of 
the part in warm water, and the injured surface should be thoroughly 
covered with the dry soda. The part should then be covered with cotton¬ 
wool or common wadding. Carron oil, consisting of equal parts of lime- 
water and linseed oil, is a favorite remedy with many, but has the dis¬ 
advantage of being very dirty and having an unpleasant odor. Car- 
bolated vaseline, containing ten drops of carbolic acid to the ounce, is an 
excellent application. It should be spread upon thin cloths with a case- 


1412 


ACCIDENTS AND EMERGENCIES. 


knife to the thickness of a knife-blade, and applied over the burnt 
surface. When suppuration occurs, the injured surface should be 
thoroughly washed two or three times a day with warm water and cas- 
tile soap, and afterward rinsed with a one per cent lotion of carbolic 
acid. If the burned parts are very badly swollen with oedema, as is 
frequently the case with burns of the face and scalp, hot fomentations 
should be applied for the purpose of stimulating the circulation. 

We very recently had the opportunity of trying this method of treat¬ 
ment in the case of an engineer who was badly burned by an explosion 
of gas, and with the most excellent results. A remedy which has been 
recently recommended very highly is thymol. It is to be used in the 
proportion of one part to one hundred of linseed oil at first, and afterward 
in proportion of one part to one thousand of oil. It should be applied 
several times a day. 

When the patient suffers with chilliness and other symptoms of shock, 
the treatment recommended for this condition should be given. See 
page 1395. The fever which frequently accompanies extensive burns, 
especially after suppuration begins, should be cautiously treated by 
means of tepid sponging, full baths, and large tepid compresses about 
the body. 

Scalds of the mouth, which occur most frequently in children who 
sometimes attempt to drink from the spout of the tea-kettle, require 
a warm moist atmosphere. This may be secured by enveloping the head of 
the patient in a blanket or oil-cloth and conducting beneath the covering 
steam from a tea-kettle by means of a rubber hose. A better means, 
however, of using warm vapor in these cases is the steam inhaler. See 
page 802. If there is great swelling of the epiglottis, so as to inter¬ 
fere with the breathing, lancing sometimes becomes necessary. 

FRACTURES. 

Fractures of bones are very common in connection with other acci¬ 
dents. Old people are especially liable to injuries of this kind on ac¬ 
count of the increased proportion of earthy matter in the bones in old 
age. Fractures of long bones in children are very likely to be but par¬ 
tial, or what is known as “green-stick ” fracture. Fractures may oc¬ 
cur from a blow, fall, or violence of any kind applied directly to the 
limb, or may result from indirect violence, the bone being broken in 
consequence of a blow received upon some other part of the body, as in 
fracture of the collar-bone from a fall upon the hands, or the base of the 



Flowers and Root of Aconite, or Wolfsbane. 

Plate XX. POISONOUS PLANTS. 









FRACTURES. 


1413 


skull from force received upon the top of the head. Bones are also 
sometimes broken in consequence of violent muscular action, as in 
fracture of the knee-pan which occasionally occurs in consequence of 
violent efforts in jumping. 

Fractures are variously classified as complete or incomplete, trans¬ 
verse or oblique, crushed, impacted, simple or compound. Simple 
fracture is one in which the skin is not broken. In compound fracture 
the injury to the bone is accompanied by a lacerated wound of the part. 
This is a much more severe accident than simple fracture. 

Fractures are indicated by pain, swelling, change in the form of 
the injured part, and a grating sound or crepitus felt by rubbing the 
ends of the fragments together. Loss of power of the voluntary motion 
in the limb, and an unnatural degree of mobility shown upon manipu¬ 
lation, are other characteristic signs. In examining limbs supposed to 
be fractured, they should be carefully compared with those of the oppo¬ 
site side. 

The Healing of Fractures. —The bones heal very slowly com¬ 
pared with most other tissues. The process of repair consists in the 
throwing: out of a sort of cement about the ends of the fragments of the 
injured bones, which forms what is known as a callus, which is depos¬ 
ited in such a way as to constitute a sort of splint for the bone. At 
first, the callus is somewhat cartilaginous; after a time it becomes 
changed to bone. In very rare cases, the bones fail to unite, though 
this does not, according to Prof. Hamilton, occur in more than one case 
in five hundred. More or less deformity remains even if the bones 
are exactly coapted to each other. If the bones are not accurately set, 
or if after being set they are not properly kept in place, a considerable 
degree of deformity may result. 

In some cases union takes place with the bones at more or less of an 
angle with each other. A deformity may also result from a shortening 
of the fractured limb due to overlapping of the fragments. This is 
especially frequent in fractures of the thigh in which more or less short¬ 
ening generally occurs, the amount varying from a small fraction of an 
inch to two or three inches. If the shortening is not more than an inch, 
it will scarcely be noticed by the individual himself, and will not be ob¬ 
served in his walk. 

Stiffness of joints in the vicinity of fractures is often found after 
recovery from the injury, being due either to interference with the mo¬ 
tion of the joint by the callus, or to long-continued disuse of the joint. 


1414 


ACCIDENTS AND EMERGENCIES. 


General Treatment of Fractures. —The limb should be restored 
at once as nearly as possible to a proper condition, and hot fomenta¬ 
tions should be applied to relieve and prevent soreness and inflamma¬ 
tion. As soon as possible, a surgeon should be called to set the limb. 
This is not generally nearly as painful an operation as commonly sup¬ 
posed, it being seldom necessary to apply any very great amount of 
force to get the parts into proper position. In case very great swelling 
has occurred before an opportunity is afforded to set the bones, hot 
fomentations or alternate hot and cold applications should be employed 
until the swelling and inflammation are reduced, before any attempt is 
made to set the broken bones. 

The greatest difficulty against which a surgeon has to contend in 
the treatment of fractures is the contraction of the muscles, by means 
of which the fragments are drawn apart. This may generally be over¬ 
come by putting the limb in a condition in which the muscles will be as 
completely relaxed as possible. 



Fig-. 365. 


In setting bones, the lower fragment is drawn firmly down, the up¬ 
per one being held in position, or drawn in the opposite direction. 
This is always necessary to cause the ends of the bones to come to¬ 
gether properly. It is generally necessary, however, to make some de¬ 
gree of pressure upon the sides in order to secure perfect adjustment 
of the parts. After the bone has been set, a proper splint or other ap¬ 
paratus should be applied in such a way as to keep the parts in posi¬ 
tion. In measuring limbs to see if they are of the same length, as 
should always be done, .care should be taken to put both limbs in the 
same position, and to take measurements from the same points. 

Compound fractures require very careful management, and with 
the best of care not infrequently result in considerable deformity. 


BANDAGES. 


1415 



Fig. 366. 


Bandages. —Bandages are made of cotton, cotton flannel, ordinary 
drilling, or of very thin, loose muslin, according to the purpose for 
which they are to be used. In the application of bandages to frac¬ 
tured limbs great care should be 
taken to apply them with even 
pressure, and not so tight as to 
interrupt the circulation of the 
blood. Figs. 365 and 366 repre¬ 
sent the roller bandage and the 
mode of applying it, and Fig. 

367 the appearance of the limb 
after the bandage has been 
properly applied. The width of 
bandages varies from one to three 
or four inches. In making them, 
care should bo taken to remove 
all loose threads from the edges. 

The plaster-of-Paris bandage 
is very useful in the treatment 
of many fractures. It is made 

by rubbing into a cloth bandage with loose meshes dry plaster-of- 
Paris, as much being rubbed in as can be held by the cloth, the band¬ 
age being rolled as the plaster is rubbed in. In using, the bandage 
should be placed in water for two or three min¬ 
utes and then applied to the limb as rapidly as 
possible. 

Bandages saturated with flour starch are 
sometimes employed. Glue, shellac, silicate of 
s >da, or soluble glass, and parafine, have also 
been used in a similar manner. The advantage 
of bandages of this kind is that they obviate 
the necessity for splints—themselves forming most 
perfect splints—giving the parts equal pressure 
on all sides. In case it is necessary to remove 
the bandage occasionally for the purpose of giving 
the limb attention, it may be easily done by cut¬ 
ting open one side and springing the sides so as to 
allow the bandage to be slipped off' the limb. 

Splints. —These are supports of various kinds used in the treatment 



Fig. 337. 























1416 


ACCIDENTS AND EMERGENCIES. 


of fractures. They are composed of various materials, and are of differ¬ 
ent forms, according to the parts to which they are to be applied. The 
old-fashioned wooden splint is now largely displaced by coarse flat 
splints which are supplied in sets. Leather, gutta-percha, and various 
other substances are frequently employed, and possess the advantage that 
they may be molded to any part after having been rendered flexible 
by soaking in hot water. Heavy pasteboard or binder’s board may be 
used in the same way. In case of emergency a shingle, or a piece of 
thin board of any sort, may be made to answer the purposes of the 
splint. 

In the use of splints, they are padded by strips of folded flannel or 
strips of cotton, and are placed on either side of the limb in such a way 
as to hold the ends of the fractured bone together, the bandage being 
applied around the outside. Special appliances are required in the 
treatment of special fractures, such as apparatus for extension, cradles 
for suspending the limbs, fracture boxes, inclined planes, etc. 

Pyaemia and Septaemia. —These are conditions of the system in 
which there is general poisoning from the absorption of pus or germs 
They often occur in cases of compound fracture, the ends of the broken 
bones wish their numerous open blood channels presenting the most 
favorable opportunity for absorption. The occurrence of pyaemia or sep- 
tiemia is indicated by fever, the pulse being small, quick, and irregular. 
Delirium and stupor are often present. Severe chills, followed by fever 
and profuse sweating, with extreme depression, are also present. If the 
wound is discharging, the matter changes from the natural creamy 
color and consistency, to a bloody or dark thin fluid. The skin about 
the wound becomes bluish or purple, healing ceases, and the wound gaps 
open. The joints are affected with rheumatic pains, sometimes abscesses 
forming in them. Breathing is difficult and increased in frequency. 

Pvsemia occurs in connection with other conditions, as well as in 
fracture. Whenever it occurs, from whatever cause, the wound from 
which absorption takes place should be thoroughly disinfected by wash¬ 
ing with carbolic acid alone, or a solution of permanganate of potash. 
The sick-room should be thoroughly ventilated. Disinfections should be 
thoroughly used for the purpose of disinfecting the discharges from the 
body. The diet should be simple, but unstimulating in character. If 
the stomach will not receive food, nutritive injections into the bowels 
should be employed. Chilliness should be combated by hot jugs and warm 


FRACTURES. 


1417 


wrappings. If the fever risas high, cold spongings and cool enemas 
should be employed. 

Fractures ot 1 he Skull, In fractures of the bones of the skull, 
some of the fragments are very likely to become depressed upon the 
brain, occasioning loss of consciousness, or other disturbances of the nerv¬ 
ous system. Sometimes blood-vessels are enlarged, so that a large clot is 
foimud in the brain, giving rise to symptoms similar to those which re¬ 
sult from apoplexy. 

The proper treatment of these cases consists in lifting up or remov¬ 
ing altogether the depressed portion of bone, an operation known as tre¬ 
phining. 

Fractures of the Spine— When the back, or spinal column, is 
broken, the spinal cord is almost always more or less injured, the re¬ 
sult of which is paralysis of the lower extremities. In these cases the 
bowels and bladder, as well as the lower extremities, are usually para¬ 
lyzed. The patient should be kept 
quiet in bed. The urine should be 
drawn with a catheter, and the blad¬ 
der should be washed out daily. 

Complete recovery is very doubtful. 

Fracture of the Nose. —Fracture 
of the bones of the nose is readily 
recognized by the characteristic de¬ 
formity. Great swelling usually oc¬ 
curs in a very short time, sometimes 
making it difficult to tell whether 
there is fracture or not. Hot fomen¬ 
tations should be applied at once, as 
by this means pain and swelling, and 
subsequent inflammation may be very 
much diminished. A pencil should 
be passed up into the nose, and by 
its aid, together with manipulation 

by the fingers, the depressed bone should be lifted into position. 
The bones may be held in place by means of a little wooden plug 
smeared with tallow, or plugs of cotton saturated with sweet oil. 

Fracture of the Lower Jaw. —This is generally the result of a 
blow upon the face. It may be most easily recognized by an examina- 



3Tig\ 368. 




141S 


ACCIDENTS AND EMERGENCIES. 


tion of the teeth, which are thrown out of line when the jaw is frac¬ 
tured. After the broken parts are put in proper position, a bandage 
should be applied as shown in Fig. 368. 

Fracture of the Upper Jaw. —Fracture of the upper jaw occurs 
very rarely. The parts should be put in as good position as possible, 
and held in place by adhesive straps and bandages. 

Fracture of the Collar-Bone. —This is the most frequent of all 
fractures. It occurs most often in children. It is indicated by pain, 
dropping of the shoulder, swelling over the broken bone, irregularity, 
and a grating, sensation when the shoulder is moved. There is no 



Fig- 369. Front View. Fig. 370. Back View. 


difficulty in setting a fracture of the clavicle, but it is by no means 
easy in all cases to hold the fractured ends in position. The most sim¬ 
ple method of treating fracture of the clavicle is a figure-of-eight 
bandage made out of a pair of suspenders which are passed in front of 
each shoulder, and crossed and buckled behind, making a figure 8, the 
shoulders being included in the loops. By this means the shoulder of 
the injured side may be drawn back, so that the ends of the bones are 
brought near together. Our respected teacher, Prof. Sayre, of Bellevue 
Hospital College of New York, has devised a very simple method of 
treating these cases by means of adhesive straps, as shown in Figs. 369 
and 370. 






I 


FRACTURES. 


1410 



Fracture of the Ribs. —In cases of injury to the chest, it is often 
found very difficult to determine whether or not the ribs are broken. 
When fracture has occurred, there is generally sharp pain at a definite 
point, which is increased by deep breathing or coughing. In cases of 
fracture, these symptoms are generally aggravated when the patient lies 
down. Sometimes grating of the ends of the bones, or crepitus, can be 
distinctly made out. 

In doubtful cases it is best to apply a broad 
bandage tightly about the chest; this will usually 
give relief. When the fracture can be made out 
with certainty, strips of adhesive plaster should 
be applied to the affected side in the manner in¬ 
dicated in Fig. 371. 

Fractures of the Humerus, or Arm-bone.— 

A fracture of this kind may occur near the shoul¬ 
der, the elbow, or midway between these points. 

When the fragments are impacted—that is, crowded together by 
the force of the blow,—the arm should be placed in an easy position 
and kept quiet. If the fragments are not attached or impacted, they 
should be set. The splint should be applied in such a 
way as to hold the fragments in place. The simplest 
method is that of Dr. Hamilton. The splint recom¬ 
mended by him may be made of pasteboard, felt, 
leather, or other material. Its form is shown in Fig. 

372. It should be long enough to reach above the 
point of the shoulder. The edges of the notch in the 
upper end should be brought together by means of 
stitches, and while flexible the splints should be mold¬ 
ed to the shape of the shoulder and arm, and allowed 
to become dry. Another short splint should be placed 
upon the inside of the arm. Each splint should be 
padded or covered with woolen cloth; it should then 
be secured to the arm by means of rollers, and the arm 
placed in a sling. It is well to bandage the arm before 
applying the splint, beginning at the fingers. 

This method is applicable to fractures in the upper part of the arm. 
When the fracture occurs at the middle or lower part of the arm, a 
splint in the form of a right angle and of sufficient length to reach from 
the shoulder to the wrist should be employed for the inside of the 



Fig. 372. 




















1420 


ACCIDENTS AND EMERGENCIES. 


arm, a short splint reaching from the shoulder to the elbow being placed 
upon the outside. After the fragments have been adjusted, the 
splints, properly padded, should be secured in place by proper bandages. 
When the elbow or other joints are much injured by the accident pro¬ 
ducing the fracture, the pain and inflammation should be subdued by 
the use of hot and cold applications before the splints are applied. 
When any of the nerves of the arm are injured so as to produce pa¬ 
ralysis, the application of electricity should constitute a part of the 
treatment. 

Fractures of the Fore-Arm. —Either one or both bones of the 
fore-arm may be broken, but the treatment remains the same as in 
other cases. The splints required for this fracture should be of suf¬ 
ficient length to reach over to the end of the elbow and the middle of 
the palm. They should be a little wider than the arm itself, so as to 
take ofl‘ the pressure of the bandage. Care should be taken not to cut 
them so wide that the arm will be loose. The splints should be applied 
in such a way that the elbow can be flexed. In setting the bone, the 
arm should be drawn with the palm upward so as to make the bones 
parallel inside of the hand. The splints should then be applied and the 
arm drawn with the thumb upward. While held in this position, 
straps of adhesive plaster may be applied around the end of each, which 
may be afterward reinforced by a bandage. 

When the radius, or outer-bone of the arm, that upon the thumb 
side, is broken, the hand drops to one side. This fracture, known as 
Colies’s fracture, is occasioned by a fall upon the hands. It is also some¬ 
times called “ back-door ” fracture, because it so frequently occurs from 
slipping upon the ice in stepping from the back-door. The term 
“silver-fork ” fracture is also applied to it on account of the shape of 
the wrist which resembles the bend at the point where the shank of the 
fork joins the tines. 

The limb is very rarely perfectly restored. After this accident, 
more or less stiffness of the wrist generally remains. This fracture is 
best treated by means of a pistol-shaped splint for the inside, reaching 
from the elbow to the ends of the fingers, and a short, strait 
splint, reaching from the elbow to the wrist, for the outside of the arm. 
The splints should be carefully stuffed or padded on the inside. The 
hand should be brought up into position as nearly as possible and the 
splints applied and kept in position by a roller bandage. Considerable 


FRACTURES. 


1421 


care should be taken in the treatment of this fracture, as not in¬ 
frequently considerable swelling occurs, which sometimes results in 
loss of the hand. After the splint has been adjusted, the arm should 
be put in a sling. 

Fracture of the Bones of the Baud. —Fractures of this kind may 
occur from a blow upon the back of the hand or striking some hard 
object with the knuckles. In treating it, the ends of the fragments 
should be placed in position, and a ball of yarn placed in the hand for 
the patient to grasp. The bandage should then be applied. A little 
deformity remains, but the usefulness of the hand is not impaired. 

Fracture of the Fingers. —There is no difficulty in recognizing- 
fractures of the fingers. They are very easily treated. It is only nec¬ 
essary to see that the fingers are in a natural position, and that the 
palmar surface is not drawn to one side. Even if the soft parts as 
well as the bones have been completely severed, if the parts have not 
been crushed too much, union •will often take place, and the severed 
fragments should be brought together and kept in position. A piece 
of pasteboard or wood, or a perforated zinc or tin, should be placed 
upon the palm side of the fingers after the fragments have been ad- 
j usted, and the bandage should be applied. The starch or plaster band¬ 
age is very useful in these cases. 

Fracture of the Thigh. —Fractures of the thigh may occur at 
the neck of the femur, its most constricted portion, or in some portion 
of the shaft. Fracture of the neck is most likely to occur in old peo¬ 
ple. It has been produced in elderly persons by a very slight degree 
of violence, as tripping on the carpet or door-sill, making a misstep, or 
some other equally insignificant fall. 

Fracture of the neck is generally produced by a blow or fall 
upon the foot, or knee, or upon the outside of the hip. Pain and 
swelling are present as in other fractures. There is a slight change in 
shape of the hips. The outer portion of the injured hip being flatter 
than the corresponding portion of the outer side. The foot is drawn 
outward, the limb is shorter, and there is loss of power to use the limb. 

Fractures in the shaft of the thigh are most often the result of di¬ 
rect violence, as a severe blow, being run over by a wagon, a fall from 
a considerable height, etc. The symptoms of this form of fracture are 
change in the form of the limb, unnatural motion, shortening of the 
limb, and turning of the foot outward. In determining the length of 


1422 


ACCIDENTS AND EMERGENCIES. 



the shortened limb, in 
fracture of the thigh, 
great care should be 
taken in measurement. 
The clothing of the pa¬ 
tient should be removed, 
and he should lie on a 
flat surface, the legs par¬ 
allel with each other and 
in line with the body. 
One end of a string or 
tape-line should then be 
held at the navel while 
measurements are taken 
to the upper side of the 
bony prominence on the 
inside of each ankle. 

This form of fracture 
should receive the atten¬ 
tion of a careful surgeon, 
—as even with the very 
best of treatment, more 
or less deformity will be 
likely to result. Various 
methods of treatment are 
recommended. When 
the bones are impacted, 
all that is required is that 
the patient should remain 
in bed and keep the limb 
quiet while the healing is 
taking place. A plaster- 
of-Paris bandage is very 
useful in these cases. 
When the fragments are 
not driven together, any 
one of several methods 
may be employed. Prob¬ 
ably the safest of these 


Fig-. 373 























Indian Turnip. 

Plate XX. 






FRACTURES. 


1423 


is that known as extension, in which the patient is placed in 
bed and extension applied to the injured limb in such a way as to 
overcome the tendency to shortening, which is likely to occur in con¬ 
sequence of contraction of the muscles. A very convenient form of 
apparatus of this sort is shown in Fig. 373, in which the weight is at¬ 
tached by a rope passing over the pulley to a broad band of adhesive 
plaster which is secured to the leg by a roller bandage. Counter ex¬ 
tension is made by means of a strap, which passes between the thighs 
and is attached to the upper end of the bed-stead. Sometimes the 
counter extension is made by having a foot-board raised eight or ten 
inches, so that the weight of the body will counteract the tendency of 
the weight to draw the body back to the foot. Some surgeons employ 
the plaster-of-Paris bandage in these cases. Others recommend very 
highly the double-inclined plane. Two or three months are required 



Fig\ 374. 


to effect a union in these cases, and from one-fourth of an inch to 
two inches or more shortening; will be likely to occur in most cases. 

In many cases the limb is never restored to its full usefulness, al¬ 
ways remaining weak and lame. When the fracture is treated with 
the limb extended, the knee is generally found to be stiff when the 
dressing is removed, and this difficulty must be overcome by fomenta¬ 
tions and daily manipulations. In cases in which more than partial 
recovery occurs, it is generally ten or twelve months before the patient 
is entirely well. 

Fracture of the Knee-pan. —The patella, or knee-pan, may be 
broken transversely or vertically. In some cases it is shattered by a 
severe fall or blow. This fracture is generally occasioned by violent 













1424 


ACCIDENTS AND EMERGENCIES. 


jumping, or a sudden movement to avoid falling backward. The frag¬ 
ments of the broken bone generally unite in six or eight weeks, but it 
is quite rare that actual bony union takes place, the parts being gen¬ 
erally bound together by a sort of ligament. Very little inconven¬ 
ience is experienced, however, unless the ligament becomes stretched, 
as is sometimes the case even to the extent of three or four inches. 

The best method of treatment is that suggested by Prof. Hamilton 
which is so well shown in Fig. 374, that further description is unneces¬ 
sary. 

Fracture of the Leg.—Either one or both bones of the leg may 
be fractured. The tibia, or inner bone of the leg, which forms the shin, 
although much stronger and larger than the outer bone, is most fre¬ 
quently broken on account of being less well protected by muscles. 
What is known as Pott’s fracture is an injury in which the outer 
bone of the leg is broken at a point about three inches above the ankle, 
and the inner ankle is either broken or separated from the heel bone 

by laceration of the ligaments. The 
result of this accident is turning: 
of the sole of the foot inward. 
When the tibia is broken, the point 
of fracture can generally be quite 
easily found by feeling along the 
shin. The outer bone is so thorough¬ 
ly covered by muscles that it cannot 
be so easily felt, but the crepitus can generally be distinguished. 

Treatment .—The bone should be set, and the limb placed in the 
fracture box, an illustration of which maybe seen in Fig. 375. A piece 
of cloth a yard long and about two feet wide should be placed in the 
box in such a way as to cover the bottom and sides, the edge of the 
cloth hanging over outside of the box. A quantity of dry bran or sand 
should next be placed in the box, a sufficient amount being poured in 
to form a cushion for the foot and lower part of the lfg, to the shape 
of which it should be molded. Bran or sand should be poured in 
around the sides of the leg*. Bran or sand is necessarv onlv in cases in 
which there is a wound, which are very frequent in this form of frac¬ 
ture. Hr. Hamilton’s method of treating fractures of the leg is by 
means of the plaster-of-Paris bandage. Ordinary splints of pasteboard 
or other material may also be successfully used in cases of fracture of 



















DISLOCATIONS. 


1425 


the lower end of the fibula in which the foot is turned to one side. 
The legs should be supported on pillows or cushions, while fomentations 
are applied over the seat of the injury until the inflammation is re¬ 
duced. Then the foot should be bound and held in position by means 
of a splint extending from above the knee to a few inches below, the 
foot. The splint should be carefully stuffed and applied to the inner 
s\de of the limb, the foot being strapped down in such a manner as to 
bring it into its natural position. The plaster-of-Paris splint is also 
applicable to these cases. As the ankle is apt to be stiff*, the splints 
should be removed as early as possible. Passive movements should 
be employed diligently for the purpose of overcoming the stiffness. 

Fractures of the Bones of the Foot.— The bones of the heel and 
the ankle are the most likely to be broken. Fractures of the bones 
of the foot are sometimes very difficult to recognize. Stiffness of 
the ankle joint, with a limping gait, are likely to result from severe 
fracture of the bones. Although union generally takes place quite 
promptly, it is often several months before the patient is able to use the 
foot much in walking. Before splints are applied, hot fomentations 
should be employed to reduce the soreness and inflammation. When 
this has been accomplished, splints should be applied in accordance 
with the principles already explained. 

TUStOCATIOAS. 

Dislocations are often very easily confounded with fractures; in 
fact, the two injuries are often inflicted at the same time. The chief 
distinguishing features of dislocations are, unnatural position of the 
limb, altered shape of the injured joint, and less than the natural degree 
of motion in the joint. Pain and swelling, and more or less discolora¬ 
tion, are also usually found in the vicinity of the affected joint. 

Treatment of Dislocations. —The first thing to be accomplished 
is reduction of the dislocation, or returning of the bone to its natural 
position. This should be accomplished at as early a moment as possible, 
and can generally be done if attempted immediately after the accident 
without any very great difficulty, by simply pulling upon the limb in 
such a way as to draw the bone toward the socket at the same time 
manipulating the displaced end in such a way as to facilitate its return 
to its natural position. One of the great obstacles in the way of re¬ 
ducing a dislocation is the contraction of the muscles, which is in 

90 


142G 


ACCIDENTS AND EMERGENCIES. 


some degree involuntary, though in the greater part voluntary, 
as is shown by the fact that if the patient’s attention is di¬ 
verted, the muscles become relaxed and the process of reduction is 
greatly facilitated. This may generally be accomplished by asking 
the patient a question, or speaking to him in a rather loud and quick 
tone of voice just at the time the reduction is to be attempted. In very 
bad cases the use of chloroform or ether is necessary hi order to caqse 
the muscles to relax. In moderate cases, however, continuous and firm 
pulling upon the limb will, after a time, tire the muscles so that they 
will relax and allow the bone to return to its place. After the reduc¬ 
tion has been accomplished, the limb should be kept perfectly quiet 
until the torn ligaments of the injured tissues shall have had time to 
heal. It is generally necessary to apply bandages to the part, and 
sometimes a splint is required. When there is much pain, swelling, or 
inflammation, hot fomentations should be applied, or a hot shower or 
pour may be used. If hot applications increase the pain, cold or even 
ice compresses should be employed. 

In some cases, alternate hot and cold applications give most relief. 
The drop bath, Fig. 208, is very useful in many of these cases. A 
joint which has been injured by dislocation should be used very little 
for three or four weeks. If it becomes stiffened, hot fomentations and 
gentle manipulations will soon restore it to a useful condition. It 
should be recollected that a bone which has once been put cut of joint, 
is very liable to get out of joint again, and special care should be taken 
to protect it from any violence. 

Dislocation of the Jaw.—Dislocation Is usually recognized by the 
chin being thrown to the opposite side if the displacement occurs but 
on one side, and in wide gaping of the mouth when the dislocation 
occurs upon both sides at once. This accident is most frequently 
caused by yawning or violent laughing. It may be easily reduced by 
passing the thumbs, well protected by a bandage or towel, to the back 
side of the mouth and making a downward pressure upon the back 
teeth. When this is done the muscles of mastication draw the bone 
into place. Care should be taken to avoid a recurrence of the accident, 
to which a person having once suffered is especially liable. 

Dislocation of the Shoulder. —The most common of all disloca- 
cations is displacement of the upper end of the arm-bone into the ax¬ 
illa. This may generally be recognized by measuring the shoulder 


DISLOCATIONS 


1427 


by means of a tape passed under the armpit and over the top of the 
shoulder. If one shoulder is dislocated, it will be one or two inches 
larger than the sound shoulder. This dislocation may usually be easi¬ 
ly reduced in the following manner: The patient being seated in a 
chair, the operator stands by his side, and placing one foot upon the 
edge of the chair, brings his knee into the axilla and forcibly bends 
the arm over it. In case this does not succeed, the patient should lie 
down upon the sofa while the operator, standing by his side, places 
his foot in the armpit, and taking hold of the hand of the patient or of 



Fig\ 376. 


the ends of a stout bandage which is fastened about the arm, pulls 
steadily and with considerable force for one or two minutes; then 
tiring the arm to the center of the body, and the head of the bone 
will almost always slip into its socket at once. 

The old-fashioned plan of reducing dislocations of the shoulder 
was by means of the pulley, as seen in Fig. 376. This method is 
now seldom employed, however. It is found that in many cases 
dislocations of the shoulder can be readily reduced by gentle man¬ 
ipulation applied with very little force. In case a person sud¬ 
denly suffers dislocation of the shoulder while alone, as in the 
/'field, he may succeed in reducing the dislocation himself by reaching 
over a fence and grasping one of the lower boards with the hand of 








1428 


ACCIDENTS AND EMERGENCIES. 


the injured side, then throwing his weight upon the affected side in 
such a way as to sustain the weight of the body by the injured 
shoulder. In some cases the application of an apparatus is necessary 
to retain the dislocated shoulder in position until the lacerated liga¬ 
ments have an opportuity to heal. Fig. 377. 

Dislocations of the Elbow. —When the elbow is dislocated back¬ 
ward, the most common form, the point of the elbow will be found 
projecting much more than naturally, and it will be impossible to 
bend the arm more than to a right angle, though it may be drawn out 
without pain. This dislocation can generally be reduced very easily 

by simply placing the knee in 
the bend of the elbow and bend¬ 
ing the arm around the knee 
while pulling upon it with con¬ 
siderable force. After the dis¬ 
location is reduced, the arm 
should be placed in a sling. 
Hot fomentations should be ap¬ 
plied to relieve soreness, and if 
inflammation threatens, cool or 
ice compresses should be used, as 
much as is necessary. 

Dislocation of the Wrist.— 

This is a very rare displacement. 
It is indicated by an abnormal 
position of the hand and immobility of the wrist joint. All that is 
required is firm pulling upon the hand, which causes the displaced 
bones to slip into position. 

Dislocation from Pulling the Arm. —This is a form of disloca¬ 
tion which occurs in young children in consequence of being pulled 
forcibly by the arm. There is still some question among surgeons as 
to the exact nature of the dislocation, some claiming that the dislo¬ 
cation is at the wrist, and others at the elbow joint. It is probable 
that either joint may be affected. The hand will be found turned 
upon the palm, the patient being unable to turn it backward. All 
that is necessary is to grasp the hand and forcibly turn it upon the 
back, which will cause the bones to resume their proper position. 








DISLOCATIONS. 


1429 


Dislocation of the Thumb and Fingers.— Dislocation of the 
thumb is readily recognized. Fig. 378. Dislocations of the fingers 
are equally evident. These displacements can be readily reduced by 
pulling upon the thumb or fingers. If 
success is not readily obtained, a better 
purchase may be secured by means of a 
very simple contrivance, such as is shown 
in Fig. 379, which can be easily made 
by any one in a few minutes. A piece 
of shingle about a foot in length and an 
inch and a half in width should be per¬ 
forated near one end with two pairs of 
holes, from an inch and a half to two 
inches apart, into which narrow tapes should be passed, by means 
of which the finger should be made fast to the shingle. By grasping 
the short end of the shingle, the operator can readily draw the dis¬ 
located bone into position. 

Dislocation of the Hip. —The simplest plan of treating disloca¬ 
tion of the hip is that known as the automatic method. The patient 
lies upon the floor on his back. The operator raises the injured limb 
to a right angle, and places the foot of the patient between his legs in 
such a way that the back of the foot rests against his sacrum. The 
limb is then firmly grasped just below the knee, and the patient is 
lifted until the hip is raised from the floor. The body should be 




Fig-. 379. 


held in this position for a minute or two, by the end of which time 
the head of the femur will be heard to click into its socket. In case 
the effort is not successful, both limbs should be treated in the same 
way at once. If neither effort is successful after several trials, a sur¬ 
geon should be called ; or if the services of a physician cannot be se¬ 
cured, the method by manipulation may be employed. In this, the op¬ 
erator with one hand grasps the affected limb by the ankle, and flexes 
the limb nearly to a right angle, placing the other hand just below 






1430 


ACCIDENTS AND EMERGENCIES. 


the bend of the knee. The knee should now be carried outward), -the 
limb being also twisted in the same direction and then brought slowly 
down to its natural position. If neither of these means succeed, it 
may become necessary to resort to the old-fashioned method of reduc¬ 
tion, by means of pulleys, as shown in Fig. 380. 

Dislocation of the Knee-Joint. —This form of dislocation is very 
infrequent, owing to the thorough manner in which the knee-joint is 
supported by ligaments. The dislocation is very easily reduced. 
Long-continued treatment is generally necessary, on account of the ex¬ 
tensive injuries done to the soft parts of the surrounding knee. 
Alternate hot and cold applications are generally required, together 



Fig:. 380. 


with perfect rest of the joint for many weeks. In the majority of 
cases the integrity of the joint is rarely fully restored. The patient 
should not attempt to walk upon the limb unless it is supported by a 
bandage of some sort firmly applied. 

Dislocation of the Ankle. —This accident is generally the result 
of jumping. In nearly all cases, more or less fracture of the ends of 
the leg bones also occurs. Dislocation of the ankle joint is always 
present in Pott’s fracture, already described. The dislocation is easily 
reduced by pulling upon the foot and pressing the displaced bones 
into position. Properly prepared splints should be applied to keep the 
parts in position. Hot and cold applications should be made to pre¬ 
vent and relieve inflammation. 

Dislocation of the Bones of the Foot. —Backward dislocations 
at the ankle joint are generally irreducible, on account of the great 
strength of the heel cord, or tendo Achillis. This cord has been 
sometimes divided ; but this should rarely, if ever, be done, since by 
prolonged rest and proper treatment combined, later, with passive ex- 






MISCELLANEO US A CCIDENTS. 


1431 


ercises and persistent efforts on the part of the patient, the foot can be 
made a very useful one, even though the dislocation remains unreduced. 

Other dislocations of various bones of the foot sometimes occur in 
consequence of great violence. They can often be reduced by careful 
manipulation, but in some cases resist all efforts at replacement. The 
displaced bones will generally accommodate themselves to their abnormal 
position sufficiently to render the foot very useful, even though they 
cannot be restored to their proper position. 

Dislocation of the Toes. —This is a very rare accident. It should 
be treated in essentially the same manner as that described for disloca¬ 
tion of the fingers. 


MISCELLANEOUS ACCIDENTS, 

Treatment of the Drowned. —In the treatment of persons in 
whom life seems to be extinct in consequence of drowning, the two 
most essential measures are, the restoration of breathing and of heat. 
Life cannot be long sustained without respiration, neither can the vital 
forces long continue their functions when the temperature of the body 
is very greatly lowered. When respiration is suspended, the greatest 
source of production of heat is cut off, so that the patient may die from 
the depressing influence of cold, although respiration might be fully re¬ 
stored by the use of proper means. The restoration of breathing must 
of course be considered as the first essential; but attention should be 
given to the restoration of heat with almost equal promptness and thor¬ 
oughness. The following rules for the treatment of the drowned were 
prepared by the committee on accidents of the State Board of Health 
of Michigan, for general circulation. They are so concise, and the 
measures of treatment recommended so efficient, that we arc glad to 
quote them without modification, as follows :— 

“Rule 1. —Remove all Obstructions to Breathing. Instantly 
loosen or cut apart all neck and waist bands; turn the patient on his 
face, with the head down hill; stand astride the hips with your face 
toward his head, and, locking your fingers together under his belly, raise 
the body as high as you can without lifting the forehead oft the ground 
(Fig. 381), and give the body a smart jerk to remove the mucus from the 
throat and water from the windpipe; hold the body suspended long 


1432 


ACCIDENTS AND EMERGENCIES. 


enough to slowly count one, two, three, four, five, repeating the jerk 
more gently two or three times. 

“ Rule 2. —Place the patient face downward, and maintaining all 
the while your position astride the body, grasp the points of the shoul- 



Fig. 381. 


ders by the clothing, or if the body is naked, thrust your fingers into 
the armpits, clasping your thumbs over the points of the shoulders, and 
raise the chest as high as you can (Fig. 882) without lifting the head 



Fig-. 382. 


quite off the ground, and hold it long enough to slowly count one, two, 
three. Replace him on the ground, with his forehead on his flexed arm, 
the neck straightened out, and the mouth and nose free. Place your el- 

O ' v 















Henbane. 



Sheep Laurel. 

Plate XXL 













RESTORING TEE DROWNED. 


14-33 


bows against your knees, and your hands upon the sides of his chest 
(Fig 383) over the lower ribs, and press downward and inward with 
increasing force long enough to slowly count one, two. Then suddenly 
let go, grasp the shoulders as before and raise the chest (Fig. 382); then 
press upon the ribs, etc. (Fig. 383). These alternate movements should 
be repeated ten to fifteen times a minute for an hour at least, unless 
breathing is restored sooner. Use the same regularity as in natural 
breathing. 

“ Rule 3.—After breathing has commenced, restore the animal heat. 
Wrap him in warm blankets, apply bottles of hot water, hot bricks, or 
anything to restore heat. Warm the head nearly as fast as the body, 
lest convulsions come on. Rubbing the body with warm cloths or the 
hand, and slapping the fleshy parts, may assist to restore warmth, and 



the breathing also. If the patient can surely swallow, give hot coffee, 
tea, milk, or a little hot sling. Give spirits sparingly, lest they produce 
depression. Place the patient in a warm bed, and give him plenty of 
fresh air; keep him quiet. 

“ Avoid delay. A moment may turn the scale for life or death- 
Dry ground, shelter, warmth, stimulants, etc., at this moment are noth¬ 
ing,— artificial breathing is everything, —is the one remedy, —all others 
are secondary. 

“ Do not stop to remove wet clothing before efforts are made to re¬ 
store breathing. Precious time is wasted, and the patient may be fatally 
chilled by exposure of the naked body, even in summer. Give all your 
attention and effort to restore breathing by forcing air into, and out of, 
the lungs. If the breathing has just ceased, a smart slap on the face, or 
a vigorous twist of the hair will sometimes start it again, and may be 









1434 


ACCIDENTS AND EMERGENCIES 


tried incidentally, as may, also, pressing the finger upon the root of the 
tongue. 

‘ Before natural breathing is fully restored, do not let the patient lie 
on his back unless some person holds the tongue forward. The tongue 
by falling back may close the windpipe and cause fatal choking. 

“ If several persons are present, one may hold the head steady, keep¬ 
ing the neck nearly straight; others may remove wet clothing, replacing 
at once clothing which is dry and warm; they may also chafe the limbs, 
and thus promote the circulation. 

“ Prevent friends from crowding around the patient and exclud¬ 
ing fresh air; also from trying to give stimulants before the patient 
can swallow. The first causes suffocation; the second, fatal choking. 



Fig. 384. 

“Do not give up too soon. You are working for life. Any time 
within two hours you may be on the very threshold of success without 
there being any sign of it.” 

Figs. 384 and 385 illustrate the method employed by the U. S. Life- 
Saving Service. The patient upon being taken from the water “ is turned 
upon his face, a large bundle of tightly rolled clothing is placed beneath 
the stomach, and the operator presses heavily upon his back over the 
bundle for half a minute, or as long as fluid flows freely from his mouth. 
Fig. 384. 

“ The mouth and throat are then cleared of mucus by introducing 
into the throat the end of a handkerchief wrapped closely around the 










RESTORING TIIE DROWNED. 


1435 


forefinger, the patient is turned upon his back, under which the roll of 
clothing is placed so as to raise the pit of the stomach above the level 
of any other part of the body. If an assistant is present, he holds 
the tip of the patient’s tongue, with a piece of dry cloth, out of one 
corner of the mouth, which prevents the tongue from falling back and 
choking the entrance to the windpipe, and with his other hand grasps 
the patient’s wrists and keeps the arms stretched back over the head 
which increases the prominence of the ribs, and tends to enlarge the 
chest. The operator then kneels astride the patient’s hips and presses 
both hands below the pit of the stomach, with the balls of the thumb 
resting on each side of it and the fingers between the short ribs, so as 
to get a good grasp of the waist. Fig. 385. He then throws his weight 
forward on his hands, squeezing the waist between them with a strong 



Fig-. 385. 


pressure, while he counts slowly one, tivo, three, and, with a final push, 
lets go, which springs him back to his first kneeling position.” 

Sylvester’s Method. —After clearing the mouth of dirt and saliva, 
and drawing the tongue forward, the patient is laid upon the back with 
the shoulders and head slightly raised. The operator then kneels behind 
his head, grasps the arms just above the elbows, and draws them stead¬ 
ily upward until they meet above the head. By this means, the ribs are 
elevated, and inspiration is produced. The arms are then brought down to 
the sides of the chest, the ribs being compressed against the chest, so as 
to produce expiration. These movements are to be repeated twelve to 
sixteen times a minute. 

The application of electricity, and the use of alternate hot and cold 
applications to the spine, are of service in cases in which they can be 
used efiicientl} 7 '; but they should not be allowed to interfere with artifi¬ 
cial respiration, which is the most important of all measures. In suffoca- 













1436 


ACCIDENTS AND EMERGENCIES. 


tion, choking, strangling, hanging, and whenever respiration is sus¬ 
pended by any cause whatever, the methods of artificial respiration de¬ 
scribed should be employed. In case of suspended respiration from the 
use of chloroform or any anaesthetic, the head should be placed lower 
than other parts of the body, so as to favor the circulation of the blood 
in the brain. In fact, standing the patient upon the head, is of almost 
as much importance as artificial respiration. 

Lightning-Stroke. —Suspended respiration inconsequence of light¬ 
ning-stroke, also calls for the application of artificial respiration. Any 
one of the methods above described may be employed. Burns, frac¬ 
tures of the bones, paralysis, and various other injuries which result by 
injury from lightning, should be treated as when produced by other 
causes. 

Freezing. —Parts which have been frozen should not be thawed too 
quickly, as more harm will be done by the rapid thawing than by 
the freezing. If a person has been exposed to the cold so long that con¬ 
siderable portions of the body are frozen, he should be carefully kept 
away from the fire or a very warm room, being first brought into a room 
of quite low temperature, where the frozen parts should be rubbed with 
melted snow, or very cold water, until they become pliable. The tem¬ 
perature of the room should be gradually raised, as the parts are thawed. 
Sometimes it is necessary to continue rubbing for several hours before 
the interrupted circulation is restored. After this has been accomplished, 
the parts should be anointed with sweet oil or vaseline. By this course, 
much of the injury which generally results from freezing may be 
avoided. 

If ulceration takes place, the sore should be treated as directed for 
burns. 

If a person finds himself in danger of freezing, through exposure in 
the open country in very cold weather, he should resolutely resist the 
drowsiness which will come over him and keep moving until the last. 
If a piercing wind is blowing, he should take shelter in some hollow 
in which there may be an accumulation of snow. The snow itself is 
not a bad protector from the cold, so that a person would be much 
safer if buried in a snow-bank than when exposed to the wind. 

Clothes oil Fire. —A little presence of mind at the moment when 
clothing takes fire, will generally prevent the frightful burns, often fol¬ 
lowed by fatal consequences, which occur by the clothing taking fire. 


SWALLOWING FOREIGN BODIES. 


1437 


On the occurrence of this accident, from whatever cause, the individ¬ 
ual should at once envelop himself in a blanket, cloak, shawl, carpet, 
rug, or any other article by means of which the flames may be smoth¬ 
ered. lire cannot bum without air. By depriving the fire of oxygen, 
the flames may be speedily extinguished. Fig. 386 illustrates the ap¬ 
plication of this method to a child. 

Swallowing Foreign Bodies. —Small coins, buttons, and other 
round objects, generally create no very great disturbance if they reach 
the stomach, as they usually do. Much unnecessary alarm is often 
felt when articles of this kind have been swallowed. It is well to 
remember, in these cases, the ingenious remark of an eminent physician, 
to a mother who was much troubled because her son had swallowed a 



quarter. He assured her that she need have no fears if she was sure the 
quarter was a good one, for good quarters would always pass. Pins and 
needles swallowed often find their way to the surface of the body after 
working through the tissues, sometimes for months and even years. 
Angular bodies sometimes do considerable harm, not only during the 
act of swallowing, by laceration of the gullet, but after reaching the 
stomach, in passing through this organ to the intestines. In order to 
obviate, as much as possible, the danger of injury from objects swal¬ 
lowed, the patient should be directed to eat freely of rather coarse vege¬ 
tables, so as to distend the stomach and bowels. 

Choking- —Sometimes portions of food, or foreign bodies of vari¬ 
ous sorts, become lodged in the throat in such a way as to produce in¬ 
terference with respiration by choking. The head should be held low, 
and an effort should be made to remove the obstruction with the fin¬ 
ger. The advice “ to go down on all fours and cough ” is excellent. 
The plan usually followed by mothers in case of choking in children, 






















1438 


ACCIDENTS AND EMERGENCIES. 


holding the head down, and striking the back vigorously, is a good one 
Pressing upon the Adam’s apple, will sometimes cause an obstruction 
to be expelled. When a body becomes lodged in the gullet, much dif¬ 
ficulty is sometimes experienced in dislodging it. It is sometimes 
necessary to pass an instrument down the throat for the purpose. 
What is known as the bristle probang, shown in Fig. 387, is the best 
instrument for this purpose. 

Very small fish-bones can usually be dislodged from the throat by 
swallowing some rather hard food, as crackers or a crust of bread 
coarsely chewed; but when larger bones are caught in the throat no 
attempt should be made to push them down, as is often done. They 
should be removed from above by a surgeon. 

Dirt ill the Eye. —Dirt on the eye would be a more proper ex¬ 
pression, as foreign bodies lodged upon the surface of the eyeball, or 



Fig. 387. 


beneath the lids, are not really in the eye, but upon it. Although they 
sometimes cause serious mischief, as well as much pain and inconven¬ 
ience, they are by no means so dangerous as foreign bodies lodged in 
the eye, or within the eyeball. Particles of sand, dust, or other sub¬ 
stances in the eye, may be very easily removed by the corner of a 
handkerchief, or by drawing the upper lid away from the eye, and 
gently stroking over it in a downward direction. Violent blowing of 
the nose, with the eyes tightly shut, will often suffice to remove par¬ 
ticles which are not imbedded in the mucous membrane. Little bodies 
known as eye-stones, obtained from certain mollusks, have no specific 
virtue, although they are often used for the purpose of removing dirt 
from the eye. Flaxseed is often employed for the same purpose. The 
way in which these objects operate is by producing a profuse flow of 
tears, which carries away the obstruction. They are not to be recom¬ 
mended. When particles of iron, cinders, or other foreign substances 
are imbedded in the mucous membrane, some blunt instrument may 








FOREIGN BODIES IN TI1E NOSE OR EAR. 


1439 


generally suffice to effect a removal, unless the cornea is the part in¬ 
volved. When the part is imbedded in the cornea, care should be used 
in attempting to dislodge it, that it is not pushed farther into the tis¬ 
sues. Such particles may generally be dislodged in the following man¬ 
ner . Let the patient hold the eye perfectly still, while the operator 
passes back and forth before the cornea, and over the object, a knife 
with a sharp smooth blade, gradually approaching nearer to the sur¬ 
face, until finally the foreign body is removed. When this is skillfully 
done, the eye may not be detached at all, as the foreign body generally 
protrudes a little above the membrane. If the particle is imbedded in 
the eye so deeply that it cannot be removed by any of the means de¬ 
scribed, a surgeon should be at once consulted, as much injury may re¬ 
sult if the obstruction is not speedily removed. 

Lillie ill the Eye. —The intense burning of lime, or other caus¬ 
tics in the eye, is speedily relieved by the application of a little diluted 
vinegar, or lemon juice. The eye should also be thoroughly washed. 
Water should be first applied, as it is generally most convenient. A 
solution of sugar is also recommended for neutralizing lime, as it 
combines with it to form a saccharate of lime. 

Foreign Bodies in the Ear.—Small objects, and sometimes insects, 
are frequently gotten into the ear. In some instances flies have been 
known to deposit their eggs in the ear, which in due time were hatched 
into a numerous progeny of grubs. In attempting to remove objects 
from the ear, great care should be taken that more harm than good is 
not done. By far the best of all measures for this purpose is gently 
syringing the ear with tepid water. The head should be bent to one 
side, and by means of the fountain syringe elevated to a sufficient height 
to give a moderate force, a stream of water should be directed into the 
ear for some minutes. In nearly every instance the foreign substance 
will be removed. If the foreign body is an insect, a little glycerine 
may be introduced into the ear with a camel’s hair brush, or a feather. 
If these measures do not succeed, a loop of fine wire or horse-hair may 
often be employed with success. 

Foreign Bodies in the Nose. —Foreign bodies introduced into the 
nose, if not crowded too far up by injudicious attempts at removal, 
may generally be quite readily removed by forcibly blowing the nose, 
the mouth and the unobstructed nostril being tightly closed. Another 
plan is to blow the patient’s nose for him by closing the empty nostril 


1440 


ACCIDENTS AND EMERGENCIES. 


with the finger, and then blowing suddenly and strongly into the 
mouth. The glottis closes spasmodically, and the whole force of the 
breath goes to expel the button or bean, which commonly flies out at 
the first effort. This plan lias the great advantages of exciting no terror 
in children, and of being capable of being at once employed, before de¬ 
lay has given rise to swelling and impaction. Sometimes the obstruc¬ 
tion can be expelled by exciting sneezing. Care should be taken to 
avoid crowding the object further in. A loop of wire, or blunt hook, 
may in some cases be successfully used. A hair-pin answers very well 
for this purpose. The loop end should be first employed, and if this 
does not answer the purpose, one of the other ends should be slightly 
bent in the form of a hook. A hair-pin may be used as a pair of pin¬ 
cers in the absence of a better instrument. If the object is not tightly 
imbedded, or if it is of a soluble character, it may be washed out, mak¬ 
ing the water from a syringe pass up the unobstructed nostril and out 
at the one containing the foreign body, or by use of the post-nasal 
douche. 


ACCIDENTAL POISONING, 

The human race is exposed to danger from poisoning on every hand. 
These enemies to life are not only produced in the various arts in which 
man is engaged, but are produced in profusion by nature under various 
circumstances, and often under such specious guises as to render the 
most constant vigilance necessary to avoid injury. The materia medica 
also affords a long list of poisons, many of which are the most rapidly 
fatal of any known. Thus man is surrounded on every hand with 
danger to life from either direct or indirect poisoning, in addition to all 
the various other causes of disease to which attention has been more 
specially called in previous portions of this work. 

In the strictest sense, a poison is any substance, which, when re¬ 
ceived into the body, occasions morbid action or disorders of the vital 
functions, since anything may become a poison if taken in suf¬ 
ficient quantity, as a person may be made sick by overeating, even of 
the most wholesome food. The general usage of the term, however, 
confines its application to such substances as when received into the 
body are capable of producing death or severe illness. An antidote is 
some substance capable of neutralizing, or favorably modifying, the in¬ 
jurious effects of the poison upon the system. 



Yellow Jessamine. (fJelseminmn.) 



May Apple, or Mandrake. (Podophyllum.) 

Platk XXII 























ACCIDENTAL POISONING. 


1441 


General Treatment for Poisoning. —Whatever treatment is em¬ 
ployed should be applied with the utmost promptness and thoroughness 
As a general rule, the first thing to be thought of is an emetic. A tea¬ 
spoonful of ground mustard, or an equal quantity of powdered alum 
in a goblet of warm water, generally acts with promptness. If neither 
alum nor mustard are at hand, a teaspoonful of salt may be taken in 
the same way, or tepid water alone may be employed, and if taken 
rapidly and in sufficient quantity, vomiting will be very likely to occur. 
In case it is not produced promptly, the throat should be tickled with 
the finger or a feather An eminent physician has recommended the 
following as a general antidote for poisons. It renders insoluble such 
poisons as zinc, arsenic, digitalis, etc., and so makes them inert. A 
saturated solution of sulphate of iron, two ounces; calcined magnesia, 
two ounces; washed animal charcoal, or bone-black, one ounce. The 
iron solution should be kept in one bottle, and the calcined magnesia 
and charcoal in another. When wanted for use, add the contents of 
the two bottles to a pint of water, shake thoroughly, and take from 
three to six tablespoonfuls. 

Specific Methods of Treatment in Cases of Poisoning.— 

Nearly all cases of poisoning may be successfully treated by means 
of some one of the the following methods, the particular application of 
which is pointed out in the alphabetical list of poisons which follows 
them :— 


METHOD 1. 

Give the patient at once a teaspoonful of ground mustard or pow¬ 
dered alum in a glass of warm (not hot) water, giving afterward sev¬ 
eral glasses of warm water. If vomiting is not quickly produced, 
tickle the throat with the finger or with a feather. Repeat the vomit¬ 
ing until certain that the stomach is completely empty. If the poison 
is of an irritating character, give milk or white of egg after vomiting. 

METHOD 2. 

ALKALIES. 

Give two or three tablespoonfuls of vinegar in half a glass of water, 
or the juice of two or three lemons, then give three or four tablespoon¬ 
fuls of olive oil and a large draught of milk. Do not give emetics nor 
use the stomach-pump. Ammonia, a volatile alkali, when inhaled, 

91 


1442 


ACCIDENTS AND EMERGENCIES. 


should be antidoted by the inhalation of the vapor of hot vinegar by 
means of a vapor inhaler or an ordinary tea-pot. 

METHOD 3. 

ACIDS. 

Give a teaspoonful of baking soda in a glass of milk or water. In 
the absence of soda, give a teaspoonful of soft soap or an equal quan¬ 
tity of shaved hard soap, magnesia, or chalk. Give white of egg and 
plenty of milk ; but do not use emetics nor the stomach-pump. 

METHOD 4. 

METALLIC POISONS. 

Give white of egg, either clear or stirred in a little cold water, and 
a mustard or alum emetic. After patient has vomited freely, give 
plenty of milk or white of egg, or a thin mixture of wheat flour and 
milk. Do not wait to get the egg if it is not convenient, but give 
emetic at once and egg afterward. 

METHOD 5. 

NARCOTIC POISONS. 

Give two or three tablespoonfuls of powdered charcoal. If a sup¬ 
ply is not ready at hand, take a coal from a wood fire, quench it, fold 
in a towel and crush as fine as possible with a hammer or mallet. 
Next apply Method 1, or excite vomiting while the charcoal is being 
prepared. After the patient vomits, give charcoal again freely. It 
will do no harm in almost any quantity. Apply ammonia to the nos¬ 
trils, give strong tea or coffee, and make alternate hot and cold appli¬ 
cations to the spme. Also apply friction to the surface, and arouse 
the patient by walking him about, if possible. When the respiration 
becomes very weak, artificial respiration should be resorted to. 

METHOD 6. 

COMPOUNDS OF ARSENIC. 

Apply Method 1, and soon as possible give the sediment, or precipi¬ 
tate, obtained by adding ammonia or soda to tincture of muriate of 
iron. The precipitate should be thrown on a towel and rinsed with 
clean water two or three times. The tincture of iron can be obtained 


ACCIDENTAL POISONING. 


1443 


at any drug-store, and should always he kept in the house whenever 
arsenic in any form is kept. It is well to give milk and white of egg 
freely after the patient vomits. 

METHOD 7 . 

Apply Method 1, then give strong tea or decoction of oak-hark, or 
infusion of tannin. 

3IIETTIOI) 8. 

Pour cold water on the head, make alternate hot and cold applica¬ 
tions to the spine, and resort to artificial respiration. Hot fomentations 
over the heart are useful to excite this organ to increased activity when 
it is flagging. Artificial warmth, friction to the surface, and t]ie in¬ 
halation of ammonia are also useful measures. In case of asphyxia 
from anaesthetics, the patient should be held with the head downward 
while artificial respiration is being practiced. 

METHOD O. 

Apply Method 1 and then make cold applications to the head, hot 
and cold applications to the spine, and surround the patient with hot 
bottles or hot-water bags, or administer a hot bath or a hot blanket 
pack. Apply a hot fomentation over the heart. Make patient drink 
copiously of hot drink of some kind. 




1444 


ACCIDENTS AND EMERGENCIES. 


POISONS AND THEIR ANTIDOTES, 


NAME 

ANTIDOTE 

NAME 

ANTIDOTE 

0 F 

AND 

OF 

AND 

POISON. 

TREATMENT. 

POISON. 

TREATMENT. 

Acid, Acetic. 

Method 3. 

Chlorine Gas,. 

Method 8 and inhalation 

Acid, Muriatic or Hy- 



of ammonia, ether or 

drochlorie . 

Method 3. 


alcohol, and steam. 

Acid, Nitric. 

Method 3. 

Caustics (See Acids and 


Acid, Sulphuric .. 

Method 3. 

Alkalies),. 


Acid, Hydrocyanic or 


Chloral, . 

Methods. Artificial ins¬ 
piration with head. 

Prussic. 

Method Sand inhalation 



of ammonia and chlo- 


down. 


rine from moist chlo- 

Chloroform, . 

Methods. Artificial res- 


ride of lime. 

piration with head 

Acid, Citric. 

Method 3. 


down. 

Acid, Oxalic. 

Method 3. Give also 

Chloride of Iron,. 

Method 1, magnesia, 


powdered chalk or 


plenty of tea. 


plaster, sweetened 

Chromium,. 

Method 1, magnesia or 


lime-water, and milk. 

chalk in milk, white 

Acid, Arsenious . 

Method 6. 


of egg. 

Acid, Carbolic. 

Method 3. 

Cocculus Indicus, . 

Method 5. 

Aconite. 

Method 5. 

Colchicum,. 

Method 5. 

Alcohol,. 

Method 5. 

Copper and its com- 


Aloes,. 

Method 1. 

pounds,. 

Method 4. 

Alum,.. 

Method 1. 

Copperas,. 

Method 1, magnesia, 
large drafts of tea. 



Ammonia,. 

Method 2 and inhala¬ 
tion of steam for sev- 

Corrosive Sublimate, .. 

Method 4. 


eral hours. 

Cotton Root,. 

Method 1. 

Ana;sthetics, . 

Stimulants, artificial 

Creosote,. 

Method 3. 


respiration. 

Cream of Tartar,. 

Method 1. 

Antimony,.. 

Method 7. 

Croton Oil,. 

Warm-water emetic. 

Arsenic and its prepa- 



milk, and white of 

rations. 

Method 6. 


eggs. 

Atrophia,. 

Aqua Fortis,. 

Method 5. 

Method 3. 

Cyanide of Potash, .... 

Method 8 and inhala¬ 
tion of ammonia and 
of chlorine from moist 

Aqua Regia,. 

Method 3. 


chloride of lime. 

Barium and its com- 


Deadly Nightshade, ... 

Method 5. 

pounds,. . 

Method 1 and Glauber's 
or Epsom salts. 

Digitalis,. 

Method 5 with fomenta¬ 
tions over the heart. 

Belladonna,. 

Method 5. 

Elaterium, . 

Method 1 

Bitter Almonds,essence 
or oil of.».. 

Methods and inhalation 

Ergot,. 

Method 1. 


of chlorine from moist 

Ether,. 

Method 8 with the head 


chloride of lime. 


down. 

Bitter Sweet,. 

Method 1. 

Fungi,. 

Method 9. 

Bismuth,. 

Method 4. 

Fool’s-Parsley. 

Method 9. 

Blue Vitriol. 

Method 4. 

Fox-glove,. 

Method 5. 


Inhalation of ammonia 
and vapor of alcohol. 

Gases, poisonous. 

Method 8. 


Gamboge, . 

Method 1. 

Calabar Bean,. 

Method 5. 

Garden Nightshade, ... 

Method 5. 

Calomel, . 

Method 4. 

Gelsemium,. 

Method 5. 

Camphor,. 

Method 1. 

Green, Paris. 

Method 6. 

Cantharides, . 

Method 1. 


Method 1, magnesia and 
copious drafts of tea. 

Carbolic Acid, .. 

Method 3. 


Carbonic Acid Gas, .... 

Method 8. 

Hartshorn,. 

Method 2. 

Carbonic Oxide Gas,... 
Castor Oil Seeds, . 

Method 8. 

Method 5. 

Hellebore, . . 

Method 5. 

Hemlock,. 

Method 5. 

Coal Gas,.. 

Method 8. 

Henbane. 

Method 5. 















































































POISONS AND THEIR ANTIDOTES. 


1445 


NAME 

0 F 

POISON. 

ANTIDOTE 

AND 

TREATMENT. 

Hydrochloric Acid, .... 

Method 3. 

Hydrocyanic Acid,. 

Method 8 (See Cyanide 

Hyoscyamns,. 

of Potash) 

Method 5 

Indigo,. 



milk. 

Iodine,. 

Method 1 and starch or 

Iodide of Potash. 

flour paste. 

Method 1. 

Iron. Chloride and Sul¬ 
phate of .. 

Method 1, magnesia and 

Jalap,. 

plenty of tea. 

Method 1. 

Laudanum, . 

Method 5. 

Lead and its comp'nds, 

Method 4 and Glauber’s 

Litharge,. 

or Epsom salts in 
tablespoonful doses 
in milk. 

Method 4 and Glauber’s 

Lime,.. 

or Epsom salts in 
tablespoonful doses 
in milk. 

Method 3, large doses 

Lobelia, Ind’n Tobacco, 

of sugar. 

Method 9. 

Lunar Caustic,. 

Method 4. 

Mercury, its comp’nds, 

Method 4. 

Monk’s-hood,. 

Method 5. 

Morphia,. 

Method 5. 

Muriatic Acid,. 

Method 3. 

Mushrooms,. 

Method 9. 

Narcotics,. 

Method 5. 

Nicotine,. 

Method 9. 

Nightshade. 

Method 5. 

Nitrate of Silver,. 

Method 4. 

Nitrate of Potash,. 

Method 1. 

Nitrate of Mercury,.... 

Method 4. 

Nitre,. 

Method 1. 

Nitric Acid,. 

Method 3. 

Nitro-Benzol, . 

Method 9. 

Nitrous-Oxide Gas,.... 

Method 8. 

Nitro-Muriatie Acid,... 

Method 3. 

Nux Vomica,. 

Methods 1 and 8. Inha- 

Oil, Pennyroyal.. 

lation of chloroform. 
Method 1. 

Oil, Savine. 

Method 9. 

Oil, Tansy. 

Method 9. 

Oil, Vitriol. 

Method 3. 

Oleander,. 

Method 9. 

Opium and its comp’ds. 

Method 5. 

Oxalic Acid,. 

Give pulverized plaster 

or chalk, or sweetened 
lime-water, and milk. 

Paris Green,. 

Method 6. 

Peach-pits,. 

Method 9. 

Pearlash,. 

Method 2. 

Potato Balls,. 

Method 9. 

Potato Sprouts,.. 

Method 9. 


NAME 

0 F 

POISON. 

ANTIDOTE 

AND 

TREATMENT. 

Phosphorus,. 

Method 1 and skim- 
milk. Do not give oil. 

Poke,. 

Method 5, 

Potash,. 

Method 2. 

Potash, Bitartrate of.. 

Method 1 

Potash, Bichromate of 

Method 4. Also give 
chalk or magnesia. 

Potash, Cyanide of. 

Method 8 (See Cyanide 
of Potash). 

Potash, Nitrate of_ 

Method 1. 

Potash, Sulphate of_ 

Method 1. 

Prussic Acid, .. 

Method 8. Inhale am¬ 
monia and chlorine 
from moist chloride 
of lime. 

Pulsatilla,. 

Method 5, 

Quicklime,. 

Method 2. 

Rhubarb,. 

Method 1. 

Red Precipitate,. 

Method 4. 

Savine, . 

Method 9. 

Silver, Nitrate of. 

Method 4. 

Soothing Syrups,. 

Method 5. 

Soda, Caustic. 

Method 2. 

Spigelia, . 

Method 5. 

Stramonium,. 

Method 5. 

Strychnia,. 

Methods 1 and 8, inha¬ 
lation of chloroform. 

Sugar of Lead,. 

Method 4, Glauber’s or 
Epsom salts in table¬ 
spoonful doses in 
milk. 

Sulphate of Copper,.... 

Method 4. 

Sulphate of Iron,. 

Method 1, magnesia and 
tea. 

Sulphate of Zinc,. 

Warm-water emetic, 
plenty of milk. 

Snlphureted Hydrogen, 

Method 8. 

Sulphuric Acid,. 

Method 3. 

Sulphurous Acid Gas, 

Method 8. 

Tartaric Acid,. 

Method 3. 

Tartar Emetic,. 

Method 7. 

Thorn-apple, .. 

Method 5. 

Tin, compounds of. ... 

Method 1. 

Toadstools,. 

Method 9. 

Tobacco,. 

Method 9. 

Veratrum,.«... 

Method 7. 

Verdigris,. 

Method 4. 

Vermilion,. 

Method 4. 

White Lead,... . 

Method 4. Glauber’s or 

Epsom’s salts in table¬ 
spoonful doses in 
milk. 

Water Hemlock,. 

Method 5. 

White Vitriol, . 

Warm water emetic, 
milk. 

White Precipitate,- 

Method 4 . 

Wolf’s-bane,. 

Method 5. 

Yew,. 

Method 9, 

Zinc, Chloride of . 

Method 1. 





















































































SURGERY. 


ABSCESS. 

Siqipurcition, or the formation of pus, is one of the results of in¬ 
flammation. Pus, or matter, is generally supposed to be composed of 
foul elements from the blood; but it has been shown by careful micro¬ 
scopical examination that pure pus is chiefly made up of corpuscles or 
globules, so closely resembling the white globules of the blood as to be 
almost indistinguishable from them. There is some discussion among 
pathologists as to the source of these corpuscles, some claiming that 
they are really white blood corpuscles which have left the blood-ves¬ 
sels, while others claim that they are formed in the tissues where the 
pus is produced. Recent investigations on the subject seem to show 
that both views are in a measure correct, both the blood and the tissues 
Contributing to the formation of pus. 

Pus may be formed upon an open surface, as in the suppuration of 
a wound, or it may be confined in a cavity in the tissues. The accu¬ 
mulation of pus in the tissues is termed an abscess. When such an ac¬ 
cumulation is the result of acute inflammation, it is termed an acute 
abscess. The occurrence of suppuration in an inflamed part is generally 
indicated by a marked increase of pain and fever. The pain is generally 
described as heavy. When the abscess is near the surface, the swelling 
becomes pointed, and feels soft under the finger. By degrees, the outer 
wall of the abscess becomes thinner, until finally the red color disappears 
and little blisters are seen just beneath the surface of the skin, which 
mark the point at which the opening is usually formed, being at first 
a small, round hole which is soon considerably enlarged by ulceration. 
In some cases abscess, or formation of pus, is indicated by a chill, or 
several chills in succession. This is especially the case in abscess of the 
liver, kidneys, and ovaries. Abscesses in internal organs are also often 
accompanied by profuse sweats. 

Treatment. —There is a natural tendency in pus to work toward 
the surface. The general system is usually protected from the ab¬ 
sorption of pus by a wise provision of nature in surrounding the pur- 
1446 



BOILS. 


1447 


ulent matter with a wall of resistance which prevents its absorption. 
When an abscess occurs near the surface, it should be treated by hot 
fomentations or poultices, and may generally be allowed to open and 
discharge by the natural process unless it is so situated that an ob¬ 
jectionable scar would result. Large abscesses should be opened freely 
by means of the scalpel, Fig. 388, bistoury, Fig. 389, or lancet. 

Chronic abscesses are sometimes difficult to cure, on account of the 
discharge being kept up. In these cases, it is necessary to wash out 
the cavity of the abscess daily with carbolic acid lotion, ten or 
twenty drops to the ounce of water. In some cases, permanganate of 
potash, two ounces to the pint of water, and a weak solution of iodine, 



Fig-. 388. 



Fig-. 389. 


are useful. An excellent means of lessening the amount of discharge 

o o 

from a large abscess is to inject a saturated solution of tannin. 

BOILS-FURraCLES. 

A boil originates in the death of a small portion of the skin, which 
generally involves a sweat, or sebaceous, gland. Inflammation is the 
natural process by which the portion of dead tissue is separated from 
the living. The boil first appears as a red and somewhat painful 
nodule in the skin, about the size of a bean or pea. Very soon a 
white point forms at the apex, swelling spreads about the center, usu¬ 
ally attaining about the size of a dollar. At the end of four or five 
days, the* central portion, marked by a white point, becomes loosened, 
and a discharge occurs consisting of a plug or core, together with mat¬ 
ter, blood, and fragments of dead tissue. The suppuration generally 
ceases in three or four days. 

Treatment. —Boils may often be cut short if treated early by 
continuous applications of ice. Dr. Eade, of London, claims to have 
discovered that boils and carbuncles are parasitic diseases, and that the 














































1448 


SURGERY. 


proper treatment is very strong carbolic acid injected into the center of 
the boil by means of the hypodermic syringe. The best plan to be recom¬ 
mended for general employment is the early application of hot fomen¬ 
tations, by which the pain may be relieved and the natural process 
hastened. When there is a great deal of general irritability, warm full 
baths are very advantageous. 

If the boil does not open promptly, it should be freely lanced, after 
suppuration has taken place, as shown by softening. Warm poultices 
should be continued after lancing. Blind boils should be lanced and 
poulticed. The practice of squeezing boils is a very injurious one, as the 
matter is thereby dispersed into the surrounding tissues, often producing 
a numerous crop of boils in the vicinity of the first one. The discharge 
of matter should be secured by a large opening and gentle pressure. 

CARBUNCLES. 

The carbuncle is a sort of compound boil, the several centers of 
suppuration being joined together. Carbuncles differ from boils, how¬ 
ever, in the fact that they have a marked tendency to spread, and 
generally involve much more of the deeper portions of the connective 
tissue. Malignant pustule is a bad form of carbuncle communicated 
to man by infection from animals suffering with murrain or charbon. 
This form is quite often fatal. It may be contracted by handling the 
flesh or hides of animals which have died with the disease. 

Treatment. —This affection may be treated after the same plan 
recommended for boils, but requires greater attention to the general 
health of the patient, as carbuncles seldom occur except when there is a 
very low state of the blood. An eminent Dublin physician recommends 
very highly the application of pressure, by means of strips of adhesive 
plaster applied over the carbuncle, beginning at the outer margin and 
covering all except two and a half inches in the center, which is left 
for the discharge. The strips will be loosened in a day or two, and 
must be renewed as the swelling decreases. A ten-grain solution of 
carbolic acid is a very excellent lotion for treating carbuncles after 
sloughing has taken place. Permanganate of potash, ten to twenty 
grains to the ounce, should be used when there is a fetid odor. 

BED-SORES. 

These are generally produced by pressure from lying too long 
in one position. The best treatment is the employment of preventive 
measures, which consist in perfect cleanliness of the parts and daily 


ULCERS. 


1449 


rubbing with alcohol, a saturated solution of alum, or alum and tan¬ 
nin, and rubbing the parts with gycerine twice a day after washing. 
When the bed-sore is formed, its suppuration may be hastened, and the 
foul odor corrected, by sprinkling over the sore dry powdered char¬ 
coal. An excellent healing application consists of finely powdered 
iodoform, which should be sprinkled over the surface of the sore, lint 
saturated with carbolized oil, ten drops to the ounce, being afterward 
applied for protection. A remedy which has been very highly recom¬ 
mended is galvanic electricity, generated and 
applied by means of silver and zinc plates. 

The whole sore should be covered with a 
thin silver plate, which may be made from a 
silver dollar by hammering it out thin. In 
the immediate vicinity, upon the sound tis¬ 
sues, should be placed a zinc plate of about 
the same size, a single thickness of flannel 
intervening between the zinc and the skin. 

The cloth should be kept moistened with vine¬ 
gar, by the action of which upon the zinc 
the electric current will be generated. Some observers claim 
to have seen large sores heal over in twenty-four to forty-eight 
hours under treatment by this method. By the use of an air cushion, 
Fig. 387, pressure may be taken off the affected part, and healing thus 
facilitated. In some cases it becomes necessary to partially suspend the 
patient by means of a swing. 



DAVIDSON RUBBER CO. 

Fig. 390. 


ILCERS. 

An ulcer is a wounded or raw surface which shows no tendency 
to heal. It generally starts from inflammation. An irritable ulcer is 
one which is red, sensitive, protrudes, and bleeds freely. The little 
red points, or granulations, are painful to the touch. A fungous ulcer is 
one in which the granulations are considerably elevated by exuberant 
growth, commonly termed proud flesh. Callous ulcers are those which 
have thick and hardened margins. These ulcers are generally very 
inactive, are quite deep, and have rounded edges and a glazed surface. 

Treatment. —Irritable ulcers should be treated by the application 
of nitrate of silver, or of a hot iron, by means of which the irritable 
surface will be destroyed. They should afterward be compressed by 
means of strips of adhesive plaster. If this treatment cannot be em- 


1450 


SURGERY. 


ployed, carbolic acid ointment and other mild ointments should be used. 
Sprinkling the surface with powdered iodoform will often relieve the 
pain of irritable ulcers. Iodoform may also be used in the form of an 
ointment, two to four drams to the ounce of vaseline. 

Fungous Ulcers require the application of remedies for the purpose 
of destroying the fungous granulations. Nitrate of silver, or a hot 
iron, may be used for this purpose, or the parts may be washed with a 
decoction of oak-bark, or dusted with powdered alum. After the 
proud flesh has been removed, pressure should be applied by means of 
narrow strips of adhesive plaster. 

Callous or Inactive Ulcers require remedies to destroy the calloused 
margins, and to increase the circulation. The hardened edges may be 
touched with solid nitrate of silver, or with a strong solution of the 
same. To stimulate the circulation, one of the most efficacious reme¬ 
dies is continuous immersion of the part in warm water. The same ef¬ 
fect, to a considerable degree, may be obtained by the employment' of 
the alternate hot and cold spray, two or three times a day. Hot 
fomentations may also be advantageously employed. The use of elec¬ 
tricity is frequently followed by excellent results. The application 
may be made in the usual way, by means of sponges, or by the simple 
method recommended for bed-sores. 

Large ulcers which are in a healthy condition for healing, large 
surfaces which have been deprived of the skin by accident, as burns, 
etc., afford a good opportunity for the employment of skin grafting , 
which consists in applying to the granulations small portions of 
healthy skin taken from some other parts of the body or from some 
other individual. The grafts of skin should be very small, and care 
should be taken to place them upon the raw surface with the proper 
side downward. After the application, the entire part should be care¬ 
fully covered with gutta-percha tissue, which should be kept in place 
without removal for two or three days. Great care should be taken in 
dressing that the newly formed portions of skin are not rudely brushed 
away. 

At the end of a week or ten days, little points of the newly form¬ 
ing skin may be seen making their appearance where the grafts were 
applied. This measure in some cases is very important, as sores so 
large as to be otherwise incurable may be healed by means of it. By 
the aid of this remarkable discovery, cases have occurred in which re- 


SYNOVITIS. 


1451 


covery has taken place when the whole scalp has been torn off by the 
hair becoming entangled in machinery, the new scalp being formed by 
the growth of hundreds of little grafts placed upon the denuded sur¬ 
face. 


SYNOVITIS. 

This affection consists in an inflammation of the synovial or lining 
membrane of a joint. It is indicated by enlargement of the affected 
joint. The disease may occur in either the acute or the chronic form. 

Treatment .—In many cases, improvement of the general health by 
proper hygienic treatment is essential. The best remedies for 
chronic synovitis are rest, fomentations, alternate hot and cold applica¬ 
tions to the joint, hot leg baths, and manipulations of the joint, with 
inunction. Attention should also be given to the muscles of the affected 
limb, which are likely to undergo wasting in these diseases. This ten¬ 
dency may be counteracted by the daily employment of massage and 
general faradization. The eminent Dr. Metzger depends almost 
wholly upon manipulations of the joint and limb, rubbing upon the 
sides of the joint about the knee-cap, and from the feet upward, so as 
to stimulate the circulation and promote absorption. Some form of 
unguent, as sweet oil, vaseline, lard, or fresh butter, should be used, 
so as to avoid irritation of the skin and facilitate the manipulation. 
The various liniments recommended for this disease owe their efficiency 
almost entirely to the rubbing with which they are applied. The plas- 
ter-of-Paris bandage is an excellent means of securing rest to the 
joint. 

In cases in which there is little or no pain, the elastic bandage is 
very useful for promoting absorption by compression. The bandage 
should be applied from the foot upward, so that it may not interrupt 
the circulation in the lower part of the leg. Care should be taken to 
bend the joint daily, so as to prevent permanent stiffness. If this is 
done at the same time that traction is being made upon the limb, no 
pain will be given nor harm done. As soon as the swelling and tender¬ 
ness are entirely removed, so that there remains only thickening of the 
tissues about the joint, the patient should be instructed to begin using 
the limb moderately, increasing the exercise from day to day as he can 
without exciting inflammation. If the swelling increases slightly by 
exercise, the joint should be given rest again for a few days, and then 
the exercise resumed. 


1452 


SURGERY. 


GOfiBESE. 

Gangrene, or death of the tissues, is frequently a very formidable 
condition, and one which requires prompt and efficient treatment. The 
danger is not only from extension of the disease, but from absorption 
of the elements of the dead tissues. In order to prevent infection of 
the system through absorption, bathe the parts frequently in carbolic 
acid solution, twenty drops to the ounce, and apply a charcoal poultice. 
Prof. Frank Hamilton, of New York City, recommends as the most 
efficacious remedy for gangrene, continuous immersion of the affected 
part in 'water as hot as can be borne. When other remedies do not 
succeed, pure carbolic acid may be applied to the sloughing parts. 

Senile Gangrene. —This is a form of gangrene which occurs m 
elderly persons, and after low fevers, or great loss of blood, in conse¬ 
quence of deficient circulation. It affects most frequently the foot, 
and generally appears first as a small black or purplish spot upon the 
inside or end of the great toe, sometimes without pain or sign of in¬ 
flammation, at other times with slight redness, which gradually extends 
until the death of the affected parts occurs with separation from the 
sound tissues, or until a large portion of the body is involved, and 
the patient dies. 

In some cases, the affected part seems to shrivel up until it resem¬ 
bles a piece of dried beef. In a few cases, the beginning of the dis¬ 
ease is indicated by an unnatural white and shriveled appearance of the 
affected part. 

If there is much inflammation, apply cool solutions of carbolic 
acid, a dram to the pint. If the parts are cold, and white or blue, with 
no evidence of inflammation, apply heat. Prolonged immersion of the 
affected part in hot water is an excellent remedy. 

VARICOSE vi:i\s. 

As elsewhere explained, a varicose condition of the veins is one in 
which they are enlarged and tortuous. The lower extremities are 
most often affected. 

Treatment. —The difficulty may be readily relieved by the use of 
the elastic silk stocking, or of a rubber bandage. The best means for a 
radical cure is tying the affected veins at a number of points along 
their course, with long-continued rest to the limb in an elevated position. 


ANEURISM. 


1453 


ANEURISM. 

This disease consists of the dilatation of a blood-vessel. It may af¬ 
fect arteries in any part of the body. It very frequently occurs in ar¬ 
teries in the interior of the body, in which case little can be done for it 
in the line of treatment, except what has been recommended elsewhere. 
See page 1055. When the affected arteries are near the surface of the 
body, prolonged pressure with the finger upon the artery affected, above 
the point at which the tumor exists, and ligation of the affected artery, 
are the most useful measures. A person suffering with aneurism should 
be prepared to act with promptness, in case of bursting in the sac. 
Upon the occurrence of such an accident, a pad should be applied over 
the point of rupture and tightly compressed with a bandage. 

nevus. 

This abnormal growth consists of enlarged and greatly dilated cap¬ 
illaries. When near the surface, they are of a dark cherry color; when 
more deeply seated, of a steel-blue color. They often exist from birth, 
and hence are sometimes improperly termed mother’s marks. 

Treatment. —Use mild measures first, such as continuous pressure 
by means of a coin inclosed in a bandage, and vaccination. If these 
measures do not succeed, pass red-hot needles under it at several points, 
for the pm'pose of exciting inflammation. The ligature may be em¬ 
ployed. We have obtained the most satisfactory results by the use of 
galvanic electricity in the form known as electrolysis. 

VASCULAR GROWTHS. 

These are most likely to occur near the mouth of the female urethra, 
where they appear as little red prominences of an exceedingly painful 
character, occasioning very great pain at the time of urination or soon 
after. We have treated many of these cases with entire success by means 
of galvanic electricity. 

ENLARGEMENT OF TIIE LYMPHATIC GEANRS. 

Enlargement of the lymphatic glands of the neck and armpits is 
generally due to scrofula. The application of plasters, tincture of io¬ 
dine, and various irritants, greatly aggravate the local inflammation, and 
probably do no good. Ur. Hamilton says: “I have never had any evi¬ 
dence worthy of acceptance that these agents have in a single instance 
dispersed these swellings.” We protest that the application of tincture of 


1454 ? 


SUIiGERY. 


iodine to an inflamed gland to amuse the patient until nature effects a cure, 
is an act of cruelty. The most proper treatment is the application of 
fomentations, and lancing as soon as softening occurs. Alternate hot and 
cold applications will sometimes cause absorption to take place, if made 
two or three times a day for a long time. 

AMPUTATION. 

Amputation is a measure sometimes necessary to preserve life from 
the consequences of disease or injury; but is justifiable only when it 




Fig. 391. Amputation of the Arm. 


can be clearly settled beyond all reasonable doubt that recovery cannot 
take place by other means, or that the injury or inconvenience occa¬ 
sioned by the disease or deformity will be greater without the operation 
than with it. An operation of this kind must of course be left to the 
experienced surgeon, except in cases of emergency in which a limb has 
been so badly mangled by machinery or otherwise that it is held to the 
body by only a few shreds of tissue, which may be readily divided with 
a pair of scissors. 










DISEASES OF THE BONES AND JOINTS. 


1455 


Operations of this kind were formerly among the most formidable 
in surgery on account of the severe pain and the great loss of blood at¬ 
tendant upon them; but the discovery of anaesthetics has abolished the 
necessity for suffering, and by the use of Esmarch’s bandage (see Fig. 
391), the operation is now an almost bloodless one. In amputating 
a leg, a short time ago, in which the anaemic condition of the patient 
made it important that as little blood as possible should be lost, the 
hemorrhage amounted to scarcely an ounce during the whole operation. 

It is needless to give in a work like this directions for the perform¬ 
ance of the various forms of amputations required in different portions 
of the body. 

DISEASES OF THE BONES AND JOINTS, 

Inflammation of Bone. —Inflammation of bone may involve simply 
the periosteum, when it is known as 'periostitis. It occurs most often 
in young persons. It is accompanied by a chill, high fever, and severe 
pain of the affected part. There is marked swelling, but no redness. 
The skin is tense, and usually pits on pressure with the finger. Every 
jar is painful. When suppuration occurs, the swelling increases, the skin 
becomes red, and the nearest joint becomes swollen and painful. Aiter ten 
or twelve days, softening of the part indicates the presence of pus. Peri¬ 
ostitis occuring at the end of the thumb or finger is termed a felon. 
Periostitis often involves inflammation of the bone itself, which also gener¬ 
ally occurs in young persons, and is most often the result of injury. 
The symptoms are intense aching pain at the seat of inflammation, puffy 
swelling, with an abrupt margin which advances as the disease contin¬ 
ues, fever, great restlessness, and, in severe cases, delirium. 

It is generally difficult to distinguish between inflammation of the 
bone and periostitis. The treatment for both forms of inflammation 
is essentially the same, and consists of applications of ice at the start, 
with elevation of the affected part. If the disease continues, not be¬ 
ing checked by treatment, a surgeon should be called to lance the 
bone. 

Caries of the Bone. —This is an affection of the periosteum, or 
covering of the bone, which- corresponds to an indolent or inactive ul¬ 
cer of the skin. The tissues of the affected parts are tender and 
swollen, and the patient suffers with severe boring and tearing pains 


1456 


SURGERY. 


at night. Improving the patient’s general condition by careful diet 
and correct hygiene, constitute the means of treatment. Bad cases re¬ 
quire a surgical operation for removal of dead hone. 

Necrosis of Bone. —Death of bone is generally the result of in¬ 
flammation. When too large a portion of the bone is not involved, and 
the periosteum is left intact, nature generally effects a cure by separat¬ 
ing the dead from the healthy tissues, and supplying the place of the 
1 diseased bone with newly formed tissue. In many cases, an opening 
to the surface is made, through which the dead bone, gradually under¬ 
going decomposition, is discharged. After complete separation be¬ 
tween the dead and the healthy bone has taken place, the dead bone 
may be removed by a surgical operation. 

Excision or Resection of Bones. —Removal of the whole or of 
a portion of various bones is frequently required in injuries by which 
their integrity lias been destroyed, and after disease which has resulted 
in death of the bone. The object of the resection is to promote the re¬ 
pair of the diseased or injured part. In case of death of portions of 
bone, removal is only performed after the dead bone has fully separated 
from the new. The wise surgeon always endeavors, in the resection of 
bones, to leave the periosteum of the bone as nearly intact as possible, 
as by so doing a new formation of bone may occur. 

A few years ago, we removed from the thigh of a young man who 
had been crippled for several years, several inches of dead bone, involv¬ 
ing a considerable portion of the shaft of the femur which had under¬ 
gone decay, or necrosis, and was separated from the healthy bone. The 
formation of a new bone had already begun, and progressed rapidly 
after the operation, so that in the course of a few months the young 
man pronounced his once crippled and diseased leg stronger and more 
vigorous than the other. We hardly think this was really the case; 
but the patient was led to his conclusions by the fact that the newly 
formed bone was larger than the other one, and he did not encounter 
the slightest inconvenience in its use. 

Inflammation of the Joint —Acute inflammation of the joint 
begins with swelling, heat, and pain, but very slight fever. The 
joint is distended by a great increase of serum and synovia. 
The treatment of this form of disease is simply rest, and the applica¬ 
tion of fomentations three or four times a day, with tepid compresses 
the balance of the time. Recovery generally takes place quite rapidly. 


STIFF JOINTS. 


1457 


Chronic inflammation of a joint may result from the acute 
form, or may be chronic from the start. The joint is much 
swollen without either heat or pain. It most commonly affects the 
knee. The patient can generally walk quite easily, but exercise is fa¬ 
tiguing and increases the swelling. This is the so-called white swell¬ 
ing of the knee-joint. (For treatment see “ Synovitis.”) 

Anchylosis — Stiff Joint. —Stiffness of a joint may be either true 
or false. In the first condition, the mobility of the joint is destroyed 
by a bony union of the articulating bones. In false anchylosis, the 
stiffness is due to the formation of fibrous bodies between the bones 
of the joint, to the contraction of ligaments, muscles, or tendons, or 



Fig. 392. 


their adhesion together or to adjacent tissues, and various other causes. 

Treatment .—Bony anchylosis is incurable. In some cases, how- 
~ ever, the difficulty may be greatly relieved by a surgical operation by 
means of which a new joint may be formed. This has been effected 
in the hip joint by removal of the end of the femur, or of a portion 
of the bone near the end, and, in case of the elbow and the knee joints, 
by the removal of the ends of the articulating bones. By keeping up 
passive motion after the operation, the ends of the bones are prevented 
from uniting, and thus an artificial joint is produced by a process 
which sometimes occurs in fractures when bones fail to unite. False 

9*2 





1458 


SURGERY. 


anchylosis, may in mild cases be relieved by fomentations, manipulation, 
and passive movements, of the stiffened joints. Sometimes considera¬ 
ble force is required to overcome the rigidity of the joints. Various 
forms of apparatus have been constructed for the purpose of applying 
the necessary force. One of the most efficient of these is shown in 
Fm. 392. Another form of apparatus for the same purpose is shown 
in Fffi. 393. 

Floating Cartilage.— This is a term ap¬ 
plied to loose and floating bodies in the joint 
which are sometimes of a cartilaginous nature. 
The presence of these bodies is indicated by sud¬ 
den loss of muscular power in the limb, or ina¬ 
bility to support the body, generally accom¬ 
panied by a sharp pain. On moving the joint 
freely in one direction or another, the pain and 
disability suddenly disappear, leaving only a 
slight soreness. The floating body can generally 
be felt upon one side just below the knee-pan. 
Inflammation of the joint is sometimes set up 
by the irritation of these bodies. 

Treatment .—The patient should give the 
affected joint rest in the horizontal position for 
some days, and should use the limb carefully 
taking especial care to avoid such motions or 
positions as are likely to excite the unpleasant symptoms. Patients are 
sometimes much benefited by using the elastic knee-cap, or a leather 
splint applied to the joint. In case none of these simple measures give 
relief, a surgical operation for removal of the foreign body may become 
necessary ; but an operation of this kind is accompanied by considerable 
risk to life, as well as danger of destroying the joint. 

Hip-Joint Disease. —This is one of the most important affections 
of the joints, and its symptoms should be understood by all, as the dis¬ 
ease frequently begins quite insidiously There is a difference of opin¬ 
ion among surgeons as to the cause of this affection, some attributing it 
chiefly to scrofula, while others, particularly the eminent Prof. L. A. 
Sayre of New York, insist that it is chiefly due to injury of some kind. 
The usual symptoms are, drawing up of the leg, wasting of the muscles, 
and pain in the region of the knee. The patient frequently cries out in 
the night from pain of the limb. As the disease progresses, the thigh 



Fig-. 393. 


when walking, always 




HIP-JOINT DISEASE. 


14 .')!) 


becomes rolled outward, the child limps as he walks, and stands with 
one heel raised from the ground and the toe turned out. If examined 
when stripped, it will be noticed that the fold beneath the buttock is 
higher upon the affected side than upon the opposite. As the disease 
advances, the limb becomes still more drawn up and the hip-joint stiff 
Although for several months, at first, the patient may be able to run 
about freely, he now becomes able to use the limb much less, or not at 


Fig-. 394. 

all. If he be laid upon a table, or other hard, Hat surface, being stripped 
for the purpose, it will be noticed that the body curves upward and the 
affected limb is slightly bent, as may be seen in Fig. 304. 

If now the affected limb be raised, as shown in Fig. 305, the curve in 
the back disappears. If the same thing is done with the sound limb, no 
change will be made in the curve of the body. If both limbs are bent 




and moved from side to side, or otherwise, together, it will be seen that 
the pelvis, although a part of the trunk, moves with the limbs. Even 
when the pelvis is held firmly by an assistant, it will be found to move 
whenever the affected limb is moved, showing that the joint has become 
stiff’, or that anchylosis has taken place. The buttock of the affected side 
will be found to be somewhat flattened on account of the filling up of 
the hollow observable m the sound hip. If a slight blow is made upon 
the sole of the foot when the limb is extended, pain will be felt. 

Treatment .—The proper treatment of this disease consists in remov¬ 
ing the pressure from the affected surfaces by extension of the limb, or 


















14G0 


SURGERY. 


drawing the affected bone partly out of its socket. This may be done 
either by confining the patient in bed and attaching a weight to the leg 
of the affected side by means of a pulley and adhesive straps, as in cases 
of fracture of the thigh, Fig. 373, or by the use of an instrument known 
as the hip splint, Fig. 300. The splint is much to be preferred to exten¬ 
sion by the weight and pulley, as the latter measure necessitates con¬ 
finement in bed for a long time, and, in consequence, injury to the gen¬ 
eral health. The pulley should be removed at night, and alternate hot 
and cold applications should be made over and about the affected hip. 
Special attention should be given to improvement of the general health 
by exposure to fresh air and sunshine, by good diet, etc. The treatment 
of hip-joint disease should always be conducted under the care of a skill- 



Fig;. 396. 


ful surgeon. If it is detected early, an entire cure may take place ; byt 
when the disease is considerably advanced, more or less deformity will 
always remain. In many cases the best that can be hoped for is recov¬ 
ery with a stiff joint. Shortening of the limb takes place in nearly 
all cases. 

Caries of the Knee and Ankle Joints. —The disease usually 
causes but slight symptoms for several months, such as jerking of the 
leg, limping, pain after exercise or on pressure, more or less swelling. 
These symptoms gradually increase, the limb becoming flexed, and the 
joints finally stiffened. In the ankle joint, the disease is generally the 
result of chronic inflammation, which terminates in the formation of ab¬ 
scesses and exposure of the joint. When the knee joint is affected, a 
steel splint should be applied in such a way that extension of the limb 
may be produced by which the articulating surfaces will be drawn apart. 
The plaster-of-Paris bandage is the best treatment for this affection. 













CURVATURE -OF THE SEINE. 


1461 


The hot and cold spray, tepid pour, and fomentations, may also be ad¬ 
vantageously employed in treatment. 

Angular Curvature of the Spine. —This is the result of caries of 
the anterior portion of the body of the vertebra}, which allows the verte¬ 
brae to coine nearer together in front, thus prying the spinal processes 
apart and producing an unnatural prominence. The disease makes its 
appearance the most frequently between the ages of four and twelve 
years. It is indicated by unnatural squareness of the shoulders, stiffness 
in walking, pain produced on slight 
jarring, slight tilting backward of the 
head, unnatural separation of the feet 
in standing, pains in the stomach or 
bowels, generally about the navel, and 
difficulty in bending the trunk in the 
morning. Upon examination of the 
spine there will be found in some part 
of it an unnatural prominence. When 
the vertebrm of the neck are affected, 
the head is usually thrown back, the 
breathing is short and irregular, and 
often accompanied by a slight sigh or 
grunt. The patient is also much 
troubled with hiccough. When the 
disease is located in the lower part of 
the back, pain often runs around the 
pelvis and down the legs. Sometimes 
there is contraction of some of the mus¬ 
cles of the thigh, in consequence of 
which one or both limbs may be 
drawn up. In this case, the patient is generally hollow-backed when 
standing upon the feet, the spine being turned forward. 

Treatment .—The proper treatment of this affection consists in re¬ 
storing the spine as nearly as possible to its natural condition, and giv¬ 
ing it absolute rest in that position. This may be most easily accom¬ 
plished by a properly adjusted splint or brace. When the disease is in 
the central or lower portion of the spine it may be most easily treated 
by means of the plaster-of-Par is jacket, a method of treatment perfected 
and chiefly introduced by Dr. L. A. Sayre, professor of Orthopaedic 



Fig. 397. 








1IG2 


SURGERY. 


Surgery in Bellevue Hospital College, New York City. In the applica¬ 
tion of this bandage the patient is suspended by the head and shoulders 
by means of the harness shown in Fig. 397. The weight of the body 
thus acts as a force in straightening the curvature while the patient is 
suspended. In this way, the jacket is applied so that the condition of 
the spine secured during suspension is maintained, and thus the diseased 
surfaces are kept apart and an opportunity given for nature to e fleet a 



cure. Of course the spine cannot be straightened all at once, and it is 
necessary that the suspension should be frequently practiced, so that by 
degrees the spine may return to its natural condition. 

The wheel carriage, Fig. 398, is a very useful apparatus, by the use 
of which a patient suffering with disease of the spine may be able to 
take a considerable amount of exercise in the open air. When the ver¬ 
tebrae of the neck are affected, an apparatus somewhat similar to a 
“jury-mast ” is sometimes required. Fig. 399. 

























CURVATURE OF THE SPIRE. 


1403 



Fig. 400. 


Lateral Curvature of the Spine, as illustrated in Fig. 400, is 
very much more common than angular curvature of the 
spine. It occurs most often in girls between the ages of 
twelve and sixteen. Among the first symptoms are dull, 
aching pain in the back, especially between the shoulder- 
blades, a tendency to stoop, lassitude, and general weakness. 

One shoulder will be observed to be a little lower than the 
other. Upon a careful examination of the spine it will 
be found to be curved to one side. 

Treatment ,—Since this disease arises largely through 
weakness and irregular action of the muscles of the back, 
it is necessary in treatment not only that the curves should 
be corrected by proper splints, or braces, but that the weak¬ 
ened muscles should be strengthened. In its early stages, 
the disease can generally be corrected by means of proper 
exercises, such as, swinging by the 
hands several minutes at a time and 
several times a day, climbing a lad- 
der hand over hand, exercising with 
the trapeze, etc. When further 
advanced, other means become nec¬ 
essary, one of the most efficient of 
which is the spinal swing, Fig. 401, 
and the use of proper splints and 
braces. The plaster-of-Paris jacket 
is recommended by Prof. Sayre for 
these cases, and we have employed it 
in connection with the spinal swing 
with success in several bad cases. 

The apparatus shown in Fig. 402, 
may be sometimes usefully employed 
in these cases. 

Hysterical Joints.— Cases of 
hysteria are occasionally met with 
in which the principal symptoms 
are found in the joints, the hip being 
most likely to be affected. The 
patient complains of great pain, 
tenderness and stiffness of the joints. 









1464 


SURGERY. 


yet there is no swelling or any other indications of inflammation. 

Treatment .—The treatment of this affection consists in the re¬ 
moval of the cause of the nervous disorder of which it is a symptom. 
Improvement of the general health, and especially the removal of any 
existing local disease, particularly disorders of the womb in women, 
is of first importance. Alternate hot and cold applications, and the 
employment of galvanism, are the best local measures to employ. 

The patient should be encouraged to make ef¬ 
forts to use the affected limb as much as pos¬ 
sible. In some cases, the splint may be used 
to advantage. 

Ganglion—Weeping Sinew.— This is an 
enlargement upon the sheath of a tendon, con¬ 
taining serum or synovia, most frequently 
found upon the back or the front of the wrist, 
or upon the top of the foot. An enlargement 
of this sort most often originates from blows 
or strains, and hence is most likely to occur 
in mechanics, gymnasts, laborers, and those who 
are accustomed to lifting heavy weights. We 
have seen it in young ladies, in whom it 
seemed to have been brought on by piano¬ 
playing. The enlargements vary in size from 
that of a pea, to a small hen’s egg. The con¬ 
tents consist of a colorless fluid resembling the white of an egg. 

Treatment .—Weeping sinew sometimes disappears of itself, but 
in such cases usually returns. A cure may sometimes be effected by 
pressure by means of an elastic bandage. The most common method 
of treatment is rupture of the sac by a blow with a flat stick, or the 
back of a book. The affected part should be given complete rest after 
an operation of this sort, and a bandage should be worn about the seat 
of the disease for some time, so as to prevent the sac from refilling. 

House-Maid’s Knee. This is a difficulty similar to weeping sinew, 
consisting of an enlargement of the bursa or sac found between the 
knee-cap and the skin covering it. Fig. 403. It derives its name from 
the fact that it occurs very frequently in persons who are accus¬ 
tomed to kneel in the work of scrubbing floors, etc. Weavers are sub¬ 
ject to similar enlargements upon the buttocks. Persons engaged in 



Fig-. 403. 


CONTRACTION OF TENDONS AND MUSCLES. 


1465 


other occupations suffer with similar difficulties in other parts of the 
body. 

Treatment .—If treated at once upon its first occurrence, this diffi¬ 
cult)' may generally be cured quite promptly by rest, the application of 
ice, or the alternate hot and cold spray or pour, and bandaging with 
flannel or rubber bandage. A cold decoction of oak-bark may also be 
advantageously employed. 

Inflammation of Tendons. —Tendons and their sheaths often be¬ 
come inflamed in consequence of sprains and other injuries. In addi¬ 
tion to the local pain, the patient suffers 
with fever, which is introduced by a chill. 

When the chills are repeated, there is 
much danger. 

Treatment .—Rest and the application 
of cold are the most efficient measures. If 
there is much pain, hot fomentations, or 
hot packs applied to the whole limb affect¬ 
ed, are very efficient. The limbs should 
also be elevated. 

Contraction of Tendons, Muscles, 

etc.—A muscle always contracts during 
inflammation, and hence in inflammation 
of the muscles, care should be taken to 
keep the inflamed muscle extended, and 
thus prevent contraction. The contrac¬ 
tion of tendons is also the result of in¬ 
flammation or long-continued pressure. 

The membrane, or fascia, beneath tin*, skin also frequently contracts in 
consequence of inflammation. Various forms of contraction and de¬ 
formity often result, which are only relieved by division of the con¬ 
tracted parts. The division should generally be made by a small knife 
introduced beneath the skin so that an open wound is not made. Some ¬ 
times quite a number of incisions are necessary. When small tendons 
are divided, the extension of the contracted parts should be gradual. 
In case of large tendons, the parts may he at once forcibly restored 
to a proper condition and held there by means of splints and bandages. 
The division of tendons is known as tenotomy. 

Contracted muscles also often require division in the same way. 
Contractions of the skin frequently occur in consequence of deep burns. 







14C6 


SURGERY. 


This should be prevented as far as possible by holding the parts in proper 
position and resisting the tendency to contraction. Contractions of 
of this sort generally soften and become more elastic after a few 
months. In some cases it is necessary for a surgeon to dissect out .the 
contracted bands, supplying their place with healthy skin from the 
adjacent parts. 


DISEASES OF THE HANDS AND FEET, 

A large share of the diseases of these organs result from neglect 
or abuse. The hands are frequently injured by the use of irritating 
substances and by exposure to cold while wet or moist. The feet 
generally suffer most from neglect of proper cleanliness and improper 
or insufficient covering. Both hands and feet frequently become 
sources of great discomfort and annoyance for want of proper atten¬ 
tion. In cold weather, persons whose hands are liable to chap should 
avoid the use of soap altogether, cleansing the hands by washing 
with corn meal or oatmeal and water. The application of glycerine 
or vaseline after washing is a very excellent means of prevent¬ 
ing chapping. The hands may generally be protected from irritating 
substances by anointing with oil or vaseline before exposure. Crack¬ 
ing the fingers is a bad habit, as it causes enlargement of the joints. 
Biting the finger-nails is not only disagreeable, but injurious, and is 
the principal cause of hang-nails of the fingers. The habit when once 
acquired, is often difficult to break. It may often be accomplished, 
however, bv smearing the ends of the fingers and nails with some bit- 
ter or otherwise disagreeable substance, as extract of aloes or tincture 
of red pepper. 

Ag-Nails. —In some persons, the thin layer of skin at the root of 
the nail has a tendency to adhere to it as the nail grows out. After 
a time it becomes loosened, and peeling back forms a ragged fringe at 
the root of the nail, the fissures of which are likely to run down into 
the skin, thus often becoming very annoying. The best way to pre¬ 
vent this annoying difficulty is to gently press back the portion of 
skin referred to, every few days, after soaking the hands in warm 
water, thus preventing it from adhering to the nail. 

Hang-Nail of tlie Finger. —This is a little portion of partially 
detached tissue adjacent to the nail, which is usually the result of a 


RUN-AROUND. 


1467 


slight injury of some kind, and by constant contact with various ob¬ 
jects becomes inflamed and quite annoying. 

Treatment .—Clean the nail carefully, dry with a bit of absorbent 
cotton or soft cloth, and apply an adhesive plaster. It should be re¬ 
newed every day or two until the cure is completed. If a consider¬ 
able degree of inflammation has been excited, and there is a raw sur- 
face of considerable size, a little powdered alum or tannin should be 
applied before the application of the plaster. 

Kun around — Onychia, —This is an inflammation of the matrix of 
the nail, which results in ulceration of the soft tissues about the nail. 
It sometimes results from injury. It is more often due to an un¬ 
healthy state of the system. The nail gradually becomes loosened, its 
edges and root roughened and raised up. In the malignant form of 
the disease, the end of the finger becomes greatly enlarged and bulb¬ 
ous, the nail becomes loosened, and when long-continued, the bone 
may be enlarged. 

Treatment .—The affected part should be thoroughly cleansed and 
then touched daily with a strong solution of alum or of sulphate of zinc. 
In severe and obstinate cases, a little powdered alum may be applied 
to the inflamed tissues with advantage. In very bad cases, the re¬ 
moval of the nail becomes necessary. Special attention should be 
given to the improvement of the general health by hygienic measures. 

Claw-like Nails —Sometimes through perverted nutrition of the 
nail, they assume the form of claws. The only treatment is removal 
of the nail and its matrix. 

Felon, or Whitlow. —The most common seat of this affection is 
the palmar surface or ends of the lingers. The difficulty generally re¬ 
sults from some injury. The symptoms are: throbbing pain, with 
' tenderness, and hard swelling of the affected part. The skin upon the 
back side of the finger, particularly around the nail, becomes red and 
irritated. There are several varieties of felons, some originating in or 
beneath the tissues of the skin, and others in the periosteum or cover¬ 
ing of the bone. The latter variety is the most serious, and sometimes 
results in destruction of the bone. 

Treatment .—As soon as the difficulty is discovered, the hand 

should be given entire rest and should be carried in a sling, or held in 

such a position as to diminish the circulation in the limb. The dis- 

e used finder should be soaked in water as hot as can be borne. Some 
© 


1468 


SURGERY. 


recommend that the finger should be soaked in hot lye. In case the 
latter remedy is employed, great care should be taken, as we have 
seen injury to the finger occasioned which was really quite as severe 
as that which was likely to result from the felon itself, by the inju¬ 
dicious employment of this measure. In some cases, cold gives the 
most relief; but it is necessary to immerse not only the affected finger, 
but the whole hand, and as large a portion of the arm as possible. If 
these measures do not succeed in checking the progress of the disease, 
the finger should be lanced as early as possible, a free incision being 
made to the bone. The incision should generally be made by the side 
of the finger, so that injury may not be done to the tendons. After 
lancing, a poultice should be applied 

Warts are due to excessive growth of the papilke of the skin. 
They occur most frequently upon the hands of young persons. They 
are occasionally seen upon the face. The idea that warts are conta¬ 
gious has little.foundation. Warts of the face are likely to degenerate 
into cancers. 

Treatment .—After thoroughly oiling the skin about the wart, 
touch it with the end of a stick dipped in nitric acid. Acetic acid 

may also be used for the 
same purpose. The applica¬ 
tion should be repeated every 
few days until the wart is 
destroyed. Warts some¬ 
times disappear very sudden¬ 
ly, which has given rise to 
■the idea that they may be 
driven off by various ma¬ 
neuvers supposed to possess 
the power of dispersing warts 
in a magical manner. It is 
possible that in these cases the imagination may be instrumental in 
effecting a cure. 

o 

Corns. —A corn is a callus produced upon the toes by pressure, or 
friction. Although there are many different varieties of corns, they 
are generally classified as soft and hard. Soft corns are generally situ¬ 
ated between the toes, and arise from pressure of the toes together. 
The moisture of the skin which is confined by the contact of the toes, 








CORNS. 


1469 


keeps the callus from becoming hard, as would be the case in other sit¬ 
uations. 

Hard corns are much more common, and are found upon the prom¬ 
inent parts of the toes. Hard corns are generally made up of a num¬ 
ber of layers of thickened epidermis, as shown in Fig. 404. When 
neglected, they may become the source of much pain and inconven¬ 
ience. The pair is generally of a burning, lancinating character. 

Treatment. —The treatment is very simple, but needs to be applied 
with great perseverance. Soak the feet in hot water once or twice a 
day, then apply to the center of the corn a little acetic acid with the 
end of a pine stick. By this means, the hardened skin will be softened, 
and it may be easily scraped away with a dull knife, or rubbed down 
with a piece of line sand-paper or pumice-stone. Prof. Syme, a noted 
Scotch surgeon, also recommends, in addition to these measures, the ap¬ 
plication of nitrate of silver over the center of the spot from which 
the corn has been removed, as a means of preventing its return. When 
the corn is very hard, it should be covered with a compress wet in a 
strong solution of soda or saleratus, which should be kept on every 
night. 

In order to prevent its return after removal, the part must be pro¬ 
tected from pressure. The best means of doing this is to cover the toe 
with a piece of soft buckskin saturated with oil, having an opening 
cut in it the size of the corn so as to bring the pressure upon the sur¬ 
rounding parts and relieve the diseased portion of skin. This is espe¬ 
cially useful in cases in which the tissues have become very sensitive 
from long pressure. The operation performed by corn doctors for the 
removal of these troublesome, callosities is seldom effective, as the corn 
is always sure to return. Almost any one can perform the same oper¬ 
ation after softening the corn in the manner directed, by seizing the 
center of the corn with a proper pair of pincers and working carefully 
between the hard tissues composing the corn and the healthy skin, with a 
penknife. In applying strong acetic acid or nitrate of silver to corns, 
care should be taken not to encroach upon the sound skin, and it is a 
good plan to oil the skin about the corn before making the application, 
as a means of proteotion. 

Soft corns should be treated by means of astringent applications, as 
a strong solution of tannin in water or glycerine, a decoction of oak- 
bark, or a mixture of equal parts of powdered alum and white of egg. 
It is also important to separate the toes by placing between them a lit¬ 
tle wad of cotton or lint. 


1470 


SURGE BY. 


Bullions. —A bunion is an enlargement of a bursa of the foot. It 
is similar to the affection elsew here described as a house-inaid’s knee, 
the principal difference being that in this case the bursa beneath the 
great toe is most likely to be affected. The little toe sometimes suffers 
in the same way. Bunions are also caused by wearing 
illy fitting shoes, especially narrow toed shoes. Fig. 
405 illustrates a foot badly distorted by an improperly 
fitting shoe, having a large bunion upon the first joint 
of the great toe. 

Treatment .—The treatment consists in the wear¬ 
ing of shoes which afford plenty of room for the toes, 
softening of the thickened skin by alkaline washes, 
and protection from pressure by the same means as 
suggested for corns. When the toe is very much dis¬ 
torted, it may be drawn into position by means of 
Fig- 405 narrow adhesive strips. A very efficient way of 
straightening the deformed toe is to place upon it a cot, 
or some soft material, the free end of which should be attached by 
means of a strong rubber ribbon to a strip of adhesive plaster ap¬ 
plied around the heel, and extending along the side of the foot. In 

some cases several strips of adhesive plaster 
are necessary. Fig. 406 illustrates an appa¬ 
ratus which has been constructed for use in 
these cases. 

Stone Bruises. —This is an affection of 
the balls of the toes due to slight bruising. 
Stone bruises most often occur in children who 
go barefooted. They are characterized by 
pain, tenderness, and some swelling. 

Treatment .—The best treatment is the hot 
foot bath, or a hot pour or fomentation applied 
to the bottom of the foot. The last-named 
remedies are preferable when they can be ap¬ 
plied thoroughly, as they enable the foot to be 
kept in an elevated position. 

Cracks or Fissures Between the Toes. —These are sometimes 
very annoying. They generally arise from neglect to cleanse the feet 
thoroughly, allowing accumulation of acrid perspiration. They heal 



v Fig. 406. 






t 


INGROWING TOE-NAIL. 


1471 


readily if the feet are kept properly cleansed. The pain and irritation 
can be easily relieved by separating the toes by means of a piece of 
lint or soft cotton, saturated with glycerine or carbolated vase¬ 
line. The feet should be bathed a few times with a strong solution 
of alum, or a decoction of oak-bark should be applied between the toes 
once a day for a week or two. 

Ingrowing Toe-Nails. —This difficulty’generally affects the outer side 
of the great toe. It is generally produced by wearing narrow-toed shoes 
or boots, and trimming the nails too closely at the corners. In conse¬ 
quence of the pressure of the shoe, the edge of the nail is 
forced down into the flesh, producing much pain and irri¬ 
tation, especially in walking. Cutting away the edge of 
the nail does no good, as it will soon grow out and the 
difficulty will be aggravated. When the irritation is 
extreme and kept up for a long time, inflammation and 
even ulceration may occur. 

Treatment .—When there is much soreness or inflammation, soak 
the feet in water as hot as can be borne two or three times a day, and 
apply cool compresses the rest of the time, giving the feet entire rest. 
When the inflammation is considerable, subdue it in this way: The 
center of the nail should be scraped very thin, a notch should be cut 
in the center at the end, and the edge should be raised by carefully 
drawing under it threads of floss silk. An ingenious little instrument. 
Fig. 407, has recently been devised by means of which the edge of 
the nail may be raised, while the center is depressed. It has been 
highly recommended by those who have used it. Sometimes the case, 
becomes so bad that removal of the nail is the only remedy. 



Fig. 407. 


1472 


SURGERY. 


DEFORMITIES OF THE HANDS AND FEET, 


Deformities of the hands and feet, are both natural and acquired. 
In Figs. 408 to 418 are illustrated a number of different forms of 
deformity, some of which represent hands and feet with a superfluous 



or a deficient number of digits. In cases in which there is a sixth toe or 
finger, Figs. 412, 414, and 415, the extra digit is generally imperfectly 
developed. In some cases in which the number of digits is normal, 
two or more are connected together, as in Figs. 409 and 410, reminding 
one of the webbed feet of the goose. Extra digits are generally in the 
way; when this is the case, they should be removed by a surgical 
operation. 

Clubbed Hands is a quite serious deformity, though fortunately 
rare. Much can be done to straighten the deformed organs by fre¬ 
quently manipulating them in such a way as to bring them into proper 
shape. In a majority of cases it is necessary to place the patient in 
the hands of a skillful surgeon. 

Club-Foot is a deformity surgically known as talipes, of which 
there are several distinct varieties, as shown in Figs'. 419 to 428. 
Fig. 419 represents a form of the disease known as talipes equinus. 
Fig 420 represents talipes valgus, or splay foot. Fig. 421 illustrates 
talipes varus, the most common form of club-foot. Figs. 422 and 428 















CLUB-FOOT. 


1473 


represent two forms of talipes calcaneus. Club-foot generally exists 
at birth, but is sometimes acquired in childhood. In the majority of 
cases club-foot requires treatment by a skillful surgeon, but much can 
be done by the nurse toward obviating these difficulties, if attention is 
given to the condition of the feet at birth. If they are found to be 



Fig. 419. Talipes Equinus, Fig. 420. Talipes Valgus. 


deformed as shown in Fig. 421, which is the most common of all the 
deformities of the feet, the nurse should take pains to turn the feet 
gently into a proper position by pressure of the hand. This should be 
done several times a day, and if persevering efforts are made in this 
direction a cure may often be effected. When the condition becomes 




Fig. 421 . Talipes Varus. Fig. 423. Talipes Calcaneus. 

established by long continuance, it is often necessary to employ some 
form of apparatus in treatment. Figs. 424 and 425 represent shoes 
and braces intended to be worn in certain forms of club-foot. 

Flat-Foot. —This condition is similar to splay foot. It consists in a 
loss of the arch of the foot. Persons suffering in this way have a very 
93 














1474 


SURGERY. 


low instep. The difficulty is occasioned by relaxation of the liga¬ 
ments of the foot. The principal inconvenience occasioned is pain 
upon walking or standing long upon the feet. 



Fig 1 . 424. Shoe for Talipes Calcaneus. Fig:. 425. Shoe for Talipes Varus. 

Treatment .—The arch of the foot should be supported by a prop¬ 
erly constructed pad placed underneath it. The pad may be composed 



Fig:. 426. Outline of 
Sole of Normal Foot. 



Fig. 427. Sole of Nor¬ 
mal Foot, also showing 
relative size of a fash¬ 
ionably toed shoe. 



Fig. 428. Effect of 
Wearing Narrow-toed 
Shoe. 


of cotton, rubber, or cork, placed beneath the instep in the shoe, or by 
means of adhesive strips and elastic tubes attached to the instep in 
such a way as to support it by traction. 
















DEFORMITIES OF THE FEET. 


1475 


Deformities of the Feet from Improperly Made Shoes. —The 

hands do not often become deformed to any great extent, unless in conse¬ 
quence of some serious accident or long-continued disease, as rheu¬ 
matism or paralysis. But the contrary of this is true of the feet. In 




430. 



Figs. 431 to 433, Deformed Feet from improperly made shoes. 


fact, it is almost impossible to find a properly shaped foot in any indi¬ 
vidual who has ever worn shoes or boots. Figs. 426 and 427 rep¬ 
resent the outline of the sole of a healthy foot. In Fig. 427 may 



Fig. 432. Deformity of Chinese Woman’s Foot, produced 
by bandaging. 



Fig. 433. Outline of Sole of 
Chinese Womon’s Foot. 


also be seen in dotted lines the outline of a narrow square-toed shoe. 
As will be readily seen, it is impossible for a well formed foot to be 
crowded into such a narrow space without injury. The character of 










1476 


SURGERY. 


the injury inflicted upon the foot is shown in Figs. 428, 429, and 430, 
which illustrate similar deformities greatly increased by wearing im¬ 
properly made shoes for a long time. Fig. 431 also illustrates the 

same. Not very much worse are 
the deformities produced by the 
absurd custom in vogue in China, 
of bandaging the feet, illus¬ 
trated in Figs. 432 and 433. 
Figs. 434, 435 and 436 illustrate 
improperly constructed shoes, 
which are very certain to pro¬ 
duce diseases of the feet, if worn 
any great lehgth of time. In 
Figs. 437 and 438 are illustrated 
a form of shoe recommended by 
Prof. Meyer, the most scientific 
and reliable writer on this sub- 






434. 


435. 


436. 


Fig's. 434 to 436, Outlines of Improperly Made 


ject. Although shoes made after 
shoes. " " ' this style could not be said to 

be particularly beautiful, they will certainly be much better adapted 
to the shape of the feet, and hence much more conducive to the com¬ 
fort and health of the feet, than 
any style of shoes fashionable 
at the present day. 

Weak Ankles. —This is a 
condition most often found in 
children. It may be the result 
of hereditary weakness, or of 
acquired disease, as infantile pa¬ 
ralysis. Such cases require the 
employment of a properly made 
shoe, such as is illustrated in 
Fig. 439. The weak joint should 
be treated locally with electric¬ 
ity, the hot and cold pour, and 
daily rubbing. 

Bow-legs, or Bandy-legs.— 
This a deformity in which the 
legs are bowed outward, as shown 



Figs. 437 and 438, Outline of Soles of Prof. 
Meyer’s Shoe. 




























KNOCK-KNEE. 


1477 


in Fig. 440, which also illustrates an excellent form of brace to be 
worn in these cases. By the application of the brace very early in life, 
the difficulty may be overcome. Surgical operations have also been 
devised for the purpose, but these should not be resorted to when the 
difficulty can be cured by means of a properly adjusted brace. The 
principal cause of bow-legs is encouraging children to learn to walk 
before their limbs are sufficiently strong to sustain the weight of the 
body without injury. 



Fig. 439. Shoe and Brace for 
Weak Ankle. 



Fig. 440 . Brace for 
Bandy Leg. 


Knock-knee, or Genn-Yalgum. —This is a condition in which the 
legs are bent inward so that the knees interfere with each other in 
walking. It occurs in consequence of weakness of the ligaments or mus¬ 
cles about the knee. It sometimes occurs in consequence of strains. In 
some cases of children it becomes so bad that the patient cannot walk 
without crutches. Children suffering with this difficulty are generally 
poorly nourished, and hence supplying hygienic conditions is one of 
the most important elements of treatment. It is generally necessary, 
in addition, to support the weak limb by means of a splint placed at 
the back of the joint and over the outer side of the limb. The band¬ 
age should be applied in such a way as to correct the deformity as 
much as possible, the limb being by degrees restored to its natural con¬ 
dition. Very bad cases require specially constructed apparatus, such 
as is shown in Fig. 440. 
















1478 


SURGERY. 


Short*Leg. —This may be a natural or an acquired deformity, 
When the degree of shortness is not very great, the difficulty of walk¬ 
ing may be relieved to a very considerable extent, and distortion of the 
body prevented, by an addition to the sole of the shoe worn upon the 



Fig 1 . 441. Brace for 
Knock-knee. 


Fig. 442. Extension 
for Short Leg 


Fig. 443. Apparatus 
for Short Leg 


foot of the shorter limb, as shown in Fig. 442. In cases in which 
there is a great degree of shortening, an instrument similar to that 
in Fig 443 is sometimes required. 


DISEASES OF THE EYE. 

The eye is one of the most delicate of all the organs of the body, 
and in consequence of improper treatment is very often the seat of 
serious disease. Owing to its delicate structure, and the great variety 
of affections to which it is subject, the majority of eye diseases require 
for their successful treatment the services of a physician who has 
given special attention to the treatment of this class of maladies. 
When such services cannot be secured, and the patient is obliged to do 
the best he can for himself, it is much safer to do nothing, or, at any 
rate, to adopt only such measures as are naturally suggested by the 
morbid condition of the patient, than to adopt active measures which 
may be more potent for harm than for good. 
















CONGESTION OF THE CONJUNCTIVA. 


1479 


We shall call attention in this section to a few of the more com¬ 
mon affections of the eye, especially to such as are capable of benefit 
by home treatment. 

Congestion of the Conjunctiva, or Mucous Membrane of the 
Eye. —This is generally the result of exposing the eyes to the irritation 
of a strong wind, smoke, or dust. It is also occasioned by long-con¬ 
tinued use of the eye in viewing small objects, as in reading, using 
the microscope, or engraving. Employing the eyes in small work 
by a strong artificial light is especially injurious. Congestion of the 
eyes occasions a sensation of smarting and itching in the eye, with 
heaviness and weight in the eyelids. The white of the eye is red¬ 
dened, the blood-vessels being swollen so as to be visible. The symp¬ 
toms are generally worse when exposed to a strong artifical light. 
The eyes are often watery Congestion is distinguished from inflam¬ 
mation by the fact that it is not attended by any other than a watery 
discharge. 

Treatment .—The eyelids should have rest, and the eye should be 
bathed with tepid water several times a day. The eye douche is a 
very useful method of treatment, but cold water should not be em¬ 
ployed, as it always does the eyes harm, contrary to the popular no¬ 
tion that bathing the eyes in cold water is a means of strengthening 
them. This is not an infrequent cause of congestion. In case there 
is considerable heat in the eye, a thin, tepid compress should be placed 
upon it and changed every few minutes. With this treatment the 
majority of cases will recover in a short time. After the disease be¬ 
comes chronic, it may be necessary to apply a mild astringent, such as 
a solution of sulphate of zinc, a half a grain or a grain to the ounce 
of water. A few drops of this solution should be dropped into the 
eye once a day. In dropping medicines into the eye, the patient should 
be instructed to roll the eye upward, and the lower lid should be drawn 
down so as to form a little pouch, into which the medicine should be 
dropped. The patient should then be requested to close the lids and 
roll the eye about, so as to distribute the lotion over the whole mucous 
membrane. Cool compresses, or tepid bathing of the eye, should be 
employed after the application of the solution. We have found the 
tepid spray, and in some cases the hot spray, or hot sponging of the 
eye, a very excellent method of relieving congestion when other 
measures do not succeed promptly. 


1480 


SURGERY 


Catarrhal Conjunctivitis—Cold in the Eye. —Persons suffering 
with catarrh of the mucous membrane complain that the lids feel as 
if there were sand in the eye. They are stuck to gether in the morn¬ 
ing, sometimes so firmly that they can scarcely be opened. The white 
of the eye is greatly congested. The lining of the lids has a red, vel¬ 
vety appearance Catarrh is the result of severe or long-continued 
exposure to the same causes mentioned as productive of congestion of 
the eye. The affection is in many cases attributed to taking cold. 

Treatment .—Very little treatment is required if the patient has 
good care and gives the eyes entire rest. Dust and bright lights 
should be carefully avoided. When the lids are swollen, the eyes 
very red and hot, and the secretion of mucus abundant, the spray to 
the eye, or the eye douche, should be employed several times a day, 
Either cold or hot water may be employed for the douche. Thin com¬ 
presses wet in cold water and changed every few minutes, not being 
allowed to become warm, should be used, A very excellent way is to 
have a block of ice and keep the cloths upon the ice. Poultices should 
never be employed. A very weak solution of sulphate of zinc, or 
alum, not over two grains to the ounce of either, may be used to ad¬ 
vantage in many of these cases, a few drops being put into the eye 
every day The edge of the lids should be anointed with vaseline, 
sweet oil, fresh butter, or some other ointment. Patent eye-waters, 
and other secret remedies for the eye, should, of course, be entirely 
discarded. The practice of using poultices of tea leaves, alum whey, 
etc., etc., is to be condemned. If left to themselves, the majority of 
these cases recover without treatment, but when possible, they should 
receive careful attention, since the effects are sometimes quite serious. 
Catarrhal inflammation may be communicated from the patient to well 
persons, and hence great care should be taken to avoid opportunity 
for contraction of the disease by other persons. 

Purulent Conjunctivitis—Suppurative Inflammation of the 
Eye. —This disease is also sometimes called contagious inflammation of 
the eye, as it is clearly a contagious disease. The symptoms are simi¬ 
lar to those of the preceding disease, but are greatly intensified. At 
the beginning, the patient suffers with heat and itching in the eye, as 
if sand, or some other foreign body, had gotten into it; the edges of 
the lids stick together, and little beads of matter collect on the lower 
edge and at the corners of the lids, and become hardened; the mucous 


SUPPURATIVE INFLAMMATION OF TILE EYE. 


1481 


membrane is very red and much swollen, and the eyelids are red and 
thickened ; the discharge is at first watery, but soon becomes purulent 
or mattery. The patient now begins to suffer great pain about the eye 
and adjoining portions of the head; there is sometimes considerable 
fever; the eye is very sensitive to light; the mucous membrane becomes 
rough in appearance. This is one of the most dangerous affections of 
the eye, as the cornea is very likely to become affected by ulceration, 
which may often perforate the eye, causing a discharge of its contents. 
The disease generally runs its course in three or four weeks. It 
sometimes becomes chronic, and lasts months and even years. The 
causes are the same as those which produce catarrhal ophthalmia. 
When it breaks out in foundling hospitals, barracks, work-houses, 
boarding-schools, and similar places, it is likely to extend on account 
of its contagiousness. It is so common in India and Egypt that it is 
sometimes called Egyptian ophthalmia. The disease generally shows 
itself in one to four days from the time of exposure. The supposi¬ 
tion that this or any other disease of the eye may be communicated 
by simply looking at a person suffering with it, is erroneous. It is 
necessary that little particles of the discharge find their way from 
the diseased eye to a healthy one in order to communicate it. Com¬ 
munication is often accomplished by means of towels, sponges, etc.; 
but particles may be carried by the air. It should be generally known 
that the inflammation of the eyes to which new-born children are sub¬ 
ject may produce purulent inflammation of the eye in either children 
or adults. 

Treatment .—The results of this disease depend chiefly upon its 
intensity. Bad cases are likely to result unfavorably in spite of all 
that can be done for them. The patient should be confined in a dark¬ 
ened room, and in severe cases should be required to keep his bed. 
The room should be well ventilated, however, an abundance of fresh 
air being of great importance. The contagious character of the dis¬ 
ease should be borne in mind. A person nursing a patient suffering 
from it, would do well to protect the eyes by means of large glasses. 
When the discharge gets into a healthy eye, it should be washed away 
at once with tepid water. 

As soon as the nature of the disease is discovered, the healthy eye 
should be closed and carefully protected by means of a little pad of 
cotton, covered with adhesive plaster in such a way as to entirely exclude 
the air. This compress should be removed twice a day, and the eye 


1482 


SURGERY. 


carefully washed, great care being taken to avoid communicating the 
disease from the other eye. When the symptoms of disease occur in 
the healthy eye, the pad should be left off, and it should be treated the 
same as the other. 

In the treatment of the eye itself, cleanliness is of the greatest im¬ 
portance. The eye should be cleansed every hour or two by means of a 
syphon syringe, the small ear douche tube being gently placed between, 
the eyelids so that the whole eye may be carefully washed. When this can¬ 
not be done, a stream of water should be carefully poured upon the eye 
while the lids are drawn apart and held up by pressure with the fingers. 
The water should be of a tepid temperature, and is rendered more sooth- 
ing by the addition of a little milk. The nurse should take great care 
to avoid getting any portion of the discharge into her own eyes, which is 
quite likely to happen in the use of the syringe if special care is not 
taken. Crusts accumulating about the eye should be removed by soak¬ 
ing with warm water, or water in which soda has been dissolved, in the 
proportion of a teaspoonful to a pint. A little vaseline or lard should 
be applied to the edges of the eye two or three times a day. 

In very severe attacks, cold or ice compresses should be applied con¬ 
stantly. The best plan of application is, to moisten compresses of 
lint or sheet cotton, of sufficient size to cover the lids, and lay them upon 
a block of ice until they become cold. One of these should be placed 
over the eyes, and exchanged for a fresh one as soon as it becomes the 
least warm. When the inflammation is very high, it is sometimes nec¬ 
essary to change the compresses every five minutes. When the extreme 
cold becomes disagreeable, simple cool compresses should be employed. If 
these are still unpleasant, hot fomentations, or a hot spray to the eyes,, 
should be used several times a dav. In addition to these measures, as- 
tringent lotions may be applied with advantage. One of the best ap¬ 
plications is a teaspoonful of powdered alum to a quart of water, a small 
quantity of which should be injected between the eyelids with a syringe 
every half hoar during the day, and once in two hours duringthe night, 
at first. A surgeon should be employed in all cases of this kind when¬ 
ever possible. 

Inflammation of tlie Eyes in the Newly Born.— This af¬ 
fection may be either catarrhal or purulent in character, and in 
this respect may resemble either one of the two last-mentioned dis¬ 
eases. It occurs within a few days, or in some cases not for several 
weeks, after birth. The chief causes are infection of the child’s eyes 


GRANULAR LIDS. 


1483 


with the discharges of the mother, want of cleanliness, and exposure to 
bright lights and cold winds. The disease is generally much less severe 
than in purulent conjunctivitis in older persons, but, as previously re¬ 
marked, it may give rise to the more serious form of the disease in 
either children or adults. 

Treatment .—By proper care, this disease may be prevented. The 
eyes should be washed immediately after birth, by means of clean 
sponges, lint, etc., the nurse being careful to cleanse her hands thoroughly 
before washing the child. Prompt treatment at the beginning of the 
affection is very important. The method of treatment is essentially the 
same as that described for the preceding disease. Care should also be 
taken to cleanse the eyes by an injection of warm water before apply¬ 
ing the alum preparation. 

Diphthertic Inflammation of the Eye sometimes occurs in connec¬ 
tion with diphtheria in other parts. It is a* very dangerous disease, and 
if at all severe, is likely to result in loss of sight. The treatment is the 
same as for purulent ophthalmia. 

Sympathetic Inflammation of the Eye. —In case of severe in¬ 
jury of an eye, especially through the lodgment of a foreign body in 
it, causing inflammation and destruction of the sight, there is great danger 
that the other eye will become affected through sympathy. This danger 
is so great that it is generally considered best to remove the injured eye 
by a process known as enucleation of the eyeball. The deformity aris¬ 
ing from the operation is easily concealed by means of an artificial eye. 
Artificial eyes are now made to resemble the genuine in appearance so 
closely as to be distinguishable only by a close examination. Artificial 
eyes consist of thin porcelain plates properly curved and colored. 

Granular Lids— Trachoma. —This is a condition in which the 
mucous membrane of the eyelids becomes rough in consequence of the 
formation of little round prominences, known as granulations. The lids 
are deep red, and generally have a velvety appearance. The mucous 
membrane is very much thickened; and in consequence of the constant 
friction of the rough surface upon the cornea, it is generally congested, 
often ulcerated, and in bad cases, opaque, occasioning great pain, sensi¬ 
tiveness to light, and even diminution of sight. 

This condition is generally the result of neglect of proper treat¬ 
ment of inflammation of the eyes. It is in most cases largely depend¬ 
ent upon disorders of the stomach and liver, or both, which have been 


1484 


SURGERY. 


occasioned by improper diet, particularly the use of condiments, fats ; 
and excessive quantities of meat. 

Treatment .—The patient must carefully regulate his diet and all 
his habits of life. The food should be simple, but unstimulating in 
character. Tea, coffee, tobacco, arid condiments should be scrupu¬ 
lously avoided. Fat meats and pastry, and excessive quantities of 
animal fat, should also be avoided. Attention should be given to 
the general health, especially to improvement of the digestion and 
increasing the activity of the liver and skin by eliminative baths. 
The eye should be kept very clean by bathing in tepid water two or 
three times a day. It should also be protected from bright lights 
by wearing a hat with a broad rim, or using colored glasses. The 
best kind of glasses for this purpose, especially in the winter season 
when the reflection of the sunlight from the snow is often very 
painful and injurious, is the kind known as “London smoke.” An 

alum wash, consisting of a teaspoonful of 
powdered alum to the pint of water, or a 
solution of sulphate of zinc, two grains to 
the ounce, should be applied to the eyes 
after careful bathing two or three times a 


week. The application to the eyes of the 
hot spray, or hot fomentations, for five or 
ten minutes once a day, will often accom¬ 
plish much more than astringents or irri¬ 
tants of any sort. Care should be taken, 
however, not to employ these methods of 
treatment longer than the time specified, as 
the congestion and inflammation may be in¬ 
creased. The astringent solution should be applied directly to the af¬ 
fected surface. The mucous membrane of the lower lid may be easily 
exposed by causing the patient to look upward, while the lid is drawn 
down by pressing upon the skin just below it. The upper lid, how¬ 
ever, must be inverted by means of the fingers. This is best done as 
follows: Seize the edge of the lid by the thumb and finger of the 
right hand, and stretch it outward and downward. Then place the 
end of the fore-finger of the other hand upon the upper surface of the 
lid just below the eye-brow, pressing somewhat firmly upon the eye¬ 
ball, and turn up the outer edge of the lid. By a little practice, the 
lid can be easily folded over. It is often very convenient to be able 






INFLAMMATION OF TIIE EYELIDS. 


1485 


to perform this simple operation, as it can be brought into service 
very often in removing dirt and other foreign bodies from the eye. 
The operation may also be performed by rolling the lid over a pencil or 
knitting needle, as shown in Fig. 444. The edges of the lids should 
be anointed twice a day with vaseline or some other good ointment. 
A long time will be required in most cases to effect a cure, as the 
disease is very chronic. The disease rarely if ever recovers of itself, 
and often requires the services of a very skillful oculist. 

Inflammation of the Edges of the Lids. —This affection is indi¬ 
cated by redness of the edges of the lids, and the formation of crusts 
about the roots of the lashes. It occurs most often in dry, hot 
weather, and is especially excited by dust. Want of cleanliness, and 
neglect to use glasses when they are required, are also, common 
causes. It may be the effect of taking cold, or exposure of the eyes to 
bright light, or using them by intermittent or feeble light. It is not 
infrequently found as one of the results of scarlet fever or measles. It 
is of most frequent occurrence in scrofulous children, and in a mild form 
it is very often met with in consequence of straining the eyes with 
fine work. 

Treatment. —The most scrupulous attention must be given to clean¬ 
liness. The eye should be washed three or four times a day with tepid 
water, or milk and water, or with a weak solution of baking soda, a tea¬ 
spoonful to the pint of tepid water. When the crusts are very thick, 
bread and water poultices or fomentations should be applied until they 
are softened sufficiently to be easily removed. Diseased or stunted eye¬ 
lashes should be pulled out by means of a pair of forceps. In severe cases, 
when a considerable portion of the lid is affected, all of the lashes should 
be pulled out or trimmed close to the lid. It is often necessary to keep 
the eyelashes pulled out for some time. An alum wash, a teaspoonful 
to the pint of water, should be applied daily, after thoroughly cleansing 
with tepid water. 

Acne of the Eyelids very often occurs in persons suffering with 
acne in other parts of the face. It of course affects the edges of the lids, 
beino- an inflammation of the sebaceous or hair follicles. The causes are 

O 

the same as those which produce acne elsewhere, together with expos¬ 
ure of the eyes to cold winds, bright lights, etc. In treatment, the same 
remedies should be employed as have been recommended for inflammation 
of the edges of the lids, and in addition, cold compresses should be ap- 


1486 


SURGERY. 


plied when the heat and inflammation are considerable, and poultices or 
fomentations, when the little pimples have a tendency to suppurate or 
“ come to a head.” The diet of the patient should be very carefully reg¬ 
ulated as directed in other forms of acne. 

Blear Eyes* —This is a condition in which the natural luster of the 
eye is wanting. It is occasioned by excessive secretion of matter by 
the meibomian glands, which are excited to abnormal activity by irrita¬ 
tion, or inflammation of the edges of the lids, which are usually red and 
irritable. The term is also applied to a condition in which the natural 
secretions of the eye are wanting, which is generally the result of long 
continued inflammation, particularly of chronic granulations 

Treatment .—When due to excessive secretion of fatty matter, 
from irritation of the lids, the same treatment recommended for the pre¬ 
ceding affection should be employed. When due to deficient secretion, the 
disease is generally incurable, on account of the great changes which take 
place in the mucous membrane. It may be much relieved, however, by 
applying a few drops of milk to the eye several times a day, or a little 
glycerine in the proportion of a teaspoonful to a tablespoonful of soft 
water. 

Stye—Hordeolum. —This is a small boil, which generally has its seat 
near the margin of the lid. In some cases, the whole eyelid becomes 
greatly swollen and the eyeball congested. There is generally pain, and 
the affected part is very tender to the touch. The disease follows 
the usual course of a boil, and has a great tendency to return repeatedly, 
so that the patient may not be free from the affection for several months. 

Styes are most frequent in persons addicted to habits of dissipa¬ 
tion. They often result from disorders of the stomach. Styes are of 
frequent occurrence in persons suffering with acne. 

Treatment. —Styes, like boils, occasionally disappear without coming 
to a head, but the most usual result is suppuration and discharge. Ab¬ 
sorption without suppuration may be produced in some cases by vigor¬ 
ous application of cold or iced compresses at the beginning of the disease; 
but as a general rule, the application of poultices or fomentations is 
much to be preferred. When it is evident that pus is formed, the disease 
may be shortened by lancing with a knife. The poultices employed, 
either before or after the boil is opened, should be very small, as inj ury 
may be done to the eye by continuous application of large poultices. 
The edges of the eye should be kept anointed with vaseline, sweet cream. 


'TUMORS OF THE EYELIDS 


1487 


or some other simple unguent. Attention should be given to the diet 
and all means for improvement of the general health. 

Pterygium.— This is an affection of the eye which frequently 
arises in consequence of chronic inflammation or congestion of the con¬ 
junctiva, although it may also originate independent of any inflam¬ 
mation. It consists of an enlargement of the blood-vessels of the 
mucous membrane of the eyeball, and appears as a red triangle, the 
apex of which appears at the edge of the cornea, or encroaches upon 
it, while the base is at one corner of the eye. It often stops when it 
reaches the edge of the cornea, but sometimes extends to the center 
of the pupil, though never going beyond this point. 

Treatment .—The disease does not affect the sight, and does no 
harm, except as a blemish, unless it encroaches upon the pupil. When 
small, it may frequently be caused to disappear by applying to the eye 
an alum wash, a teaspoonful to the pint of water, three or four times 
a week. When the growth is very large, however, so that it inter¬ 
feres with the sight, it should be removed by a surgical operation, 
which can only be performed by a competent surgeon. 

Tumors of the Eyelids. —Small growths sometimes appear upon 
the eyelids, particularly near the edge. One form, known as chalazion, 
is due to obstruction of the duct of a meibomian gland in consequence 
of inflammation, which results in the accumulation of the fatty secre¬ 
tion. These tumors are generally about the size of a pea. They are 
most manifest on the inner surface of the lid, lying just beneath the 
mucous membrane. They are most often found in the upper lid. 
Another form of tumor, known as milium, is situated at the edge of 
the lid. Generally quite a number are found, each about the size of 
a millet seed. Other tumors, as sebaceous tumors, warts, fatty tumors, 
fibrous tumors, etc., as well as cancer, are sometimes found upon the 
eyelids. 

Treatment .—All these abnormal growths are best treated by re¬ 
moval by a surgical operation. In many cases, the little white tumors 
which appear along the edge may be cured by simply pricking with 
a needle and squeezing out the contents 

Ptosis—Inability to Open the Eye. —This is an affection of 
the eye in which the upper lid drops down more or less, in some cases 
to such an extent that the patient is unable to open the eye at all 
In some cases, this is due to paralysis. In others, it occurs in conse¬ 
quence of great swelling of the upper lid. 


1488 


SURGERY. 


Treatment —The cause must be removed, so far as possible. When 
due to paralysis, appropriate treatment should be employed, electricity 
being the chief remedy indicated. 

Inability to Close the Eye. —This is a condition which is gen¬ 
erally due to paralysis of the orbicularis palpebrarum, or circular 
muscle of the eye. In consequence of the wide gaping of the eyelids, 
the patient has a peculiar staring appearance. The eye being con¬ 
stantly exposed to irritation in consequence of dust, etc., there is a 
constant flow of tears, and, sooner or later, inflammation is produced. 

Treatment .—When due to paralysis, electricity should be used, be- 
ing applied daily by means of small sponge electrodes. The positive 
pole should be placed upon the forehead just above the eye, while the 
negative is passed across the eyebrow, and beneath the eye. The cur¬ 
rent should be applied not more than one to three minutes at a time. 
In some very bad cases, it becomes necessary to attach the lids 
together by means of stitches. 

Deformities of I lie Eyelids. —Sometimes, in consequence of in¬ 
flammation or injury to the eyelids, the edges may turn in or out in 
an unnatural degree, in consequence of which the functions of the eye 
may be greatly interfered with. When the lids are turned in, the 
eyelashes rub upon the eyeball and produce irritation ; when they 
turn out, the tears do not escape readily through the natural channels, 
and a portion of the mucous membrane is exposed to irritating in¬ 
fluences. 

Treatment .—Since these diseases are usually the result of chronic 
inflammation of the eyes, they should be prevented by proper treat¬ 
ment of the origin of the disease. When a deformity has been pro¬ 
duced, however, a surgical operation is usually necessary to restore the 
lid to a healthy condition. In cases of Entropion, in which the open¬ 
ing between the lids is much narrower, making the eye look smaller 
than natural, relief may be obtained by means of an operation known 
as cantho'plasty , which consists in extending the opening between the 
lids by cutting the outer corner with a knife or scissors. We have 
sometimes afforded patients very great relief from suffering by per¬ 
forming this operation. 

Wild Hairs in the Eye. —This is a common term applied to a 
condition in which the lashes grow in an improper direction or position. 
In a form of the disease known as trichiasis, the lashes are not confined 


SPASM OF TEE EYELIDS. 


1489 


to the edge of the lid, their proper position, but grow upon the mucous 
membrane within the edge, being generally very irregular, and often 
small, pale, and stunted. In another form of the disease known as 
districhiasis, there are two rows of lashes instead of one, the outer 
being in proper position, while the inner is farther back and turned in¬ 
ward. In consequence of these irregularities of the lashes, the mucous 
membrane of the eye becomes greatly irritated, the eyes becoming red, 
watery, and irritable. The patient complains of constant prickling 
and itching, as if sand, or some other foreign body, were lodged be¬ 
neath the lid. Sometimes the cornea becomes inflamed, and sight is 
impaired. 

Treatment .—When the difficulty is not very severe, it may be suc¬ 
cessfully treated by carefully extracting with a pair of small pincers 
the offending lashes, repeating the operation as often as necessary. 
After being pulled off a number of times, the growth is usually 
checked, and thus a cure is effected. In very bad cases, it sometimes 
becomes necessary to destroy the hair follicles by passing to the root of 
each lash a fine needle, dipped in a strong solution of caustic potash. 
Sometimes electricity is used for the same purpose, the current being 
passed through a needle, which is inserted at the root of the hair. In 
extremely bad cases, the mucous membrane containing the offending 
lashes must be removed by a surgical operation. 

Spasm of the Eyelids. —This is a spasmodic affection of the cir¬ 
cular muscle of the eye which closes the lids. When severe, the eye¬ 
lids are pressed so firmly together that the patient cannot open them. 
Indeed, in some cases the contraction is so strong that the eyelids can¬ 
not be drawn open without very great pain. In other cases, there is 
only temporary twitching or contraction of the lids, which soon disap¬ 
pears. This affection is generally due to irritation of the eye, as in in¬ 
flammation of the cornea or conjunctiva. It sometimes occurs in con¬ 
nection with neuralgia of the face. The irritation occasioned by 
foreign bodies in the eye often produces severe spasms. 

Treatment .—When due to inflammation, or dirt in the eye, the 
cause must be removed by proper treatment. When occasioned by 
neuralgia, heat should be applied, together with other remedies for that 
affection. In cases in which it seems to be independent of these condi¬ 
tions, it may often be removed by pressure of the finger upon the su¬ 
praorbital nerve. This may be accomplished by pressing with the fin- 

94 


1490 


SURGERY. 


ger upon a point just above the little notch which may be felt by 
passing the finger along the eyebrow. Strong pressure just in front 
of the ear will also sometimes instantly relieve spasm of the eye. An¬ 
other excellent remedy is holding the face in cold water for some min¬ 
utes, or the application of ice compresses over the eye. 

Nictitation—Twitching of the Eyelids .—This is a convulsive 
twitching of the eyelids which may be either very slight or severe. 
The twitchings sometimes follow each other very rapidly. This affec¬ 
tion most often occurs in persons of a nervous temperament, and when 
the eyes are tired from overuse and nervousness. An excited state 
of the mind will greatly increase the difficulty. 

Treatment .—The general health should be improved by proper 
remedies. If there is any irritation of the lids, the eye douche should 
be daily used. The application once or twice a day of the hot spray 
to the eyes with the lids closed, is also a useful remedy. 

Adhesion of the Lids. —In some cases, in consequence of injury, 
especially injuries of the eye from lime, acids, hot iron, etc., the 
lids become adhered together, or to the eyeball. These difficulties can 
be overcome only by means of a proper surgical operation. 

Epiphora—Watery or Weeping Eye. —This is a condition in 
which the tears are secreted more rapidly than they can be carried 
away from the eye by the nasal duct, and hence, are allowed to flow over 
the lids and down the cheek. It may result from excessive secretion 
of tears, or obstruction of the passage by which the fluids of the eye are 
conducted to the nasal cavity. Obstruction may be the result of 
closure of the opening into the lachrymal passages or tear ducts, or to 
inflammation or stricture of some part of those passages. The start¬ 
ing point of the difficulty is generally inflammation in the corner of 
the eye next to the nose. It most often accompanies a severe cold in 
the head, being really an extension of the disease of the nasal cavity 
to the mucous membrane of that portion of the eye. Sometimes, in 
consequence of the inflammation, an abscess is formed in the tear sac, 
which opens and forms a fistula from which the tears may run upon 
the face. In other cases, there is a catarrhal condition of the mucous 
membrane lining the tear sac, which causes it to become filled with a 
mucous secretion. This difficulty is indicated by a little swelling in 
the corner of the eye, which may be emptied by pressure, the mucus 
being squeezed out from the edge of the lid, from which it may be 
wiped away. 


CROSS-E YE—WA LL-E YE—SQUINT. 


1491 


Treatment .—Many people suffer on for years with a difficulty of 
this sort without making any attempt to obtain relief, although the 
difficulty may in most cases be readily cured by a surgical operation. 
It is generally necessary to divide the little tear sac, and in many 
cases, a long-continued course of dilatation of the canal which leads 
from the eye to the nose, is necessary. This is accomplished by means 
of delicate probes, Fig. 445, the size of which is gradually increased 



Fig. 445. 


as the canal is enlarged. The old method of treating these affections 
by inserting silver tubes to conduct the tears from the eye to the 
nasal cavity, is not now employed. 

Cross-Eye—Wall-Eye—Squint—Strabismus. —The term cross- 
eye, or squint, is applied to a condition in which one eye is drawn in 
toward the nose. When the eye is turned toward the outer corner, the 
condition is one known as wall-eye. Inward, or converging squint, gen¬ 
erally begins in early childhood. The squint is usually the result of 
long-sightedness, being occasioned bv the constant strain necessitated in 
viewing near objects. At first, this affection is accompanied by double 
vision; that is, the patient sees two objects where but one exists. 
After some time, however, but one object is seen, as the squinting 
eye is not used in viewing objects, in consequence of which the power 
of sight is gradually lost. The immediate cause of strabismus is the 
weakening of one or more of the muscles of the eyeball. This may 
be the result of paralysis of some of the muscles of the eyeball. 
Squint sometimes appears very suddenly. In such cases, it is gen¬ 
erally indicative of disease of the brain, as in meningitis and tumors 
of the brain. 

Treatment .—When due to paralysis, the difficulty may often 
be relieved by the local application of electricity. The negative pole 
should be placed over the closed eye, or at the inner side of the nose, 
the positive being placed upon the forehead just above the eye. In 
many cases it is necessary to perform an operation upon the eye, 
which consists in completely or partially dividing the muscle upon 
the side of the eyeball toward which the eye turns. 












1402 


SURGE 11Y. 


Oscillation of the Eyes—Nystagmus. —This affection consists of 
a peculiar restless movement, or oscillation of the eyeballs. The 
movement is generally from side to side, but is sometimes rotary. 
Patients suffering this way are often obliged to read with the print 
turned in a vertical direction on account of the blurring from the let¬ 
ters running together. The affection is occasioned by a variety of 
causes, which are, unfortunately, generally of such a character as to 
render the condition incurable. 

Inflammation of the Cornea — Paimus. —This disease is indi¬ 
cated by a congested condition of the cornea, the blood-vessels being 
visible, great sensitiveness to light, severe pain, and weeping of the 
eye. Pannus may be occasioned by the irritation of inverted eye¬ 
lashes, by conjunctivitis, and especially by granular lids. 

Treatment .—When due to granular lids, the disease should be 
treated as elsewhere recommended for that condition. Fomentations 
and hot spray to the eye are especially serviceable. 

Ulcers of the Cornea. —Ulcers of the cornea may generally be 
seen as little white spots near its margin. There is generally great 
sensitiveness to light, and severe pain, with congestion of the eye. 
This is a very serious affection, as penetration of the eye is quite apt 
to occur. The majority of cases are best treated by means of careful 
restriction of the diet, perfect rest of the eye in a darkened room, the 
application of a light bandage over the eye, and the use of the hot fo¬ 
mentation or hot spray three or four times a day half an hour each 
time. Ulcers of the cornea are very apt to leave behind them white 
spots. 

Opacities of the Cornea. —In addition to opacities, or spots pro¬ 
duced by ulcers, the cornea sometimes becomes partially opaque in 
consequence of inflammation, or pannus. There are also various other 
forms of opacities. 

Treatment .—-.Very extensive opacities of the cornea sometimes 
wdiolly disappear in time without treatment; but in many cases, the 
most thorough treatment is ineffectual. In order to secure absorption, 
it is necessary to increase the activity of the circulation in the eye, 
which may be accomplished by means of astringent solutions—as a weak 
solution of alum, or tannin, one or two grains to the ounce of water, 
or still better, by means of hot fomentations or the hot spray to the 
eye. The spray should be used daily for fifteen or twenty minutes. 


INFLAMMATION OF THE IRIS. 


1493 


The spots cannot be removed by an operation, as many people suppose, 
as they ai’e in the substance of the cornea itself, not “ films over the 
eye,” as they are sometimes called. Sometimes, however, when the 
opacity is immediately over the pupil, so that the sight is greatly in¬ 
terfered with, benefit may often be derived by an operation known as 
iridectomy, by which an artificial pupil is made at one side by cutting 
an opening through the iris. An ingenious London surgeon some 
years ago removed the opaque portion of the cornea in a case under 
his care, and substituted for it a portion of a healthy cornea from the 
eye of a rabbit. Attempts have been made to substitute a piece of 
glass for the opaque portion of cornea, but without success. 

Arcus Senilis. —This is the term applied to an affection of the 
cornea which manifests itself as a silvery rim near the edge of the 
cornea but separated from the edge by a ring of transparent tissue. 
It is due to fatty degeneration of the tissue of the cornea, and is con¬ 
sidered to be an indication of the beginning of similar changes in other 
parts of the body, particularly in the blood-vessels of the brain. It 
is seen most frequently in persons over fifty years of age, though it 
may occur at an earlier period, especially in persons addicted to the 
use of alcoholic drinks. 

Inflammation of the Iris—Iritis. —This affection is character¬ 
ized by pain in the eye so severe as to prevent sleep. The pain also 
extends to the brow and the temples, in consequence of which it is 
often mistaken for neuralgia. The eye is congested, especially about 
the cornea. The lids are likely to be swollen and puffy. There is at 
first a sensation of burning and itching in the eye, but the pain 
shortly becomes much more severe, being sharp and cutting. The 
pain is worse during the night, diminishing toward the morning. 
There is some feverishness, coated tongue, want of appetite, and often 
nausea and vomiting, so that the affection is sometimes mistaken for 
a bilious attack. Iritis, may also be regarded as a simple cold in the 
eye at first, an error which may result in loss of the sight by 
occasioning neglect. A symptom of very great importance is contrac¬ 
tion of the pupil. The pupil generally contracts promptly when ex¬ 
posed to a strong light, and dilates when the light is withdrawn. If 
the pupil is contracted and remains so, whether exposed to strong 
light or not, or if it moves very slowly, there being at the same time 
great sensitiveness to light, inflammation of the iris may be very 


1494 


SURGERY. 


strongly suspected. An excellent test is to drop into the eye two or 
three drops of a solution of atropia, two or three grains to the ounce 
of water. The effect of this treatment is to dilate the pupil. If the 
pupil is found greatly enlarged fifteen or twenty minutes after the 
application of the atropia, the iris is probably not affected. The most 
common causes of iritis are rheumatism and syphilis, which may re¬ 
sult from overuse of the eyes, from sympathetic irritation with an¬ 
other eye which has been the seat of injury, or from direct injury. 

Treatment .—The great danger of this disease is that the pupil 
will become permanently contracted through adhesion to the cornea 
or to the crystalline lens. The best means of preventing this is dilata¬ 
tion with atropia. A drop or two of the solution of atropia mentioned 



Fig. 446. 


before should be applied to the eye once in five minutes for a half 
hour at a time, three or four times a day, by means of a medicine 
dropper, Fig. 446, or a camel’s hair brush. The lower lid should be 
turned down and the solution dropped into the pocket formed be¬ 
tween the edge and the eyeball. The eye should be carefully pro¬ 
tected from light by confining the patient in a dark room if the > in¬ 
flammation is very severe. The well eye, as well as the weak one, 
should be given perfect rest, as it cannot be used without irritating 
the other. Hot fomentations or the hot spray, as hot as can be borne, 
should be applied over the closed eye one hour at a time, from three to 
six times a day, according to the severity of the case. In some cases, 
when the pain is very severe, fomentations should be kept up contin¬ 
uously, until the pain is permanently relieved. When the eye has 
received a severe injury, the application of fomentations is an excel¬ 
lent means of preventing iritis. Wet-sheet packs and vapor baths 
may often be used with advantage in treating cases of severe inflam¬ 
mation of the eye, being excellent derivative agents. 

Persons suffering with chronic iritis should carefully protect the 
eye from a bright light by means of blue or London smoke glasses, 
and should avoid taxing the eyes severely in any way. The use of 
tobacco and alcoholic liquors should be particularly avoided, as also 
exposure to the irritation of tobacco-smoke. 










CATARACT. 


1495 


Dilated Pupils—Mydriasis. —Unnatural dilatation of the pupils 
is produced by belladonna or atropia, hyoscyamus, stramonium, and 
other drugs. It may also result from paralysis of one of the nerves of 
the eye. It is frequently the result of rheumatism or of syphilis. It 
usually affects one eye, but may involve both. The sight is generally 
somewhat impaired. 

Treatment .—Electricity is a remedy of value in this affection 
when it is not due to some acute disease of the brain. Benefit may 
also be derived from frequently closing the eyelids and compressing the 
eyes as firmly as possible, and also by frequent exercise in reading. 

Contraction of the Pupil—Myosis. —This condition of the pupil 
is produced artificially by poisoning with opium or with calabar bean. 
The pupil is sometimes contract¬ 
ed to the size of a pin-head, or 
even less. This condition may 
also arise from paralysis of one 
of the nerves of the e} r e, or from 
irritation of the third nerve, 
which supplies the eye. It some¬ 
times results from long use of 

O 

the eyes in viewing minute ob¬ 
jects, as in the study of micros¬ 
copy, watch-making, reading, etc. It is also a symptom in some af¬ 
fections of the spine, and in inflammation of the brain. 

Irregular contraction of the pupils, one being large and the other 
small, is also observed in some cases of cerebral disease. Nothing can 
be done in these cases except to remove the cause of the affection as far 
as possible. 

Cataract. —This is a disease of the crystalline lens in which it 
loses its transparency, becoming opaque, so that the entrance of light 
to the eye is obstructed. When the disease is fully developed, the pa¬ 
tient can barely distinguish light from darkness. The pupil loses its 
natural blackness, the opaque lens being visible behind it. Cataract 
is sometimes spoken of as being on the eye, which is a popular error, 
as it is within the eyeball. In former times many physicians, as well 
as the common people, often mistook the white spots, already described 
as opacities of the cornea, for cataract. 

Treatment .—The only treatment is a surgical operation, which 
consists in removal of the crystalline lens. This is usually done by 



Fig. 447. 










149G 


SURGERY. 


making an opening in the eyeball near the edge of the cornea, by means 
of a cataract knife. Fig. 447. Formerly the lens was punctured by 
means of a delicate needle passed into the eye, an operation known as 
“ needleing. ” This plan was adopted particularly in young children. 
It is now abandoned, however. In the hands of skillful operators, fully 
four-fifths of those operated upon recover useful sight. It is generally 
necessary that the patient should wear glasses, two pair being usually 
required, one for distance, and the other for near objects, as the power 
of accommodation is of course lost by removal of the lens. 



Fig-. 448. Fig. 449. 


Diseases of the Choroid, or Color-Coat of the Eye— The choroid 
membrane is a continuation of the iris, and is the colored membrane 
which lines the back part of the eyeball. It can be recognized only by 
means of the ophthalmoscope. Figs. 448 and 449. 

Phis instrument consists essentially of a concave mirror with an 
opening in its center, by means of which light is thrown into the eye of 
the patient, while the examiner looks into the eye through the small 
opening in the mirror. By means of this little instrument, the whole 









































DISEASES OF THE RETINA. 


1497 


interior of the eye can be readily examined, its various structures being 
brought clearly into view. Fig. 449 illustrates the most improved form 
of the apparatus, which is furnished with a set of small lenses, arranged 
in such a manner as to be capable of being brought opposite the open¬ 
ing in the mirror, thus magnifying the view obtained by the mirror. 
Little was known respecting the diseases of the interior of the eye be¬ 
fore the invention of the ophthalmoscope by Helmholtz, about thirty 
years ago. Disease of the choroid requires the attention of a skillful oc¬ 
ulist. 

Diseases of the Retina. —Among the most common causes are 
the use of tobacco or alcohol, overuse, bad light, injury to the eye, and 
disease of the kidneys. These are among the most serious of eye dis¬ 
orders, being in many instances incurable. When resulting from the 
use of tobacco or alcohol, great improvement generally occurs from the 
disuse of narcotic stimulants of all sorts. The use of electricity is a 
valuable remedy in many of these cases. There is a peculiar form of 
disease of the retina in which it becomes covered more or less densely 
with black spots. A prominent symptom of this disease is night 
blindness. Patients thus affected are able to get along without diffi¬ 
culty in the daytime, but become partially blind after sundown. 
There is also a narrowing of the field of the eye, so that objects are 
seen distinctly only when directly before the center of the pupil. 
Little can be done for these cases by way of treatment. 

Diseases of the Optic Nerve.— When the optic nerve is seriously 
diseased, a considerable or complete loss of sight is generally the re- 
, suit. It is subject to inflammation, paralysis, and atrophy. The use 
of tobacco is a very frequent cause of these affections. The treatment 
is the same as that suggested for diseases of the retina. 

Glaucoma. —This is a very serious disease of the eye, the nature of 
which is not thoroughly well understood. The eyeball becomes very 
hard in consequence of an increase of its fluid contents, the result of 
which is paralysis of the optic nerve in consequence of the severe 
pressure. When acute, it is generally very painful. The pain is gen¬ 
erally accompanied by flashes of light, appearances of rainbow colors, 
and dimness of vision. The disease should not be mistaken for neu¬ 
ralgia, as it requires very prompt treatment at the hands of a skillful 
surgeon. It is usually necessary to perform the operation known as 
iridectomy, an operation described on page 1493. 


1498 


SURGERY. 


Specks before the Eye. — Muscse Yolitantes.— Many persons are 
constantly annoyed by various floating objects before the eyes, some¬ 
times described as specks, and again as cobwebs, circles, strings of 
beads, etc. Sometimes opaque spots of considerable size are present. 
The small specks, cobweb appearances, etc., are generally due to dis¬ 
turbance of the rays of light by changes in the cell structure of the 
vitreous humor of the eye. The larger and denser spots are generally 
due to the presence of small clots, or rather opaque bodies in the vit¬ 
reous humor. These can be readily seen by examination of the eye by 
the ophthalmoscope. Cases have been met with in which the embryo 
of the tape-worm, or the cysticercus, were found in the humors of the 
eye. Persons whose eyes are healthy, are often annoyed with floating 
specks. As a general thing, they need not give serious alarm. They 
are by some considered as an indication of an inactive state of the 
liver, and in some cases, of disease of the womb. The spots can gener¬ 
ally be seen quite readily by persons troubled with them, by looking 
at a white surface through a pin-hole opening in a card. A bright 
light covered by a ground-glass shade is a good object to look at. 
These little objects sometimes become quite an annoyance. An em¬ 
inent German microscopist has been obliged to make a map of the 
opacities in his eyes, for use in correcting the observations which he 
makes with the microscope. 

Treatment .—The most that can be done is to improve the general 
health of the patient. In case the liver is inactive, fomentations 
should be applied over the organ daily, and the abdominal bandage 
should be worn at night. Condiments, butter, fat meats, tea or coffee, 
tobacco, and alcoholic liquors should be carefully avoided. In some 
cases, benefit may be derived by the application of fomentations and 
of electricity to the eye. 

Amaurosis. —This malady has been described as a disease in 
which the patient sees nothing and the physician sees nothing. This 
remark was made before the discovery of the ophthalmoscope, and 
when the term was applied to a large number of conditions of the eye 
which were not understood. It is now applied to a gradually increas¬ 
ing paralysis of the optic nerve, or to blindness resulting from disease 
of the brain. A form of the disease known as tobacco amaurosis, is 
frequently met with in smokers. Indeed, the use of tobacco and of al¬ 
coholic liquors are the most frequent of all causes of this disease. So 


BLURRED SIGHT—WEAK VISION. 


1499 


many cases have been reported in the last few years in which the 
sight has been nearly or quite ruined by the use of tobacco that all 
oculists now condemn it as an exceedingly harmful drug. 

Treatment .—When due to disease of the brain, or paralysis of the 
optic nerve, a cure is impossible in many cases. Electricity is one of 
the most useful remedies. Tobacco amaurosis cannot be cured without 
the patient renounces the use of the weed, which is in most cases suf¬ 
ficient to effect a cure, though the use of electricity is an excellent 
means of expediting recovery. 

Pain in the Eye. —Simple pain in the eyeball is generally the 
result of excessive use of the eyes. It is also caused in cases in which 
persons who require the use of glasses neglect to use them. It need 
not be regarded as a very serious symptom if it is only occasioned by 
overwork and is relieved by proper rest, while the acuteness of the 
sight is in no way diminished. When it is very acute and continuous, 
or so severe as to prevent sleep, there are good grounds for apprehend¬ 
ing that some serious disease is present. Smarting, burning, or sting¬ 
ing pain in the eye, is generally located in the external structures. 

Treatment .—Pain due to overuse is relieved by rest and bathing the 
eyes with tepid water. The pain of inflammation is relieved by hot or 
cold applications. Cool or tepid applications are generally best in in¬ 
flammations of the mucous membrane of the lids, and hot applications 
when the cornea or iris is affected. Thick compresses should never be 
laid upon the eye. When cold applications are needed, a light compress 
of three or four thicknesses of linen or a thin sheet of lint should be wet 
and laid over the eyes, being changed every five or ten minutes, or as 
often as it becomes warm. In severe cases, several compresses may be 
employed, being kept cool by laying upon a block of ice. The thinness 
of the compress allows for evaporation, so that the heat is not retained, 
as might be the case with a thick compress, which would thus act as 
a poultice and might be the means of much harm. 

Blurred 8iglit—Weak Vision. —This is not a serious symptom 
when the acuteness of vision is not diminished ; that is, if a person can 
read fine print with ease for a short time, even though the letters soon run 
together, the difficulty is probably a purely functional trouble which will 
be readily relieved by rest and tonic treatment. If there is blurred sight, 
with neither ability to read fine print nor to see small objects clearly even 
for a short time, the symptom is sufficiently serious to demand immedi- 


1500 


SURGERY. 


ate attention from a good oculist. Blurred or weak sight can generally 
be relieved by the use of spectacles. In many cases the inability to use 
the eyes for any great length of time is due to some general disease, as 
nervous debility, dyspepsia, or cerebral congestion. These cases of course 
require improvement of the general health, or relief of the primary 
disorder. 

Loss of Sight. —In many instances, loss of distinct vision Is so grad¬ 
ual that patients are scarcely aware of the fact until their sight has be¬ 
come very extensively impaired. This is especially the case when only 
one eye is affected. We have met a number of cases in which cataract 
had become fully developed without the individual being aware of the 
existence of any difficulty with the eye. Loss of vision is indicated 
whenever there is blurred sight of either eye with Inability to read fine 
print or to see distinctly small objects which have once been readily dis¬ 
cerned. The most accurate way of testing the sight is by means of 
“ test types,” such as are shown on page 1501. 

If an individual is unable to read under any circumstances the fine 
print known as “ diamond,” there is certainly some loss of sight. If he 
can read the finest type easily for a few seconds, but is then unable tu 
read farther on account of the letters running together, the difficulty 
can probably be relieved by the use of proper glasses. In employing 
the test types, the distance at which the different varieties of type can 
naturally be read should be observed. No. I should be easily read at 
a distance of one foot from the eye; No. II, at a distance of two feet; 
No. Ill, at three feet; No. YI, at four feet, and Nos. VII and XV, at 
seven and fifteen feet, respectively. Diamond type should be read 
at a distance of twenty inches from the eye. Pearl should be easily 
read at thirty, and minion at forty inches. When the letters or 
sentences can be easily read at the proper distance at first, but after¬ 
ward cannot be made out without occasioning a tired feeling of the 
eyes, the indication is weakness of vision. When the test letters 
cannot be made out at anv distance, there is almost entire loss of sight, 
probably the result of disease. 


TEST TYPES. 


1501 


TEST TYPES. 


I. 

NPMVZ8 0F MOI. 

II. 

PHKOSUYACEGL. 

III. 

CECLNPRTVZBD. 

IV. 

VZBDFHKOSUYA4. 


vn. 

FHKOSUYAOEGL7. 

PRBDHK015. 

DIAMOND. 

Should be read at twenty inches. 

Our Father which art in Heaven, hallowed be thy name. Thy kingdom come. Thy will he done in earth as it la in Heaven. Give ua +hie 
•day our daily bread, and forgive u* our debts as we forgive our debtois. And lead us not into temptation, bat deliver as from evil for thine 
is tho kingdom, and the pow jt, aud the glory, forevor. Amen. 


PEARL. 

Should be read*at thirty inches . 

Our Father which art in Heaven, hallowed be thy name. Thy kingdom come. Thy will be done in earth ns it is in Heaven. 
Give us this day our daily bread, and forgive us our debts as we forgive our debtors. And lead us not iuto temptation, b*t 
deliver us from evil; for thiue is the kingdom, and the power, and the glory, forever. Amen. 


MINION. 

Should be read at forty inches. 

Our Father which art in Heaven, hallowed he thy name. Thy kingdom come. Thy will 
he done in earth as it is in heaven. Give us this day our daily bread, and forgive us our debts 
as we forgive our debtors. And lead us not into temptation, but deliver us from evil, for thine 


BOURGEOIS. 

Should be read at fifty inches. 

Our Father which art in Heaven, hallowed be thy name. Thy kingdom come. 
Thy will be done on earth as it is in Heaven. Give us this day our daily bread, 
and forgive us our debts as we forgive our debtors. And lead us not into tempta- 



1502 


SURGEIiY 


01(1-Sight—Presbyopia. —In old age the power of accommodation 
of the eye is diminished. The ciliary muscle becomes weakened, so 
that it loses its ability to increase the thickness of the crystalline lens 
by compression. The result of this change is that the individual is un¬ 
able to see near objects as well as formerly. In reading, he is obliged to 
hold his book or paper farther away from the eye than usual. Objects 
at a distance are seen as before, the difficulty being only observed with 
reference to near objects. By placing a convex lens, Fig. 450, before 
the eye, the deficient power of the crystalline lens is compensated for, 
and the patient can see near objects without difficulty, but is obliged 
to remove the glasses when viewing distant objects. By some means, 
the process known as accommodation, by which the eye is adapted to 

view objects at different dis¬ 
tances, which the eye becomes 
incapable of performing in old 
age, may be imitated by the use 
of artificial lenses. Old people 
who are able to see without glasses, generally have an unnaturally 
long eyeball, in consequence of which their far-sight is deficient, 
although they may have excellent vision for near objects. Old peo¬ 
ple are sometimes agreeably surprised by finding themselves able 
to read without glasses after they have been obliged to use them for 
many years. This is what is know as second sight, which results in a 
change of the cornea by which the eye is made short-sighted. 

As age advances, the eye should be occasionally tested, especially if 
the individual finds that the eyes are tired more readily than usual by 
reading or use in fine work. Upon testing with the test types, if he 
finds that diamond type is most easily read at more than twenty inches 
from the eye, while number I can readily be made out only at a distance 
of fifteen or sixteen inches, he may be sure that his eyes are becoming 
presbyopic, and that proper glasses should be adjusted. It is a mis¬ 
take to suppose that old-sighted persons can see better at a distance 
than persons with natural vision; hence, the term far-sighted, as ap¬ 
plied to persons suffering with presbyopia, is incorrect. Old-sighted 
people see better at a distance than near by, but no better than those 
whose eyes are perfectly normal. Short-sighted persons do not gener¬ 
ally require the aid of glasses nearly as soon as others, often in fact, 
getting along without them altogether. 

Long-Sight—Hyperopia.— This is a condition in which the eye¬ 
ball is too short, as shown in Fig. 451. Persons whose eves are in this 



Pis'. 450. Convex Lens. 




SHORT-SIGHT. 


1503 


condition usually suffer with great fatigue after a long use of the eye, 
generally with slight pain or heavy feeling in the forehead. When 
leading at night, the print soon becomes blurred. After resting the 
eyes awhile by closing them, or by rubbing or bathing them, the read¬ 
ing may be continued, but the eyes soon become again fatigued. In 
some cases the individual is utterly unable to read tine print at any 
distance, and is also unable to see clearly objects 
some distance away. Persons suffering in this way 
were formerly considered incurable; but it is now 
very well known that the defect is easily correct¬ 
ed by means of convex glasses, such as are used for 
old-sight. The discovery of this fact was made 
accidentally, after thousands of individuals had 
been compelled to go through life with continual 
suffering, under the idea that the' weakness of sight 
was due to commencing blindness, which would be greatly intensi¬ 
fied by wearing glasses ot any sort. In former times, if a long¬ 
sighted child happened to discover that he could read more easily 
with his grandmother’s spectacles, they were quickly snatched away 
from him, as though they were a dangerous weapon in his hands. 

Short-Sight—Myopia .—In this disease, the condition of the eye¬ 
ball is the opposite of that in long-sight; that is, the eyeball is too 
long. Fig. 452. The tendency to short-sight in some cases exists at 
birth. In a great majority of cases, however, it 
is the result of improper use of the eyes. It is 
particularly frequent among students and literary 
people, which is probably due to the sedentary 
habits of this class of persons, and especially the 
habit of using the eyes much in close work. 

The disease is very prevalent in Germany, so 
much so that the government has found it neces- Fig-. 452 - Short-sighted 

& . Eye. 

sary to allow the use of glasses among soldiers. 

It is very rare indeed among farmers, sailors, and common labor¬ 
ers. Among savages it is still more rare, if not unknown. An 
eminent oculist of Breslau, some years ago examined the eyes of over 
ten thousand school children, with the result of discovering that 
short-sight increases in students with the length of time the person is 
in school. In the elementary school, G.7 per cent of the students were 
found to be short-sighted. In the next higher grade, the percentage 




1501 


SURGERY. 


was 10.3. In the high school, about one in every five suffered with my¬ 
opia ; and in the universities or colleges, more than one in every four was 
so affected. In the high school, nearly one-half of the first class were 
found to be short-sighted. Examinations made in this country have 
developed similar facts. The idea sometimes entertained that the 
short-sighted eye is a strong eye, is a mistake. As a general rule, 

short-sight is an evidence of 
unsoundness and disease, 
which may result in most 
serious consequences to the 
sight, possibly ending in its 
destruction. Short-sight does 
not, as many peojde suppose, 
diminish with age. Although a person may become able to see near 
objects better than in youth, distant objects do not become more dis¬ 
tinct. 

Short-sight may be relieved by the use of concave lenses, Fig. 453 
placed before the eye, by means of which the error in vision arising 
in consequence of too great length of the eyeball may be corrected. 
Persons with short-sight generally do not need glasses in reading, un¬ 
less they are obliged to hold print very near to the eye, but are wholly 
dependent upon properly fitted glasses for vision at a distance. Wearing 
of properly fitted glasses is an advantage rather than a detriment to 
short-sighted eyes, but care should be taken to secure an accurate adjust¬ 
ment of the glasses to the eye. This can only be done by a compe¬ 
tent physician who has given his attention to the subject. In addi¬ 
tion to the fitting of proper glasses, attention should be given to the 
general health, and to careful removal of all causes of this condition. 

Astigmatism. —This is a condition of the eye in which the curve 
of the cornea is not symmetrical, or uniform. The consequences of 
this condition are much more serious than those resulting from long or 
short-sightedness. Nearly all objects are seen distorted. The most 
perfect eye is not absolutely symmetrical, and when the want of symme¬ 
try is more or less increased,the eye becomes astigmatic. A person suf¬ 
fering with this affection of the eye can easily see horizontal lines more 
distinctly than vertical ones, though sometimes the reverse is the case. 
This condition may be detected by means of the test diagram, Fig. 454 
If this is held a distance from the eve and gradually brought near to 



Fig.. 453 Bi-Concave Lens. 






GLASSES. 


1505 


it, it will be discovered that either the horizontal or the vertical lines 
indistinct. In some cases, this is true of the oblique lines, instead of 
the vertical or horizontal. 

Astigmatism, like long-sight and short-sight, but in a much greater 
degree, has a considerable effect upon the character. Persons who are 
born with this defect never know the proper forms of objects until 
the defect is corrected by the proper glasses. We have now under 
treatment a lady who never knew the form of the human face until 
a pair of glasses were fitted to her eyes. The change in the appear¬ 
ance of objects was so great that she 
at first was unable to recognize her 
husband without taking off her 
glasses. She expressed the most ex¬ 
quisite delight at the improved ap¬ 
pearance of various objects which 
she beheld for the first time in their 
proper form. Astigmatism is cor¬ 
rected by means of glasses ground 
from a cylinder in such a way as to 
overcome the optical defects of the 
eye. 

Glasses. —Proper glasses should 
Test for Astigmatism. be selected and carefully fitted to 

the eyes whenever they are affected by old-sight, long-sight, short- 
sight, or astigmatism. A competent physician or an oculist should be 
consulted in every case with reference to the wearing of spectacles, and 
their adaptation to the eye. Spectacle venders who travel about the 
country should not be patronized under any circumstances. Glasses 
made of flint glass, or of what is known as rock crystal or Brazilian 
quartz, are the best. The last variety is known as “ pebble ” glass. 
The only advantage which it has over other glasses is its hardness. 
Spectacles should also be perfectly clear and free from irregularities 
in the glass. 

It is sometimes advantageous to wear glasses for the purpose of 
protecting the eye from mechanical injury, when they are much ex¬ 
posed, as in certain trades. Colored glasses, as London smoke, green 
or blue glasses, are also necessary in many cases to protect the eye 
from intense light. Protection of this sort is very necessary for trav¬ 
elers in snowy regions, whose eyes are likely to suffer from the 

95 



150G 


SURGERY. 


dazzling brightness of the reflected sunlight, producing an affection 
known as snow blindness. For the convenience of persons who are 
obliged to use two sets of glasses, one for viewing near objects, the other 
for distant vision, spectacles are sometimes made in which the lower 
part of the lenses is ground so as to be adapted to near vision, while 
the upper part is adapted to distant vision. These are known as Frank¬ 
lin glasses because they were invented and first used by Benjamin 
Franklin The kind of frame to be employed is wholly a matter of taste. 

Color-Blindness. —This is an affection known as Daltonism, from 
the man who first described it, and is more common than is generally 
supposed. Persons suffering with this difficulty are unable to distin¬ 
guish red, green, or other colors. In some cases, only the form of ob¬ 
jects are discerned, all appearing of the same color. The affection is 
much more common in men than in women. Great harm may result 
from this defect, which exists in this country to the extent of about 
forty per cent of the whole male population. It is especially danger¬ 
ous in persons employed as pilots or engineers of railroad trains. It 
is an interesting fact worthy of notice that the color which the patient 
is unable to discern appears to him to be gray. It is probable that 
color blindness is in part, at least, due to the want of proper education 
of the eye in discriminating colors in early childhood. The defect is 
in many cases hereditary. It has been recently announced that color¬ 
blindness may be corrected by means of a pair of spectacles composed 
of two plates of glass between which is placed a thin layer of fuck- 
sine. 


DISEASES OF THE EAR, 

Discharge from the Ear. —When a discharge from the ear is 
not accompanied by any marked interference with hearing, it is prob¬ 
ably the result of an abscess in the auditory canal. When preceded 
by severe earache, and accompanied by marked deafness, and when of 
very long standing, the discharge probably comes from the middle ear, 
in which the process of suppuration is taking place. 

Treatment .—Syringe the ear thoroughly one to three times a day, 
according to the amount of discharge, employing tepid water with the 
syphon or fountain syringe. Care should be taken not to use too 
great force, as the membrane of the ear may be ruptured. The ear 


ABSCESSES—EAR A CHE. 


1507 


should be drawn upward and backward, and the nozzle of the syringe 
should be introduced about one-fourth of an inch. If the discharge is 
very offensive, a carbolic acid lotion in the proportion of five drops to 
the ounce, or a solution of permanganate of potash, twenty grains to 
the pint, should be employed. 

Abscesses ill the Auditory Canal. —Small boils, or furuncles, some¬ 
times form in the walls of the auditory canal, giving rise to impairment 
of hearing. They seldom occasion roaring in the ears, which is a 
.symptom met with in nearly all other diseases of the ear. 

Treatment .—Apply hot fomentations and the hot ear douche, and 
lance as soon as possible, continuing the hot douche afterward as before. 
The vapor douche is an excellent means of treatment when it can be 
employed. A cotton plug saturated with glycerine and placed in the 
ear will often give great relief. The ear should be carefully protected 
from cold air, especially when out of doors. Attention should also be 
given to the general health, which is always more or less impaired in 
these cases. 

Earache. —This is by no means so trivial an affection as is gener¬ 
ally supposed. Pain accompanied by roaring or ringing sounds and a 
sense of fullness, is generally due to inflammation of the middle ear, which 
may result in permanent impairment of hearing if not given proper at¬ 
tention. In many cases, obstinate crying of children is due to earache. 
Earache is sometimes sympathetic with disease of the teeth. The most 
common cause, however, is taking cold in the head or ears. 

Treatment .—The best remedy is heat, which may be applied by 
means of fomentations, rubber bags filled with hot water, flannel bags 
filled with hot sand, bran or corn meal, or poultices. Whatever the ap¬ 
plications are, they should be made as hot as can be borne. It is usually 
necessary to continue the applications for some time. In most cases, it 
is advantageous to employ fomentations of sufficient size to cover the 
whole side of the head and extend under the chin. The application of 
a roast onion to the ear is a very favorite remedy, but probably has no | 
advantage over fomentations. The application of the hot douche to the 
ear is a very excellent remedy if used with care. The water should be 
as hot as can be borne. The hot foot bath, hot sitz bath, and the hot 
blanket pack, are often effective in relieving pain in the ear. They 
should be employed in connection with local treatment. 


1508 


SURGERY 


Hardened Ear-Wax.— Hardening of the cerumen, or ear-wax, is 
a not very infrequent cause of deafness, and is by no means so harm¬ 
less a condition as is generally supposed. In many cases the harden¬ 
ing is not the primary disease, but is due to chronic inflammation of the 
middle ear. The most prominent symptoms of this condition are, im¬ 
pairment of hearing, roaring and pain in the ears. The practice of prob¬ 
ing the ear for the purpose of ascertaining whether it contains hardened 
ear-wax is a very hazardous one, as it may excite inflammation of the ca¬ 
nal of the ear, or even rupture the drum. Cleaning the ears with the 
end of a towel, or with a bit of sponge attached to a handle, is a bad 
practice, as the wax is crowded in. The wax sometimes becomes al¬ 
most as hard as stone. 

Treatment .—Hardened wax may be readily removed, in most cases, 
by the ear douche with warm, or hot water. In case the wax is very 
hard, it may be necessary to use quite strong soap-suds, or to place in 
the ear a few drops of a strong solution of bi-carbonate of soda. A 
good plan in these cases is to drop into the ear while the head is bent 
over, a small lump of bi-carbonate of soda, which can be easily pressed 
down in contact with the wax, after which a few drops of water 
should be added. Persons subject to hardening of the ear-wax should 
syringe the ears thoroughly every six or eight weeks. The proper 
treatment for other foreign bodies in the ear has been given else- 
where. See page 1439. 

Ringing in the Ears—Tinnitus Aurium. —Under this head is 
included all cases in which there are unnatural sounds in the ear 
The description of these sounds given by different patients is exceed¬ 
ingly varied. Some complain of sounds resembling the roaring of a 
waterfall, the rumbling of a carriage in the street, or a train of cars 
etc ; while others are continually troubled with a snapping, crackling 
sound, and similar disturbances. This affection is often a verv annoy- 
ing one, sometimes resisting all remedies. Among the principal causes 
are hardened ear-wax, foreign bodies in the auditory canal in contact 
with the drum membrane, inflammation of the middle ear, etc. The 
most obstinate cases are probably due to disease of the nerve of hear¬ 
ing. 

Treatment .—Hardened wax, or other foreign bodies, should be re¬ 
moved. When resulting from congestion, relief is sometimes obtained 
by pressure upon the large arteries of the neck. Electricity has also 


CATARRH OF THE EAR. 


1509 


proved of great service in some cases, though in others it has not suc¬ 
ceeded. The galvanic current is the most successful. 

Parasitic Inflammation of the Auditory Canal. —The external 
end of the canal is sometimes subject to inflammation in consequence 
of the growth of vegetable parasites of the nature of mold. The 
most common is some variety of the aspergillius. The principal 
symptoms are pain, dizziness, impairment of hearing, and a discharge 
from the ear. 

Treatment .—The same treatment should be employed as has been 
recommended for the preceding disease. The persistent use of hot 
water will thoroughly destroy the parasites, but the discharge will still 
continue, in some cases, requiring the treatment recommended for dis¬ 
charge from the ear. 

Acute Catarrh of the Ear. —This is an inflammation of the mid¬ 
dle ear, It is the principal cause of earache. It occurs at all periods 
of life, but is especially common in young persons. The most frequent 
cause is taking cold in the head, or in the ears. When frequently re¬ 
peated, it may lead to chronic catarrh and permanent impairment of 
hearing. Prolonged bathing, especially in cool weather, or ducking 
the head under water, is a frequent cause of catarrh of the ear. Prof. 
Roosa, an eminent aurist, also asserts that the use of tea and coffee, 
pastry, and other improper articles of diet, is a frequent cause of this 
disease. 

Treatment .—The treatment of acute catarrh of the middle ear is 
a matter of great importance for the reason just given. If prompt, 
energetic measures are not employed, the drum membrane is not in¬ 
frequently perforated by ulceration. This is not an accident fatal to 
hearing, however, as openings of this kind generally heal quite readily 
with proper treatment. Essentially the same treatment should be em¬ 
ployed as has been recommended for earache, the most useful being 
fomentations and the hot ear douche. Simply breathing into the ear 
for a few minutes will sometimes check the disease in children. Pour¬ 
ing into the ear sweet oil, glycerine, molasses, laudanum, cologne water, 
etc., is not only useless, but in many cases harmful. There is also dan¬ 
ger from the use of poultices if too long employed. Fomentations 
should be applied to the throat as well as to the ear. In severe cases, 
when a considerable amount of suppuration occurs, it is sometimes 
necessary to employ a competent surgeon to lance the drum membrane 
so as to allow the accumulated fluid to escape. As soon as the symp- 


1510 


SURGERY. 


toms have disappeared, the ear should be inflated by grasping the nose 
so as to close the nostrils tightly, closing the mouth and then attempt¬ 
ing to blow through the nostrils. By this maneuver, air will be 
forced up into the ears, and in many cases, the impairment of hearing 
will be at once relieved to a considerable degree, if not altogether. In 
cases of children who are unable to perform the experiment, the ears 
may be inflated by putting into the nostril one end of a piece of rub¬ 
ber tubing through which the mother or nurser should blow, while the 
mouth and other nostril of the infant are tightly closed. When the 
soreness and swelling have passed away, the ear should be carefully 
tested to determine whether or not the hearing is seriously impaired. 
Persons subject to inflammation of the middle ear should be very care¬ 
ful not to expose themselves to taking cold in any way. Special pains 
should be taken to protect the ears from exposure to drafts of cold air. 
In the majority of cases, complete recovery takes place. 

Chronic Catarrh of the Middle Ear. —This is a very serious af¬ 
fection of the ear, and one to which about one-half of all cases of deaf¬ 
ness are due. The disease is generally accompanied by slight pain, 
heat, and uneasiness about the ear. It is often the result of repeated 
attacks of acute catarrh of the middle ear. In a majority of cases it 
results from long-continued nasal and pharyngeal catarrh. Patients 
frequently complain of sounds in the ear, like the crackling of air bub¬ 
bles. There is generally more or less ringing in the ears and a sense of 
fullness. Dizziness is also a not infrequent symptom. In many cases 
there is a tendency to an accumulation and hardening of the ear-wax. 
Generally, also, a slight tenderness will be found by pressing with the 
finger in the hollow just below the ear, or over the front part of the ear. 
In some persons, however, scarcely any symptoms except those of im¬ 
paired hearing are present. In not a few instances the disease pro¬ 
gresses so insidiously that the patient is unaware of his condition until 
his hearing is destroyed. On the day of this present writing, we have 
met with two illustrations of this fact. A clergyman called at our 
private office, and with much concern apprised us of the fact that he 
had just made the discovery that the hearing of his right ear was very 
greatly impaired. His attention was called to the fact by incidentally 
placing a watch to his ear to see if it was running. On testing the ear, 
we found that it possessed only one sixteenth of its natural acuteness, 
and upon examination of the left ear, we found, very much to the gen¬ 
tleman’s surprise, that its hearing was also very greatly impaired, 


CATARRH OF THE MIDDLE EAR. 


1511 


the watch which should have been heard at a distance of four feet be¬ 
ing barely made out at a distance of a foot. Within an hour, while 
examining a patient from a distant State with reference to the condi¬ 
tion of his general health, we incidentally tested his hearing, although 
he remarked very emphatically that his ears were perfectly sound. In 
this case, we found the left ear had lost fully three-fourths of its acute¬ 
ness, while the hearing of the right ear was almost entirely destroyed. 
The gentleman was so greatly astonished at the result of the examina¬ 
tion that he was only convinced of his real condition after the test had 
been repeated several times. 

A curious phenomenon is sometimes observed by persons suffering 
with chronic catarrh of the ear. When surrounded with loud noises, as 
riding in a railroad car, they are able to hear as well as, or even better 
than, persons whose ears are perfectly healthy, although very deaf at 
other times. The cause of this improvement of hearing is not well un¬ 
derstood, but it has been thought that it may be due to the fact that 



the powerful vibrations produced by loud noises set in motion the mem¬ 
brane of the ear, which is thickened and rendered rigid by disease. An 
English physician, taking a hint from this fact, has suggested the ex¬ 
posure of the ear to loud noises as a mode of treatment. This plan of 
treatment has been termed ear gymnastics. 

In order to ascertain whether the Eustachian canal is open and the 
membrane moveable, it is necessary to inflate the ear. This is done by 
forcing air into it by means of Valsalva’s method, which consists in at¬ 
tempting to blow the nose while the nostrils are tightly closed with the 
thumb and finger, or still better, by Politzer’s method, in which air is 
forced into one nostril by means of a rubber bag, Fig. 455, the patient 
swallowing at the same moment that the air is forced into one nostril, 
the other being closed. In cases in which the air cannot be made to 
enter the ear by either of these methods, it is necessary to use the Eu¬ 
stachian catheter, Fig. 456. When air enters the ear, the movement 














1512 


SURGERY. 


of the structures of the middle ear can be distinctly heard by means of 
the otoscope, or diagnostic tube. Fig. 457, one end of which is placed 
in the ear of the examiner, and the other in the ear of the patient un¬ 
dergoing examination. These instruments are also very essential in the 
treatment of many diseases of the ear. 

Treatment. —Unfortunately, in the majority of cases of chronic 
catarrh of the middle ear, little can be done to improve the hearing of 
the patient. About the best that can be hoped for is to check the 
progress of the disease, and perhaps secure a little improvement. The 



Fig. 456. 



Fig. 457. 


first attention should be given to the throat, which will in nearly all 
cases be found to be the seat of chronic catarrh, though in many cases 
there is also nasal catarrh. For the relief of these difficulties, the 
treatment elsewhere recommended for them should be adopted and 
thoroughly employed, not for a few weeks only, but persistently 
for months and years. 

Among the various measures for this purpose, are the post-nasal 
douche, steam inhalation, and gargles. The best remedy for the use of 
the gargle is chlorate of potash, a strong solution of which should be 
used two or three times a day. The usual method of employing the 
gargle is very ineffective, as the soft palate prevents the solution from 
reaching the seat of the disease. In order to be of any service, the 
gargle should be taken as follows: Take into the mouth about a 
tablespoonful of the solution, throw the head backward as far as possi¬ 
ble, close the nostrils, and make the motions of swallowing without, 





NERVOUS DEAFNESS. 


1513 


however, allowing the liquid to pass into the stomach. By this means 
the solution may be made to pass up into the back part of the throat 
over the diseased surface. 

Alternate hot and cold applications made to the throat and over 
the ears, are valuable means of aiding a cure. Electricity may also be 
applied to the ears with advantage in many cases. When the external 
canal of the ear is dry and irritable, much relief may often be given 
the patient by anointing it with carbolated vaseline, ten drops to the 
ounce, sweet oil, or almost any other unguent. Great care should be 
observed to avoid taking cold. In cases in which the tonsils are en¬ 
larged, which are by no means rare, they should be removed. Atten¬ 
tion should be given to the general health, as in many instances the 
hearing may be greatly benefited by improvement of the condition of 
the stomach. 

Nervous Deafness. —This is one of the most hopeless of all diseases 
of the ear. It is by no means so common, however, as formerly sup¬ 
posed, before diseases of the ear were as well understood as at present. 
Formerly, all diseases of the ear which could not be traced to other 
causes were attributed to disease of the auditory nerve. Even at the 
present time many physicians who are not thoroughly posted in regard 
to diseases of these organs pronounce many cases of deafness to be of 
nervous origin, when the difficulty is of a much more tractable 
character. 

One of the most interesting discoveries appertaining to this class of 
maladies is the fact that diseases of the auditory nerve can be distin¬ 
guished from diseases of other portions of the ear by means of the 
tuning-fork. If the tuning-fork be sounded, and the handle placed at 
the center of the forehead, the sound will be heard most distinctly in 
the affected ear if the deafness is in the middle ear, or due to hardened 
ear-wax. If, however, it is due to disease of the auditory nerve, it will 
be heard most distinctly in the unaffected ear. 

Treatment .—Improvement of the general health, and the applica¬ 
tion of galvanic electricity to the ear, are about the only measures of 
advantage. When both ears are affected, the electricity may be ap¬ 
plied by means of small sponge electrodes which should be placed at 
the openings of the auditory canal, or just behind the ear. When only 
one ear is affected, the positive pole should be placed at the back of the 
head and the negative at the opening of the ear or upon the promi¬ 
nence j ust behind it. 


1514 


SURGERY. 


Rupture or Perforation of the Membrane of the Ear may re¬ 
sult from exposure of the ear to loud sounds, as the firing of a cannon, 
or a violent explosion of any kind, or perforation may occur by punc¬ 
turing with an instrument used in removing wax from the ear, or ac¬ 
cidentally introduced into the auditory canal, or by ulceration as a 
result of suppuration of the middle ear. Cases of rupture of the 
membrane have also been known to occur in consequence of the in¬ 
judicious use of the nasal douche. Rupture of the membrane has 

also been caused by boxing the ears, or by a blow 
upon the ear from a snow-ball. The accident gen¬ 
erally causes loud buzzing in the ear and confusion 
in the head. In many cases the ear whistles when 
the patient blows his nose, due to the passage of air 
through it. The condition of the drum membrane 
is easily ascertained by an examination by means 
of the ear speculum, of which two forms are shown 
in Figs. 458 and 459. Light is thrown upon the 
membrane through the speculum by means of the 
concave mirror, such as is used in examining the 

throat. Fig. 296. 

Treatment. -The 

pain may be relieved 
by fomentations. If in¬ 
flammation occurs, hot 
douches to the ear 
should be employed, 
but not otherwise. In 
a majority of cases, 
rupture of the mem¬ 
brane heals quite read¬ 
ily, especially when it 
is the result of punc¬ 
ture with a sharp body, 
as a knitting-needle. 

Ear Trumpets. —Quite a variety of instruments have been in¬ 
vented for the purpose of intensifying sound for the benefit of those 
who are hard of hearing, in cases in which the middle ear is the seat 
of the disease, the auditory nerve remaining intact. Two of the most 
useful instruments are shown in Figs. 460 and 461. Auricles, Fig. 462, 




Fig. 458. Ear Specula 
of three sizes. 


Fig. 459. A Bi-valve Ear 
Specula. 




























EAR TRUMPETS. 


1515 


are of rather doubtful value. The conversation tube, Fig. 463, is a 
very serviceable instrument. Fig. 464 shows at a and b, small silver 
cornets, which are recommended on account of the ease with which 


they can be concealed. They are, however, of little value as aids to 
hearing. Some years ago the discovery was made that a small bit of 
moist cotton in the ear adds greatly to the hearing power when the 
drum membrane is ruptured. Artificial drum mem¬ 
branes, Fig. 465 are now made and are often very 
serviceable, in some cases, though all are not bene¬ 
fited by them. 



6. TIEMANN & CO. N.'t. 


Fig. 460. Dipper Trumpet. 



G. ticmann&cc.n.y. 

Figr. 461. Ear Trumpet. » 




Figr. 464. Small Silver 
Cornets. 


G.TIEMANN &C0. N.Y. 
Fig - . 462. Auricles. 


Figr 465. Artificial 
Drum Membrane, 



Fig'. 463, Conver¬ 
sation Tube. 




Fig. 466. The 

Audiphone. 


The audiphone, Fig. 466, is a recent invention, which is of service 
in some cases of deafness, though it is by no means so universally ap¬ 
plicable as has been claimed by its inventor. It is composed of a sheet 
of gutta-percha attached to a handle and made tense by means of a 
cord. In use, the upper edge is placed against the front teeth, through 
which the vibrations of sound are communicated to the bones of the 























1516 


SURGERY. 


skull and to the auditory apparatus. The principal objection is its 
price, which is very exorbitant when compared with its actual cost. A 
sheet of card-board eight or ten inches square may be used in the same 
way as the audiphone. The dentaphone is practically the same as the 
audiphone, the only difference being that it may be folded so as to be 
convenient to carry in the pocket. The megaphone, an instrument by 
which very distant sounds may be distinctly heard when wholly imper¬ 
ceptible to the unaided ear, is one of the numerous inventions of Mr. 
Thos. A. Edison. The instrument constructed by him, the marvelous 
powers of which were exhibited to us by his laboratory assistant, is of 
such mammoth proportions as to be of no particular value for the re¬ 
lief of deafness. It is quite doubtful whether it can be sufficiently re¬ 
duced in size to be of any value for this purpose. 

Deaf-Mutism. —Persons who are deaf and dumb are generally un¬ 
able to speak in consequence of being unable to hear, which prevents 
their learning the significance of vocal sounds, although the vocal ap¬ 
paratus may be perfectly developed. Persons may be born deaf in 
consequence of imperfect development of the organs of hearing, or of 
disease of the ear previous to birth. In many cases, deafness is the re¬ 
sult of diseases occurring in infancy or early childhood. It is not nec¬ 
essary that hearing should be entirely destroyed to produce deaf-mut- 
ism, as a considerable degree of impairment of hearing will often pre¬ 
vent a child from making the necessary attempts to learn to speak. It is 
thought that the marriage of persons nearly related, is a frequent cause 
of deaf-mutism, as it has been supposed to be of idiocy. 

Treatment .—Although in these cases there is no call for treatment 
for the purpose of restoring the hearing, there is an imperative necessity 
for the employment of proper measures by means of which the condi¬ 
tion of these unfortunate individuals may be ameliorated. The experi¬ 
ence of numerous deaf and dumb asylums in this and other countries 
has shown beyond question that deaf mutes are capable of a high de¬ 
gree of mental culture and such a course of training as will render 
them able to compete with their more fortunate fellows in the various 
departments of life. Educated mutes are able to communicate 
readily with each other by means of the “sign language,” a sort of 
natural mode of speech which is in common use among the North 
American Indians and other savage tribes. Attention was first called 
to this mode of mute speech through its use by two deaf mute sisters. 


THE MANUAL ALPHABET. 

DEAF WiD DMB ALPHABET. 


1517 


467. A 



472. F 473. G 474. H 




476. J 





492. Z 


490. X 

: d -d i0 O q p 
C e u u) tj d 

494. VISIBLE SPEECH. 









1518 


SURGERY. 


It has been improved and perfected, until it admits of great fluency 
of expression and is capable of expressing ideas with sufficient rapidity 
to follow very closely an ordinary speaker. Educated mutes usually 
make use, to a greater or less extent, of the manual alphabet, page 1517, 
by means of which words may be readily spelled out. The greatest 
advance in the instruction of the deaf and dumb, has been through the 
discovery that mutes can be taught to understand spoken language by 
carefully watching the movements of the lips and throat, and can also 
become able to speak by imitating the movements by which various 
sounds are produced. This is known as the “German method.” A 
successful attempt has been made to illustrate the various sounds of 
speech by means of symbols termed “visible speech,” a few illustrations 
of which are given in Fig. 494. 


TUMORS, 

Of the great variety of tumors to which the human body is sub¬ 
ject, the great majority are of a benign character, although the great 
number of cancer doctors, with whom the country is infested, and who 
attach the name of cancer to every morbid growth no matter how 
simple and harmless its character, have given rise to such a wide¬ 
spread misapprehension upon this subject that the term tumor is in 
the minds of most people almost synonymous with cancer or malignant 
disease. Tumors of this class may consist of fibrous, mucous, fatty, 
osseous, cartilaginous, muscular, or vascular tissue. They produce no 
symptoms except those which arise from pressure or weight. 

Fibrous Tumors. —These growths are quite firm in character and 
slow in growth. They are found more often in the uterus than in any 
other organ. They also occur in the skin, in the throat, in the nasal 
cavity, in the globe of the ear, and in other parts of the body. They 
not infrequently contain sacs which are filled with fluid. The proper 
treatment is removal when the growth occurs in such a location as to 
be productive of inconvenience or a source of interference with the 
function of any organ of the body. 

Fatty Tumors. —These are more common than any other variety 
of tumor. They generally grow very slowly, and sometimes attain to 
very great size. They are formed by an increased growth of fatty 
tissue. They are distinguished from fibrous tumors by being less firm 
in character. They have a peculiar doughy feeling. Treatment con- 


TUMORS. 


1519 


sists in removal when the tumor becomes so large as to occasion seri¬ 
ous inconvenience. 

Cartilaginous Tumors. —These tumors are much less frequent 
than the preceding. They most frequently occur upon the joints of 
the fingers and the toes. They have a marked tendency to degener¬ 
ate into malignant growths, and hence should be removed as soon as 
distinctly recognized. 

Bony Tumors. —These growths are sometimes composed of bony 
tissue alone, at other times a mixture of bony and cartilaginous tissue. 
In still other cases, they consist largely of fibrous tissue. They are 
sometimes quite well defined in shape, and in other cases are more 
diffused. The most common form of bony tumor is that known as 
sarcoma, which is closely allied to cancer. 

Treatment .—In cases in which it can be clearly determined that 
the tumor is a sarcoma, the proper treatment is amputation of the 
limb as far above the disease as possible. 

Cystic Tumors. —Cystic tumors consist of cystic growths, which 
are generally filled with fatty matter of a cheesy consistency, or serum. 
The most common is that known as “ wen,” which most frequently 
occurs upon the scalp. Proper treatment is division of the cyst with a 
knife, and removal of the sac. 

Horny Tumors. —These growths are of very infrequent occur¬ 
rence. They occur most often upon the head and have been observed 
upon the tip of the nose. They are readily cured by removal. 

Cancer. —This formidable malady, though at first of a local char¬ 
acter, sooner or later involves the whole system through absorption of 
what is known as the cancer juice, or the broken down elements of 
the growth. There are several varieties of cancerous or malignant 
growths. Its most frequent location is the breast. It occurs most 
often between the ages of thirty and fifty, though it occasionally ap¬ 
pears at a much earlier or a much later age. The variety of the dis¬ 
ease popularly known as stone cancer, so-called on account of its ex¬ 
cessive hardness, is the most common. After ulceration has taken 
place, the term rose cancer is frequently applied. Black cancer is a 
form of the affection in which there is a great increase of coloring 
matter, producing a dark color. 

Epithelioma is the proper name of what is ordinarily known as 
skin cancer.” Cancer may occur in any part of the body. It is gen- 


1520 


SURGERY. 


erally accompanied by pain, and sooner or later, by severe ulceration. 

Among the causes of cancer, probably local irritation, as of the 
tongue and lips from a pipe and tobacco smoke, is the most active. 
Irritation of the tongue from a decayed tooth has also occasioned can¬ 
cerous disease in that organ. 

Treatment .—There is no internal remedy which exercises any cur¬ 
ative influence over this disease, neither is there any remedy which by 
external application will cause the cancer to be absorbed or disappear. 
The only remedy is removal of the diseased parts, which should be ac¬ 
complished as thoroughly and quickly as possible after its character 
has been discovered. This may be accomplished by means of caustics 
of various kinds, or by the knife. The latter method is generally to 
be preferred as the most thorough and effective. We have used both 
methods in the treatment of cancer, and unhesitatingly pronounce the 
latter as the most superior in the great majority of cases. Frequent 
freezing of a malignant growth, and constantly wearing upon it an ice 
bag or compress, are means of delaying the progress of the affection. 

MISCELLANEOUS SURGICAL DISEASES AND OPERATIONS. 

Ligation of Blood-Vessels.— This is an operation which is gen¬ 
erally performed by the surgeon, but which almost any person may be 
called upon to perform in an emergency. The operation consists in 



seizing the end of the bleeding vessel with a pair of forceps, Fig. 495, 
and tying the artery with a ligature of silk or some other strong ma¬ 
terial. Catgut, horse-hair, silver and iron wire, and other similar sub¬ 
stances are employed for this purpose. Silk ligatures arc quite irri¬ 
tating in character, and consequently soon come away by ulceration. 
When the wound must be closed immediately, catgut ligatures are em¬ 
ployed, which are after a time absorbed, so that no further attention 
need be given them. 

The operation of torsion, which consists in twisting the end of the 
severed artery, is now often employed instead of the ligature. 












HARE-Lir. 


15-21 


Hare-Lip. —This deformity results from failure of the bones of 
the two sides of the face to unite in the process of development. 
W hen the difficulty occurs upon one side alone, the patient has single 
hare-lip. When it occurs upon both sides, the deformity is double. 
The appearance of this deformity in its different 
phases is well shown in Figs. 490 to 49S. The 
difficulty seems to be hereditary in some families. 

It occurs most often in males. 

The only remedy is a surgical operation, 
which consists in paring the edges of the cleft 



496 . 




498. 


on each side and bringing them together with proper sutures. The 
operation is generally a very successful one. It should be performed, 
by preference, sometime between the third month and the period of 
teething. 

Cleft Palate.— This difficulty may exist either alone or in connec¬ 
tion with hare-lip, being also the result of defective development. The 
cleft may involve simply the uvula, or hanging part of the soft palate, 
or may extend through the whole roof of the mouth. A person suf¬ 
fering with an extensive cleft of the palate, has a peculiar nasal tone 
of voice and great indistinctness of articulation. 

The treatment consists in closure of the cleft by a surgical operation. 
As a general rule, the operation is by no means so successful as in 
hare-lip. The art of dentistry presents a much more perfect remedy 
in an artificial hard palate to close the roof of the mouth, to which is 
attached, at the back end, an artificial soft palate composed of rubber. 

Restoration of the Nose. —This is one of the nicest operations in 
mechanical surgery, and, when successfully performed, results in the 
removal of a hideous deformity, as the human face can hardly be more 
terribly disfigured than by the removal of the nose, either as the re¬ 
sult of accident or disease. The operation consists in transplanting 
portions of skin from the forehead. 

90 






1522 


SURGERY. 


Polypus of the Nose. —There are two kinds of polypi found in 
the nasal cavity, mucous, and fibrous. The mucous polypus is by far 
the most common It has a soft consistency, is of a pale yellowish 
gray, or slightly greenish color, of a shiny and somewhat translucent 
appearance. These polypi may occur singly, or multiple. They gener¬ 
ally produce a sense of fullness and weight in the affected nostril, 
which may become so much obstructed as to interfere with the respira¬ 
tion and affect the voice. The greatest difficulty is always experi¬ 
enced during damp weather. 

The treatment consists in removal by means of a pair of forceps. 
The growth should be grasped near its root and forcibly torn from its at¬ 
tachment. Fibrous tumors, when small or young, may be treated in the 
same way. They sometimes, however, become so large as to require a 
much more serious surgical operation. 

Elongated Uvula. —When the uvula becomes greatly elongated, 
as is sometimes the case, it becomes necessary to remove a portion of it. 
This is done by grasping the end of the organ with a pair of forceps 
and snipping off one-half or two-thirds of its length. 

Alveolar Abscess—Ulcerated Teeth—Gum-boil. —This consists in 
the formation of an abscess at the root of a tooth. It is generally the 
result of decomposition of a dead nerve or of the pulp of a tooth. The first 
symptoms felt are soreness of the affected tooth, which feels longer than 
natural. After a few hours, severe pain begins, which continues four 
or five days, after which, a swelling upon the gum near the tooth may 
be discovered, which in time, if left to itself, breaks and discharges. If 
not properly treated, the abscess may continue to gather and break for 
a long time Proper treatment consists in cold applications to the side 
of the face, holding ice, or iced-water in the mouth in order to limit 
the inflammation as much as possible, and lancing of the abscess when 
it is formed. A skillful dentist should be employed to treat the teeth. 

Salivary Calculus—Tartar. —This is an incrustation which is 
formed upon the teeth, chiefly on the inner portions, through decompo¬ 
sition of the saliva. It varies in color from whitish yellow to a dark 
brown, and even green. When tartar is allowed to accumulate in 
large quantities, it often causes absorption of the gums, so that the 
teeth become loosened and their utility greatly lessened. A person 
suffering with tartar upon the teeth, generally has bad breath. The 
tartar should be thoroughly removed from the teeth by a competent 


REMOVAL OF THE TONGUE. 


1523 


dentist, and the teeth should be kept entirely free from any deposit of 
this sort by means of daily cleansing and thorough brushing. The 
teeth may be greatly injured by neglect of this precaution. 

Decay of the Teeth. —Decay, or caries of the teeth, is an exceed¬ 
ingly common affection. It is generally produced by decomposition of 
portions of food left between the teeth, which undergo decomposition, 
developing lactic acid, which has the power to dissolve the enamel. 
When the teeth are only slightly diseased, and even when quite badly 
affected with caries, much good may be done by having the teeth 
properly filled by a competent dentist. When the teeth become so bad 
that filling is out of the question or useless, it may become necessary to 
have them drawn. The teeth should be saved whenever it is possible 
to do' so. It is rarely necessary to use an anaesthetic in drawing 
teeth, though nitrous oxide is much used for this purpose. A recently 
proposed substitute for anaesthetics in these cases is rapid breathing. 
In employing this method, the patient should breathe about one hun¬ 
dred times a minute, keeping up the respiration during the whole 
operation. 

Tongue-Tie. —This is an affection in which the fraenum of the 
tongue extends too far forward. The remedy is simply division of the 
superabundant tissue, care being taken to avoid cutting the arteries of 
the tongue. 

Removal of the Tongue. —This is an operation sometimes ne¬ 
cessitated by cancer. In a number of cases in which the operation has 
been performed, the surprising effect has been observed that there was 
not loss of speech ; at any rate, the power of speech was usually re¬ 
covered by practice, and became nearly as perfect as when the tongue 
was present. 

Ranula. —This consists in a cyst beneath the tongue which is 
formed by obstruction of the salivary duct. The treatment is incision 
of the cyst, and in bad cases, removal of a portion of its walls. 

Tracheotomy. —This operation consists in making an opening into 
the trachea, into which is inserted a silver tube, through which the pa¬ 
tient may breathe. When the opening is made into the larynx, the 
operation is known as laryngotomy. The operation is performed in 
cases in which there is serious obstruction in the upper part of the tra¬ 
chea or larnyx. 


1524 


SURGERY. 


Goiter, or Broncliocele- —This disease consists in an enlargement 
of the thyroid gland. When of recent standing, it can generally be 

cured by improvement of the general health, hot and cold applications 
to the throat daily, the local application of the faradic current strongly 
interrupted, and the application of uniform pressure. Galvanic elec¬ 
tricity is also useful in some cases. In old cases, electrical puncture has 
been employed with some success, and passing a ligature through the 
tumor is highly recommended by some. In a few cases, the enlarged 
gland has been removed by the knife. 

Hernia—Rupture.— This accident consists in protrusion of some 
portion of the contents of the abdomen through an opening in its wall. 
There are several varieties, the chief of which are umbilical, inguinal, 



Figr. 499, Truss. 


and femoral. Hernia may be single or double, as it occurs upon one or 
both sides. It is often the result of violent straining in lifting, or of 
straining at stool. 

Treatment .—A person who has hernia should never be without a 
properly fitting truss. Fig. 499. It should be worn constantly, as when 
the hernia is allowed to come down, it may become strangulated, so that 
it cannot be returned, and may speedily terminate the life of the pa¬ 
tient. When hernia gets down in this way, it can generally, if taken 
in hand at once, be readily reduced by careful manipulation, termed 
taxis. Taxis should be performed by placing the patient in an easy 
position, with his limbs flexed so as to take off all strain from the ab¬ 
dominal walls, and then endeavoring to push the protruding bowel back 
through the opening by means of which it has escaped from the abdom¬ 
inal cavity. A few days ago a case came under our care in which the 
hernia had been down for several days, and by means of injudicious 











FILES, OK HEMORRHOIDS. 


1525 


manipulation hail become very greatly inflamed, so that it was impos¬ 
sible to restore the intestine to the abdominal cavity without a surgical 
operation, which we accordingly performed, and with the happy result 
of effecting a cure, as the patient made a good recovery. 

Piles, or Hemorrhoids. —These are small tumors which form just 
within or just external to the anus, from dilatation of the veins of the 
part. When within the anus, they are known as internal hemorrhoids, 
which, from their tendency to bleed profusely at stool, are known as 
bleeding piles; and when about the verge of the anus they are known 
as external hemorrhoids. The latter class is generally much the more 
painful, though otherwise far less serious than the former. 

The principal causes of hemorrhoids are constipation of the bowels, 
violent straining at stool, the use of concentrated food, and obstruction 
to the portal circulation from pregnancy, or from tumors in the abdo¬ 
men, or disease of the liver. 

Treatment .-—As palliative means, the most useful measures are sim¬ 
ple unguents in cases of external piles; and in cases of internal piles, 
the use of warm water or linseed tea enemas before moving the bowels, 
and a small enema of cold water immediately after. The cool sitz bath, 
up spray or douche, and other applications to the anus are also useful. 
Suppositories of various sorts are also useful for the purpose of allaying 
irritation. The radical cure of the affection is accomplished most cer¬ 
tainly by means of the ligature applied by a competent surgeon. Within 
a few years the country has been canvassed by a horde of “ pile doctors,” 
who claim to be aide to accomplish a painless cure by means of a 
secret remedy. The treatment employed by these quacks consists of 
injections of the tumors with a mixture of oil or glycerine and carbolic 
acid in varying proportions. The process is successful in most cases, 
but is not wholly free from danger. We have employed it in a number 
of cases with success, though in many respects we prefer the older 
operation. 

Fissure of the Anus. —This is an exceedingly painful affection of 
the anus, consisting of a small, irritable ulcer just within the opening 
of the anus, which is commonly the result of rupture of the membrane 
of the part from straining at stool. It is characterized by a peculiar 
burning, teasing pain which comes on soon after relieving the bowels 
and is extremely persistent. 

Treatment .—The treatment of this condition consists in stretch¬ 
ing- the anus so as to partially paralyze the muscle, by the contraction 


152G 


SURGERY. 


of which the ulcer is kept in an irritable condition and healing pre¬ 
vented. A person suffering with fissure should keep the bowels in a 
soft condition, if necessary using an enema of linseed tea each time 
the bowels are moved. Relieving the bowels over a vessel partially 
full of hot water is one of the best means of relieving the 


pain of the affection. 

Itching of the Anus. —This affection is sometimes so in¬ 
veterate as to make life almost intolerable. Among its chief 
causes are dissipation, the use of tea, coffee, tobacco, alcoholic 
drinks, sedentary habits, piles, worms, various skin diseases, 
and nervous disorders. 

Treatment .—Take a sitz bath at 92° five minutes and 
85° ten minutes once a day. After the bath, wash the part 
well with soap, and apply equal parts of alcohol and water, 
or apply tincture of iodine or sulphur ointment. If worms 
are present, give the treatment elsewhere recommended for 
the same. 

Abscess Near the Anus. —This form of abscess is not 
uncommon. High living, irregular and sedentary habits, 
straining at stool, and general derangement of the health are 
all causes which may result in abscess near the rectum. It 
is a curious fact that this form of abscess shows a great ten- 
dency to become chronic and little disposition to heal kindly, 
often resulting in fistula. 

Treatment .—As soon as a painful swelling near the anus 
is felt, go to bed and apply ice or very cold compresses con¬ 
stantly for twenty-four hours. If the soreness and swelling 
continue to increase, apply hot fomentations to hasten the 
process. 

Fistula in Ano. —This very troublesome affection usu¬ 
ally results from the preceding. It rarely recovers of itself. 
There is no danger in curing the affection, even when it is 
of long standing, as a suppression of the discharge does not 
result in disease of the lungs in persons whose pulmonarv 
organs are weak, as is popularly supposed. 

Treatment .—The affection may be palliated by means of frequent 
cold bathing and wearing a small quantity of oakum pressed against 
the part, or a sponge squeezed out of a strong solution of permanganate 


=3 


500. 











PROLAPSUS OF THE RECTUM. 


1527 

of potash; but the only radical remedy is division of the tissues with a 
probe pointed bistoury, Fig. 500. 

Ulcer of the Rectum. —This affection is generally located two to 
four inches above the anus, and is accompanied by symptoms of uneasi¬ 
ness in the rectum, with dull pain in the back between the hips, and 
“morning diarrhea.” From extension, this disease may result in 
stricture. 

Treatment .—The treatment which is at present most highly recom¬ 
mended is confinement in bed, an exclusively milk diet, and in bad 
cases, division of the nicer and of the sphincter by a surgical operation. 

Stricture of the Rectum. —This affection of the rectum is gener¬ 
ally located within two to four inches of the anus. The condition is 
quite hard to detect, in many cases, especially when beyond the reach 
of the finger. The treatment of the disease is purely surgical, and con¬ 
sists in dividing the stricture with a knife and then dilating by means 
of proper instruments. 

Prolapsus of the Rectum—Falling of the Bowel. —This is a 
condition in which the mucous membrane of the rectum or the whole 
bowel is pressed out by means of straining at stool. It occurs most often 
in children and in persons suffering with hemorrhoids. 

Treatment .—Keep the bowels soft by a relaxing diet and enemas 
of linseed tea or milk and water. Have the patient relieve the bowels 
in a horizontal posture, with the hips supported over the edge of a vessel. 
Drawing the anus to one side by traction with the hand upon the 
fleshy portion of the hip is a good measure for prevention. Bathing 
the prolapsed part with cold water several times a day is also a useful 
measure. If the rectum does not retract of itself at the end of defeca¬ 
tion, it should be replaced by pressure with the fingers over a thin cloth 
smeared with vaseline or some other fine unguent. 

Polypus of the Rectum. —The rectum is sometimes the seat of 
growths of a character similar to those which are found in the nose, 
as before described. We had a case a few years ago in which we found 
more than two hundred of different sizes, forming a mass larger than the 
fist. The patient, a young lady, had been examined by many physi¬ 
cians, and her case had been pronounced by all a hopeless one of cancer 
of the rectum. Upon a critical examination, we discovered its charac¬ 
ter, however, and by the proper operation restored her to health after 
she had been a most pitiful sufferer for many years. 


1 .">28 


SURGERY. 


Tredtnisiit .—These tumors arc very easily cuied b\ tying a liga¬ 
ture about the neck of the tumor. It usually falls ofi in three or four 
days. In the case mentioned above we employed both the ligature and 
the galvano-cautery. 

Paralysis of the Rectum.— This may be the result of general 
paralysis or of paraphlegia, or partial paralysis may result from the long 
continuance of piles. The proper treatment is the daily application of 
electricity and frequent cold applications. 

Absence of the Anus.— This is a congenital deformity which 
should always be looked for in young children, as it is possible to 
remedy the defect by a proper surgical operation. 


Artificial Anus. —The production of an artificial anus is one of the 
devices of modern surgery for the relief of permanent stricture, 01 clos¬ 
ure of the natural outlet of the bowels from malignant disease. 

Use of the Catheter.—The passage of the catheter is in some 
cases one of the most delicate onerations in surgery, but when a gum elas¬ 



tic instrument is used, and the instrument is allowed to follow the course 
of the canal without the application of any very great degree of force, 
it may generally be accomplished with ease, even by the patient him¬ 
self. Every person who is at times dependent upon a catheter, should 
learn the art of using it properly from a skillful surgeon. The passage 
of the instrument in females is a very simple operation. 

Urinary Calculus. —In some cases stony concretions form in the 
bladder, and attain such a size as to make their removal by a surgical 
operation necessary. The old operation was by cutting open the base 
of the bladder ; but calculi are now removed by the much less for¬ 
midable operation of crushing with an instrument similar to the one 















STRICTURE OF TIIE URETHRA. 


] :>20 


shown in Fig. .‘>02. The fragments are washed out by means of a 
stream of water from a powerful rubber bulb. 

Extroversion of the Bladder. —This is a deformity in which 
there is failure of the bladder and abdominal walls to close 
up in the process of development, so that the inside of the 
bladder is exposed. The principal inconveniences occasioned 
are those arising from the constant dribbling of urine upon 
the adjacent parts of the body, which cannot be wholly 
prevented by any practical means. The defect has been 
remedied in a few cases by a surgical operation. 

Hypospadias.—In this deformity there is an imperfect 
development of the urethra, which occasions deformity of the 
penis as well as inconvenience in urinating. This defect 
may also be remedied in many cases by a surgical operation. 

Stricture of the Urethra. —This is a condition in 
which the urethra is contracted in some part of its length. 

Stricture is most often the result of inflammation. Its pres¬ 
ence is indicated by difficulty in passing urine or ability to 
pass but a small, weak stream. Sometimes there are two 
or more streams which are often curved or spiral. There 
is also usually dribbling of urine at the close of urination, 
and more or loss discharge from the urethra. 

Treatment .—The treatment of stricture can be con¬ 
ducted only by a competent surgeon ; but it is a matter of 
great importance that these cases receive prompt attention. 

Yaricocele. —This morbid condition consists in a vari¬ 
cose state of the spermatic veins. It is almost always found 
upon the left side, owing to an anatomical peculiarity of the 
spermatic vein of that side. It has been supposed to be a 
result of masturbation and its effects, but is certainly caused 
otherwise in many cases. It is not infrequently found in 
these patients , but Prof. Bartholow contends that even in 
such cases, we should “consider its presence, in general, as 
accidental.” Atrophy of the left testicle is often produced 
by the pressure of the distended, veins. 

Treatment .—The inconveniences of the disease may be 
greatly lessened by wearing a suspensory bag ; but the best treat- 

I 



502 . 













1530 


SURGERY. 


inent is an operation by means of which the scrotum is converted into 
a permanent suspensory bag. 

Hydrocele. —This is a dropsy of the testicle. The spermatic cord 
may also be affected. The tumor usually has a translucent appearance 
when viewed with a strong light behind it. It differs from hernia in 
that it cannot be reduced or pressed back into the abdominal cavity, 
does not diminish during sleep or while lying down, is not increased by 
coughing, and does not come down from above. 

o o 7 

Treatment .—The proper treatment is a surgical operation, which 
may consist of simply tapping or withdrawing the fluid by an aspira¬ 
tor, or laying open the tumor. A surgeon should be consulted. A sus¬ 
pensory bag will give temporary relief. 

Phimosis. —This is a condition in which the prepuce or fore-skin 
is so tight that it cannot be drawn back over the glands. It is best 
remedied by the operation of circumcision. In the majority of cases 
we simply slit up the foreskin to the back side of the glands. In one 
or two cases we have resorted to the use of an elastic ligature with 
success. 

Paraphimosis. —In this condition the foreskin has been drawn 
back and has become swollen behind the glands in such a manner as 
to prevent it from being drawn forward. The condition is sometimes a 
very painful one, the end of the organ becoming greatly swollen. 

Treatment .—Grasp the organ between the first and second fingers 
of each hand and press steadily against the end of the glands with 
the ends of the thumbs. 

Circumcision. —The fold called the prepuce, has upon its inner 
surface glands which produce a peculiar secretion. Under cer¬ 
tain circumstances, and from inattention to personal cleanliness, this 
secretion may accumulate, and then often becomes the cause of 
irritation and serious disease. To prevent such disorders, and to in¬ 
sure cleanliness, the Jewish law required the removal of the prepuce, 
which constituted the rite of circumcision. 

Castration. —This operation consists in the removal of the testes 
It does not at once obliterate the sexual sense, especially if performed 
after puberty, but of course renders the individual sterile, or inca¬ 
pable of reproduction. Persons on whom it has been performed are 
called eunuchs. 

An analogous operation, termed spaying, is performed upon fe¬ 
males, consisting in the removal of the ovaries. 


GLOSSARY 


FOR WORDS NOT FOUND IN THE FOLLOWING LIST, THE READER SHOULD 

CONSULT THE GENERAL INDEX. 


Abnormal, unnatural, unhealthy. 
Accoucher, obstetrician. 

Amblyopia, degeneration of the optic 
nerve. 

Amoeboid, like an amseba. 

Amorphous, of irregular form. 
Anomalous, contrary to a general rule. 
Antidote, something which will counter¬ 
act the effects of a poison. 

Antiseptic, preservative agent. 
Antiphlogistic, opposed to fever or in¬ 
flammation. 

Aphthous, affected with aphthae. 
Articulation, the union of two bones. 
Ascites, dropsy of the peritoneum. 
Asphyxia, suspended animation. 
Asthenia, debility, lack of strength. 
Atonic, wanting tone. 

Auditory, pertaining to the act of hear¬ 
ing. 

Autopsy, examination after death. 
Axilla, hollow beneath the shoulder. 
Bilateral, having two sides. 

Blue stone, blue vitriol. 

Bolus, a large pill. 

Bougie, a long flexible instrument for 
dilating narrow passages. 

Bursa, a sac. 

Cachexia, a diseased condition of the 
nutritive system. 

Cachectic, unhealthy. 

Calculus, a hard concretion. 

Canthus, the angle of the eye. 

Capillary, resembling a hair. 


Caries, ulceration of bone. 

Carpus, the bones forming the wrist. 

Catamenia, the menstrual period. 

Cautery, a burning or searing. 

Cerebral, pertaining to the cerebrum. 

Cerebration, cerebral activity, thought. 

Cerumen, ear-wax. 

Cervix, neck. 

Chlonic, convulsion with alternate re¬ 
laxation. 

Cicatricial, scar like. 

Climacteric, a critical period of life. 

Coagulum, a clot or curd. 

Collapse, a sudden failure of the vital 
force. 

Colliquative, relating to discharges pro¬ 
ducing great exhaustion. 

Collyrium, an application to the eye. 

Coma, a profound state of sleep, from 
which it is'hard to rouse a person. 

Congenital, dating from birth. 

Congestion, unnatural accumulation of 
blood in a part. 

Contagion, an agency by which diseases 
are transmitted. 

Contagious, communicable by contact. 

Convalescence, the stage of recuperation 
after illness. 

Copperas, green vitriol. 

Coryza, nasal catarrh. 

Cranium, the skull. 

Cretinism, a state of idiocy accompanied 
by goitre. 

Crisis, the turning point. 


1531 





1532 


GLOSSARY. 


Cuticle, the outside skin. 

Cutis, the “true skin.” 

Decussate, to cross. 

Demulcent, a substance of bland, sooth¬ 
ing nature. 

Depletion, lessening of vitality or activ¬ 
ity- 

Dei'inatologist, a specialist in skin dis¬ 
eases. 

Dessicated, dried. 

Diagnosis, the discrimination of disease. 

Diaphoretic, a remedy which will in¬ 
duce perspiration. 

Diathesis, constitutional a flection or 
tendency. 

Diuresis, an increased secretion of urine. 

Diuretic, a medicine which will increase 
the secretion of urine. 

Dorsal, pertaining to the back. 

Dorsum, the back. 

Dysuria, difficult urination. 

Ecchymosis, a discolored spot, the effect 
of a bruise or rupture. 

Effusion, the escape of fluid out of its 
natural vessel into another part. 

Electrotherapy, treatment of disease by 
electricity. 

Emmenagogue, a remedy that promotes 
the menstrual flow. 

Endemic, a disease arising from some 
peculiarity of situation or locality. 

Entozoa, internal parasites, worms. 

Ephemera, fever of short duration. 

Epidemic, a disease attacking at the 
same time a number of individuals, 
supposed to be caused by some pecu¬ 
liar condition of the atmosphere. 

Epigastrium, pit of the stomach. 

Epistaxis, nosebleed. 

Erotic, passionate, sensual. 

Empiricism, quackery. 

Erethism, irritation, excitement. 

Etiology, that department of medical 
science which treats of the causes of 
disease. 

Excoriated, raw, deprived of skin. 


Expectant Medication, a method in 
which the patient is left almost 
wholly to the efforts of nature. 

Extravasation, escape of fluid into the 
tissues. 

Exudation, oozing of fluid through the 
pores of a membrane or skin. 

Fascia, the thin, tendinous covering of 
muscles. 

Fauces, the posterior portion of the 
mouth. 

Febrile, feverish. 

Fluor albus, whites, leucorrhoea. 

Fceces, excrement, natural discharge 
from the bowels. 

Follicle, a gland in a membrane. 

Fomites, substances supposed to retain 
disease germs. 

Fontanel, soft spot on head of infant. 

Foramen, a cavity. 

Fungus, a morbid growth. 

Galactorrhoea, excessive secretion of 
milk. 

Ganglion, a collection of nerve cells. 

Gangrene, mortification. 

Gastric, pertaining to the stomach. 

Globus hystericus, sensation of a lump in 
the throat. 

Glottis, the openings between the vocal 
cords. 

Grumous, clotted. 

Gynecologist, a specialist in diseases of 
women. 

Hemicrania, a pain affecting but one 
side of the head. 

Hepatic, pertaining to the liver. 

Homologous, similar in structure. 

Hydatid, a tumor containing transpar¬ 
ent fluid. 

Hydropathy, the science of the use of 
water as a remedial agent. 

Hydriatics, hydrotherapy. 

Hypercesthesia, unnatural sensibility. 

Hypertrophy, over-growth. 

Hypnotic, a remedy which induces sleep. 

Hypodermic, under the skin. 





GLOSS A BY. 


1533 


Hydrotherapy, hydropathy. 

Idiopathic, a primary disease. 
Idiosyncracy, a peculiarity of constitu¬ 
tion. 

Inanition, exhaustion from want of 
nourishment. 

Incubation, the period between the ex¬ 
posure to a contagious disease and 
the attack resulting from it. 

Infection, contagion. 

Inguinal, pertaining to the groins. 
Insomnia, absence of sleep. 

Intermittent, a disease which subsides at 
certain intervals. 

Labia, lip. 

Lactation, the period of milk secretion. 
Lamina, a thin plate or scale. 

Lateral, pertaining to the side. 

Lesion, an injury of structure. 

Lethargy, unnatural sleepiness. 
Lithotomy, the operation for stone in 
the bladder. 

Lobe, a round projecting division of an 
organ. 

Lumbar, pertaining to the loins. 
Lymph, fluid of the lymphatics. 
Maceration, soaking. 

Materia medica, science of medicine. 
Menstruum, fluid medium. 
Metamorphosis, complete change of 
form. 

Metastasis, a change in the seat of dis¬ 
ease. 

Moribund, dying. 

Narcotism, narcotic poisoning. 

Nates, buttocks. 

Nephritic, pertaining to the kidneys. 
Neurosis, disease of the nerves. 

Node, a protuberance. 

Normal, natural. 

Nostrum, patent medicine. 

Ntichce, nape of the neck. 

Occiput, back part of the head. 
(Edematous, dropsical swelling which 
pits on pressure. 

Oil of vitriol, sulphuric acid. 


Olfactory, pertaining to the sense of 
smell. 

Opthalmic, pertaining to the eye. 

Osmosis circulation of fluids through 
moist membranes. 

Ossification of bone, formation of bone. 

Ovariotomy, the operation of removing 
the ovary. 

Ovum, egg, female element of genera¬ 
tion. 

Panacea, a universal remedy. 

Paracentesis, the operation of tapping 
to evacuate fluid in dropsy. 

Paralysis, loss of sensation or power of 
motion. 

Parietes, inclosing walls. 

Paroxysm, a sudden violent action. 

Pathology, the science of diseases. 

Pathognomonic, characteristic. 

Pectoral, relating to the breast. 

Pedicle, the stalk, or neck. 

Pediluvium, a bath for the feet. 

Pellicle, a thin skin or membrane. 

Petechia, small spots in shape and color 
resembling flea-bites. 

Pharynx, upper portion of the throat. 

Phlebitis, inflammation of the inner 
membrane of a vein. 

Phlebotomy, blood letting. 

Phlegmasia-dolens, milk-leg. 

Pitting, indentation produced by pres¬ 
sure with the finger. 

Plethora, a condition in which there is 
a superabundance of blood. 

Pleurodynia, pain in the chest. 

Plexus, a net-work of vessels or nerves. 

Polypus, a variety of tumor. 

Post-mortem, after death. 

Primes, vice, the alimentary canal. 

Process, a prominence on a bone. 

Prognosis, a judgment respecting the 
progress or result of a disease. 

Prolapsus, falling. 

Prophylactic, a preservative remedy. 

Pruritus, itching. 

Pseudo, spurious. 



1534 


GLOSSARY. 


Psychology, science of the mind. 

Ptyalism, an excessive secretion of sa¬ 
liva. 

Puerperal, pertaining to childbirth. 

Pulmonary, pertaining to the lungs. 

Pyrexia, condition of normal heat. 

Regurgitation, the rising of fluids into 
the mouth. 

Remittent, abating periodically in sever¬ 
ity. 

Rigor, sensation of cold with shivering. 

Spectroscope, an instrument used in 
spectrum analysis. 

Soporific, productive of sleep. 

Sedatives, medicines which depress the 
vital forces. 

Senile, relating to old age. 

Sensorium, the common center of sensa¬ 
tions. 

Sequelce, morbid conditions sometimes 
left by an acute disease. 

Serum, a component of the blood. 

Sialagogues, remedies which increase 
the secretion of saliva. 

Slough, to come off; mortification. 

Sopor, deep sleep. 

Sphincter, a circular muscle. 

Sputum, matter expectorated. 


Sporadic, a disease which arises from 
an accidental cause. 

Stertor, snoring breathing. 

Strangulation, a stoppage of the circula¬ 
tion by compression. 

Stupor, unconsciousness. 

Subcutaneous, underneath the skin. 

Sudorific, a medicine which induces 
perspiration. 

Synchronous, simultaneous. 

Syncope, fainting. 

Tenesmus, constant desire to evacute the 
bowels. 

Traumatic, pertaining to a wound. 

Trismus, partial lockjaw. 

Therapeutics, that branch of medical 
science which considers the treatment 
of disease. 

Vasomotor, pertaining to the motion of 
the blood in the vessels. 

Velum, a veil. 

Ventral, abdominal. 

Vesication, formation of blisters. 

Virus, poison. 

Viscus, any internal organ. 

Viscera, plural of viscus. 

Vivisection■, dissection during life. 

Volition, will. 

Vomica, an abscess in the lungs. 




WORKS QUOTED, AND AUTHORITIES CONSULTED 
IN THE PREPARATION OE THIS WORK. 


Acton. —The Reproductive Organs. 

Agnew. —Lacerations of the Female Perinseum 
and Vesico-Vaginal Fistula. 
Allingham. —Diseases of the Rectum. 

Allen. —Aural Catarrh and Curable Deafness. 
Ames. —Sex in Industry. 

Annual Reports of the American Public 
Health Association. 

Annual Reports of the Michigan State 
Board of Health. 

Arthur. —Prevention of Decay of the Teeth. 
Aveling. —Posture in Gyneeic and Obstetric 
Practice. 

Harwell.—C urvatures of the Spine. 

“ Diseases of the Joints. 

Bartholomew. —Hypodermic Medication. 
Bartholow. —Spermatorrhoea. 

Bayles. —House Drainage and Water Service. 
Beard and Rockwell.— Medical and Surgical 
Electricity. 

Bell. —Baths. 

The Teeth. 

“ Regimen and Longevity. 

Bennett.— Pulmonary Consumption. 

“ Nutrition in Health and Disease. 

‘‘ Clinical Lectures on the Principles 

and Practice of Medicine. 
Bernstein. —Five Senses of Man. 

Birch.— Constipated Bowels. 

Bigelow. —Rational Medicine. 

" Modern Inquiries. 

“ Nature in Disease, and Other Writ¬ 

ings. 

Billing. —First Principles of Medicine. 

Black. —Renal and Urinary Organs. 

“ The Ten Laws of Health. 

Blaserna. —Theory of Sound. 

Bi.oxam. —Organic and Inorganic Chemistry. 
Bodenhamer.— Rectal Medication. 

“ Anal Fissure. 

“ Physical Exploration of the Rec¬ 

tum. 

Bowman. —Medical Chemistry. 

Brinton. —Diseases of the Stomach. 

Buck. —Hygiene and Public Health. 

Burton. —Anatomy of Melancholy. 

Burett. —Hearing and How to Keep It. 

Byrne. —Electro-Cautery in Uterine Surgery. 

Cameron. —Manual of Hygiene. 

“ Chemistry of Food. 

Carpenter.— Mental Physiology. 

“ The Microscope and its Revela¬ 

tions. 

Chambers. —Indigestion. 

“ Restorative Medicine. 

“ Lectures on Renewal of Life. 

“ Manual of Diet. 

Chapman. —Diseases and Displacements of the 
Uterus. 

Clarke.— Manual of Surgery. 

Clymer.— Williams’ Principles of Medicine. 


Combe. —Digestion and Dietetics. 

Cohen. —The Throat and Voice. 

Inhalations, Therapeutics, and Prac¬ 
tice. 

Diseases of the Throat and Nasal Pas¬ 
sages. 

Condie. —Watson’s Practice of Physic. 

Cooke and Berkley. —Fungi. 

Cottle.— The Hair in Health and Disease. 

Dalton. —Physiology and Hygiene. 

Day. —Headaches. 

Delafield. —Post-Mortem Examinations and 
Morbid Anatomy. 

Dieulafoy. —Pneumatic Aspiration. 

Dobell. —Coughs, Consumption, and Diet. 

“ Loss of Weight, Blood-Spitting, and 
Lung Disease. 

Domville. —A Manual for Nurses. 

Duchenne.— Treatise on Localized Electrization. 
Dugdale. —The Jukes. 

Duncan.— Fecundity, Fertility, and Sterility. 
Durant. —Horse-Back Riding. 

Eassie. —Sanitary Arrangements for Dwellings. 
Ecker. —Cerebral Convolutions of Man. 

Elam. —A Physician’s Problems. 

Ellis. —Diseases of Children. 

Eyre. —The Stomach and its Difficulties. 

Fiever. —Electricity for Nervous Diseases. 
Figuier. —The Vegetable World. 

Flint. —Phthisis. 

“ Practice of Medicine. 

“ The Respiratory Organs. 

“ Diseases of the Heart. 

“ Human Physiology. 

“ Relations of Urea to Exercise. 

“ Muscular Power. 

Forbes. —Nature and Art in Disease. 

Foster. —A Text-Book of Physiology. 
Fotheroill. —The Maintenance of Health. 

“ Hand-Book of Treatment. 

Fox.—Skin Diseases. 

“ Epitome of Skin Diseases. 

Frey. —Microscopical Technology. 

Frerichs. —Diseases of the Liver. 

Garland. —Pneumono-Dynamics. 

Gardner.— Longevity. 

Gross. —System of Surgery. 

Haberson. —Diseases of the Stomach. 

Hall. —Narrative of the North Polar Expedition. 
Hamilton. —Principles and Practice of Surgery. 
Hammond. —Cerebral IIypera:mia. 

“ Treatise on Hygiene. 

“ Diseases of the Nervous System. 

“ Spiritualism and Nervous Derange¬ 

ment. 

Hartley.— Air and its Relations to Life. 
Hartshorns. —Our Homes. 

Harlan. —Eyesight and How to Care for It. 

( 1535 ; 




1536 


LIST OF AUTHORS. 


Harvey.— First Lessons in Therapeutics. 

Hart. —Manual of Public Health. 

Hassal.— Food, Its Adulterations, and the Meth¬ 
ods for their Detection. 

Heaton. —Rupture. 

Headland.— Action of Medicine. 

Hilton. —Rest and Pain. 

Holden.— The Sphygmograph. 

Hope. —Till the Doctor Conies. 

Hcfeland.— Art of Prolonging Life. 

Hunt .— 1 The Patient’s and Physician’s Aid. 

“ Stammering. 

Inman.— The Restoration of Health. 

Jacobi. —Infant Diet. 

“ The Question of Rest for Women. 
Jackson.—L etters to a Young Physician. 
James.—S ore Throat. 

Kellogg.— Plain Facts for Old and Young. 

“ Uses of Water. 

“ Household Manual. 

“ Digestion and Dyspepsia. 

“ Alcoholic Poison. 

“ Evils of Fashionable Dress. 

“ Healthful Cookery. 

“ Diphtheria: Its Nature, Causes. Pre¬ 
vention, and Treatment. 

Kingsley. —Health and Education. 

Knight.—O rthopaedia. 

Kitss, Duval, and Armory.— New Manual of 
Physiology. 

Lared.— On Imperfect Digestion. 

Latham.— Nervous or Sick Headache. 

Lee. —Food and Diet. 

Leeds.— Treatise on Ventilation. 

Leishman. —System of Midwifery. 

Letheby.— On Food. 

Lommel. —Nature of Light. 

Mackenzie.— Diphtheria, Its Nature and Treat¬ 
ment. 

Marsden.— Cancer. 

Marshall. —Physiology. 

Maudsley. —Responsibility in Mental Diseases. 
Mays.— Consumption. 

“ On the Therapeutic Forces. 

Meredith.— The Teeth and How to Save Them. 
Millard. —Charcot on Bright’s Disease. 

Miller. —Elements of Chemistry. 

Milton. —Spermatorrhoea. 

Mitchell.— Fat and Blood. 

Mivart. —Lessons in Elementary Anatomy. 
McSiierry. —Health and How to"Promote It. 
Murchison. —Diseases of the Liver. 

Napheys. —Medical Therapeutics. 

“ Surgical Therapeutics. 

Niemeyer. —Text-Book of Practical Medicine. 

*' Lectures on Phthisis. 

Osgood. —Winter and its Dangers. 

Ott. —Action of Medicine. 

Packard. —Sea-Air and Sea-Bathing. 

Pavy. —Digestion and its Disorders. 

“ Food and Dietetics. 

Peaslee.— Ovarian Tumors. 

Phillips. —Materia Mediea and Therapeutics. 


| Poulet. —Foreign Bodies in Surgery. 

Prince. —Galvano-Therapeutics. 

Richardson.— Ministry of Health. 

'• Diseases of Modern Life. 

“ Long Life and How to Reach It. 

Ringer. —Hand-Book of Therapeutics. 
Rindfleish. —Text-Book of Pathological Histol¬ 
ogy. 

Rolfe.— Exercise and Training. 

ItoosA. —Treatise on Diseases of the Ear. 
Rosenthal. —Diseases of the Nervous System, 
j Rosenberg. —The Use of the Spectroscope. 
Rottenstein. —Dental Caries and its Causes. 
Routh. —On Infant Feeding. 

Ryan. —Philosophy of Marriage. 

Soi r ER. —History of Food and its Preparations. 

| Sayre. —Spinal Disease and Curvature. 

*' Practical Manual of Treatment of Club- 
Foot. 

| Schutzenberger.— Fermentation. 

! Seguin. —American Clinical Lectures. 

Manual of Thermometry. 

I Shore.— Life under Glass. 

Sims. —Uterine Surgery. 

Simon. —Filth-Diseases and their Prevention. 
Smith. —Foods. 

“ Philosophy of Health. 

“ Health. 

“ Operative Surgery. 

Spender. —Therapeutic Means for the Relief of 
Pain. 

Storer. —Insanity in Women. 

Stricker. —A Manual of Histology. 

Siveringen. —Dictionary of Pharmaceutical Sci¬ 
ence. 

Tait. —Diseases of Women. 

Tanner. —Memoranda of Poisons. 

“ Index of Diseases and their Treat¬ 
ment. 

Thomas. —Longevity of Man. 

Tilt.— Change of Life. 

Transactions of the American Gyneco¬ 
logical Society. 

Trousseau. —Treatise on Therapeutics. 

Tuke. —Influence of the Mind upon the Body. 
Turnbull.— Anaesthetic Manual. 

Tyson.— The Cell Doctrine. 

Van Buren. —Diseases of the Rectum. 

Vaughn. —Chemical Physiology and Pathology, 
j Virchow.— Cellular Pathology. 

I Wagner. —Manual of General Pathology. 
Walker. — Intermarriage; or Beauty, Health, 
and Intellect. 

Watson. —Diseases of the Nose. 

Wells.— Long, Short, and Weak Sight. 

Diseases of the Eye. 

Wilson. —Hand-Book of Hygiene. 

“ The Skin and Hair. 

| “ Summer and its Diseases, 

j Winslow.— Manual of Lunacy. 

! Wood. —Practice of Medicine. 

Therapeutics, Materia Mediea. Toxicol¬ 
ogy. 

Ziemssen.— Cyclopaedia of the Practice of Med¬ 
icine. 











INDEX OF SYMPTOMS. 


Abdomen, pain in —Diarrhea, 906 ; 
Dysentery, 908 ; Peritonitis, 917 ; 
Colic, 910; Bowel consumption, 
919; Intestinal obstructions, 914; 
Dyspepsia, 921; Gall-stones, 959; 
Lead colic, 911; Tape-worm, 946; 
Penal colic, 1167. 

Abdomen, bloated —Consumption of 
the bowels, 919; Chronic dysen¬ 
tery, 910; Intestinal obstructions, 
914; Dropsy, 917; Cholera in¬ 
fantum, 844; Torpid liver, 954; 
Dyspepsia, 921; Colic, 910. 

Anus, itching: at —Tape-worm, 946; 
Thread-worms, 951; Piles, 1525. 

Appetite, perverted —Worms, 952; 
Dyspepsia, 921; Malacia, 945; 
Pregnancy, 1342; 

Appetite, fickle —Chlorosis, 840; Dys¬ 
pepsia, 921; Tape-worm, 946; 
Round worms, 950; Pregnancy, 
1342; Dilatation of the stomach, 
900. 

Appetite, none —Acute dyspepsia, 935; 
Bilious attack, 888; Fever, 1179; 
Consumption, 1017. 

Appetite, voracious —'Tape-worm, 946; 
Dyspepsia, 921. 

Appetite, little — Torpid* liver, 954; 
Consumption, 1017; Fever, 1179; 
Acute dyspepsia, 935 ; Bilious at¬ 
tack, 888 ; Slow digestion, 936. 

Arteries, visible pulsation of— Hyper¬ 
trophy of the heart, 1046; Or¬ 
ganic disease of the heart, 1051. 
Arcus senilis —Fatty heart, 1048. 
Asthmatic attacks —Emphysema, 
1006; Chronic bronchitis, 1000; 
Asthma, 1003. 

Back, pain in —Fever, 1179; Lumbago, 
1098; Crick in back, (Cramp) 1098. 
Bad taste in mouth —Chronic gastric 
catarrh, 895; Dyspepsia, 921; 
Acute dyspepsia, 935; Slow diges¬ 
tion, 936; Torpid liver, 954; 


Catarrh of stomach, 883; Catarrh 
of mouth, 872; Constipation, 911 ; 
Congestion of liver, 956; Jaun¬ 
dice, 960. 

Baldness —Anaemia, 836; Dyspepsia, 

921; Dandruff, 1271. 

Barking cough —Croup, 992; Spasm 
of glottis, 995. 

Beating at the stomach —Torpid liver.. 
956; Painful dyspepsia, 939. 

Bearing down in bowels or rectum— 

Dysentery, 908, 910; Inflamma- 
tion of prostate, 1287; Ovarian 
dropsy, 1305. 

Bearing down in bladder —Inflamma¬ 
tion of the prostate gland, 1287; 
Spasm of bladder, 1166; Irritabil¬ 
ity of bladder, 1166; Cystitis, 
1163; 

Biliousness —Dyspepsia, 921; Torpid 
liver, 954. 

Bile, vomiting —(Seebilious vomiting.) 

Bilious vomitiug —Catarrh of the stom¬ 
ach, 888; Bilious typhoid, 1193; 
Bilious dyspepsia, 937 ; Bilious at¬ 
tack, 888; Gall-stones, 959. 

Bitter taste in the mouth —Bilious 
dyspepsia, 957; Congestion of the 
liver, 956; Jaundice, 960; Tor¬ 
pid liver, 954; Contracted liver, 
963. 

Bladder, pain in —Cystitis, 1163. 

Bladder, irritation of— Gravel, 1167- 

Black in the face —Spasm of the glottis, 
995. 

Bleeding from the lungs —Pulmonary 
apoplexy, 1013; Consumption, 
1017. 

Bleedi n g, persistent—H ae m o p h i 1 ia, 

863. 

Bleeding gums —Scurvy, 864. 

Blinking eyes —Mimetic spasm, 1112. 

Blindness—Tape-worm, 946; Tumor 
in the brain, 1089; Cataract, 1495. 

1537 





1538 


INDEX OF SYMPTOMS. 


Blood spots on skin—Scurvy, 864. 

Bloody vomiting —Gastric ulcer, 902; 
Cancer of stomach, 904; Yellow 
fever, 1194. 

Bloody urine— Hemorrhage from the 
kidneys, 1154: Hemorrhage from 
the bladder, 1164. 

Bloody expectoration— Congestion of 
the lungs, 1009; Croupous pneu¬ 
monia, 1014; Pulmonary hemor¬ 
rhage, 1011. 

Blueness of skin—Blue disease, 1059. 

Blurred sight—Nervous dyspepsia, 
941; Torpid liver, 956; Weak sight, 
1499. 

Boring pain in the hones— Mollites os- 
sium, 1178; Caries of bone, 1455; 

Bowel discharges, light-colored— Tor¬ 
pid liver, 954; Jaundice, 960. 

Bowel discharges, changeable —Con¬ 
gestion of the liver, 956. 

Bowels, pain in moving —Inflamma¬ 
tion of the uterus, 1306; Ovaritis, 
1304; Piles, 1525; Fissure of anus, 
1525; Dysentei’y, 908, 910; Con¬ 
tracted liver, 1)63. 

Bowels, difficulty in moving —Ovarian 
dropsy, 1305; Stricture of rectum, 
Paralysis of b jwels, 1085; Consti¬ 
pation, 911. 

Bowels, irregular —Bilious dyspepsia, 
957; Torpid liver, 954; Tape¬ 
worm, 946; Consumption of bow¬ 
els, 919; Contracted liver, 963. 

Bowels, hemorrhage from —Typhoid 
fever, 1187; Piles, 1525. 

Bowels, pain in— Cholera infantum, 
894; Colic, 910; Peritonitis, 917; 
Consumption of the bowels, 919. 

Bowels, bloated— Cholera infantum, 
894; Consumption of bowels, 919; 
Dropsy, 917 ; Ovarian dropsy, 1303; 
Colic, 910; Chronic dysentery, 910; 
Intestinal obstruction, 914; Tape¬ 
worm, 946; Dyspepsia, 921; Bil¬ 
ious dyspepsia, 937; Torpid liver, 
954. 

Bowels, tenderness in —Typhoid fever, 
1187; Peritonitis, 917; Painful 
dyspepsia, 939; Torpid liver, 954 ; 
Paralysis, 1085. 

Bowels, inactive —Chronic gastric ca¬ 
tarrh, 895; Dyspepsia, 921. 


Bowels, looseness of —Diarrhea, 906; 
Dysentery, 908; Typhoid fever, 
1187. 

Breath, foul —Aphthae, 873 ; Can- 
crum oris, 874; Diarrhea, 906; 
Lead colic, 911; Ozena, 987; 
Pharyngitis, 880; Dyspepsia, 921 ; 
Decayed teeth, 1523; Constipation, 
911. 

B rea t hi n g, f requen t —Consumption, 
1017; Chronic anaemia, 837 ; Val¬ 
vular disease of the heart, 1051. 

Breathing, irregular —(See irregular 
respiration.) 

Breathing, sighing —Anremia of the 
brain, 1077; Curvature of spine, 
1461. 

Breathing, whistling —Croup, 992; 
Spasm of glottis, 995. 

Breathing, difficult —Catarrh of the 
larynx, 989; Croup, 992; Capillary 
bronchitis, 999; Hay asthma, 1005; 
Congestion of the lungs, 1009; Pul¬ 
monary apoplexy, 1013; Dropsy of 
the chest, 1037; Spinal meningi¬ 
tis, 1090; Spinal irritation, 1092; 
Asthma, 1003. 

Breathing, interruption of —Spasm of 
the glottis, 995; (Edema of glottis, 
994; Choking, 1437. 

Breathing, shallow —E mp h y s e m a, 

1006; Collapse of lung, 1008; Con¬ 
sumption, 1017. 

Breath, short —Chronic bronchitis, 
1000; Collapse of the lungs, 1008; 
Congestion of lungs, 1009; 
Anaemia, 836; Obesity, 844; Scur¬ 
vy. 864; Inflammation of the liver, 
958; Croupous pneumonia, 1014; 
Consumption, 1017; Miliary tu¬ 
berculosis, 1034; Dropsy of the 
chest, 1037; Pericarditis, 1049; 
Endocarditis, 1049; Valvular dis¬ 
ease of the heart, 1051; Pleurisy, 
1035; Curvature of spine, 1461. 

Breast, pain in —Spinal irritation, 
1092; Hysteria, 1107; Ovaritis, 
1304. 

Bronze skin— Addison’s disease, 1161. 

Chest, pain in—Consumption, 1017; 
Spinal irritation, 1092; Intercos¬ 
tal neuralgia, 1099; Pleurisy, 1036; 
Pneumonia, 1014; Angina pecto¬ 
ris, 1054. 






INDEX OF SYMPTOMS. 


1539 


Chest, tightness about —Hay asthma, 
1005; Congestion of lungs, 1009; 
Asthma, 1003. 

Change of voice —Paralysis of the glot¬ 
tis, 997. 

Chest, hollow—Chronic pneumonia, 
1017. 

Chest, sunken under collar-bone— Con¬ 
sumption, 1017; Chronic pneu¬ 
monia, 1017. 

Cheeks, flushed —Croupous pneumonia, 
1014. 

Chilliness —A cold, 981. 

Chill, or chilliness, periodically— Con¬ 
sumption, 1017; Ague, 1244. 

Chill at menstrual period —Ovarian 
congestion, 1304. 

Chill, ague —1244 ; Remittent fever, 
1252. 

Choking —Hysteria, 1107 ; Obstruc¬ 
tion, 1437. 

Clammy skin —Ansemia, 836. 

Cloudy urine —Pyelitis, 1161. 

Clumsy Augers—Locomoter ataxia, 
1094. 

Coated tongue —Catarrh of the mouth, 
873; Pharyngitis, 880; Catarrh of 
the stomach, 888; Dyspepsia, 
921; Gastritis, 887 ; Diarrhea, 906; 
Dysentery, 908; Acid dyspepsia, 
937 ; Bilious dyspepsia, 937 ; Tor¬ 
pid liver, 954; Congestion of the 
liver, 956. 

Colic pains —Cholera morbus, 893; 
Tape-worm, 946; Lead colic, 911; 
Renal colic, 1162. 

Cold hands and feet —Nervous dyspep¬ 
sia, 941; Congestion of bi'ain, 
1074; Nervous exhaustion, 1071; 
Paraphlegia, 1091. 

Cold extremities —Ansemia of the brain, 
1077; Nervous exhaustion, 1071; 
Congestion of brain, 1074; Dys¬ 
pepsia, 921. 

Complexion, yellow —Cancer of stom¬ 
ach, 904; Jaundice, 960; Addi¬ 
son’s disease, 1161. 

Consciousness, loss of —Tumor in the 
brain, 1089; Catalepsy, 1108; Hys¬ 
teria, 1107; Apoplexy, 1078; Sun¬ 
stroke, 1086. 

Constriction, sense of about body— 

Spinal meningitis, 1090. 


Constriction, sense of about head— 

Congestion of brain, 1074. 

Contracted pupils— Locomoter ataxia, 
1094; Congestion of brain, 1074; 
Opium poisoning, 1133; Disease of 
the eye, 1478. 

Constipation —Chronic gastric catarrh, 
895; Dilatation of the stomach, 
900; Dyspepsia, 921; Ovarian 
dropsy, 1305; Paralysis, 1085; 
Torpid liver, 954. 

Confusion of mind —Dyspepsia, 921; 
Nervous dyspepsia, 924; Conges¬ 
tion of the brain, 1074; Ansemia 
of brain, 1077. 

Convulsions —Tape-worm, 946; In¬ 
duration of brain, 1088; Tumor in 
the brain, 1089; Epilepsy, 1104; 
Inflammation of kidneys, 1155; 
Malarial poisoning, 1251; Loco¬ 
moter ataxia, 1094. 

Cough, barking —Croup, 992. 

Cough, crowing —Croup, 992. 

Cough, dry —Congestion of liver, 956; 

Acute bronchitis, 998. 

Cough, habitual —Chronic bronchitis, 
1000. 

Cough, hacking —Pharyngitis, 880. 
Cough, hemming —Pharyngitis, 880. 
Cough, Stomach —Pharyngitis, 1040. 
Cough, short, ringing —Croupous 
pneumonia, 1014. 

Cough, chin —Whooping-cough, 1207. 

Cough, Nervous —Nervous dyspepsia, 
941; Miliary tuberculosis, 1054; 
Consumption, 1017; Catarrh of the 
larynx, 989. 

Cough, painful—Pleurisy, 1035; In¬ 
tercostal neuralgia, 1099. 

Cramp —Cholera morbus, 893; Tape¬ 
worm, 946; Congestion of the 
brain, 1074. 

Cross-eye —Brain fever, 1086; Eye, dis¬ 
eases of, 1478. 

Croupy symptoms— Hay asthma, 1005; 
Spasm of larnyx—True croup, 992. 

Crying, Involuntary —Hysteria, 1107. 
Darting pain —Neuralgia, 1095. 

Dark ring abont the eyes —Chlorosis, 
840; Ansemia, 836. 

Dark urine —Jaundice, 960. 



1540 


INDEX OF SYMPTOMS. 


rebilily— Consumption, 1017; Anae¬ 
mia, 836; Nervous exhaustion, 
1071; Dyspepsia, 921. 

Deformity of legs —Rickets, 1387; 
Rheumatic gout, 1174. 

Deformity of joints —Rheumatic gout, 
1174: Talipes, 1473; Hip joint dis¬ 
ease, 1458. 

Delusions— Insanity, 1121. 

Delirium —Brain fever, 1086; Spinal 
meningitis, 1090; Delirum tre¬ 
mens, 1132; Insanity, 1121; Ty¬ 
phoid fever, 1187; Typhus fever, 
1191; Cerebro spinal meningitis, 
1232. 

Depraved appetite —Dyspepsia, 921; 
pregnancy, 1342; Worms, 952. 

Depression, mental— Chlorosis, 840; 
Torpid liver, 954; Melancholia, 
1125. 

Desire for drink —Polydipsia, 944; 
Diabetes, 856; Gastritis, 887; Fe¬ 
ver, 1179. 

Despondency —Softening of the brain, 
1087; Melancholia, 1125; Chloro¬ 
sis, 840. 

Diarrhea —Acute dysentery, 935; Dys¬ 
pepsia, 921; Cholera, 1202 ; Chol¬ 
era morbus, 893; Bowel consump¬ 
tion, 919; Bright’s disease, 1156. 

Difficult breathing— Croup, 992; Cap¬ 
illary bronchitis, 999; Hay asthma, 
1005; Congestion of lungs, 1009; 
Pulmonary apoplexy, 1013; 
Dropsy of the chest, 1037; Spinal 
meningitis, 1090; Spinal irrita¬ 
tion, 1092; Asthma, 1003; Ca¬ 
tarrh of the larnyx, 989; Pneu¬ 
monia, 1014. 

Difficult inspiration— CEdema of glot¬ 
tis, 994. 

Difficulty in swallowing— Quinsy, 883; 
Enlarged tonsils, 884; Stricture of 
the oesophagus, 885. 

Discharge from the nose— Catarrh, 
983; Glanders, 1224. 

Distortion of limbs— Mollitis ossium, 
1178; Hip disease, 1458 ; Rheu¬ 
matic gout, 1174; Clubfoot, 1472. 

Discharge from bowels, involuntary 

—Myelites, 1091. 

Discharge from the ear— Scrofula, 
854; Ear diseases, 1506. 


Discolored teeth —Lead poisoning, 911; 
Salivary calculus, 1522. 

Dizziness —Catarrh of the stomach, 
888; Dyspepsia, 921; Nervous 
dyspepsia, 941; Torpid liver, 954; 
Congestion of the liver, 956; Jaun¬ 
dice, 960; Hypertrophy of heart, 
1046 ; Ameinia of the brain, 1077; 
Softening of the brain, 1087 ; Apo¬ 
plexy, 1078; Inflammation of the 
brain, 1088; Tumor in the brain, 
1089; Spinal irritation, 1092; 
Congestion of the brain, 1074; Lo¬ 
comotor ataxia, 1094. 

Drawing back of head —Spinal menin¬ 
gitis, 1090; Hysteria, 1107; Caries 
of spine, 

Dreams —Congestion of the liver, 956; 
Nervous exhaustion, 1071; Con¬ 
gestion of the brain, 1074. 

Dribbling of urine —Paralysis of the 
bladder, 1166; Cystitis, 1163; 
Spasm of the bladder, 1166. 

Drooling of saliva— Salivation, 877; 
Catarrh of mouth, 872. 

Dropsy —Anaemia, 836; Valvular dis¬ 
ease of the heart, 1051; Inflam¬ 
mation of the kidneys, 1155; 
Bright’s disease, 1156; Disease of 
liver, 953. 

Drowsiness —Dyspepsia, 921; Slow 
digestion, 936; Nervous dyspep¬ 
sia, 941; Torpid liver, 954; Anae¬ 
mia of the brain, 1077 ; Softening 
of the brain, 1087; Jaundice, 960; 
Congestion of the brain, 1074; 
Bright’s disease, 1156; Cerebro 
spinal meningitis, 1232. 

Dry skin —Anaemia, 836; Diabetes, 
865; Dyspepsia, 921. 

Dry cough —Congestion of the liver, 
956; Acute bronchitis, 998. 

Dullness of mind —Torpid liver, 954; 
Congestion of the brain, 1074; 
Anaemia of the brain, 1077. 

Dusky skill— Emphysema, 1006; Blue 
disease, 1059. 

Ear, discharge from— Scrofula, 854; 
Ear diseases, 1506. 

Ears, noises iu —Nervous exhaustion, 
1071; Tumor in the brain, 1089; 
Spinal irritation, 1092; Congestion 
of the brain, 1074; Anaemia of 
brain, 1177; Catarrh of the ear, 
1509; Hypertrophy of heart, 1046. 



INDEX OF SYMPTOMS. 


1541 


Elongated palate— Catarrh of the 
mouth, 872; Chronic pharyngitis, 
880. 


Emaciation —Anaemia, 836; Diabetes, 
865; Cancer of the stomach, 904; 
Enlarged spleen, 967 ; Consump¬ 
tion, 1017; Dyspepsia, 921. 

Enlarged tonsils —Scrofula, 854. 

Enlarged glands —Scrofula, 854. 

Eularged abdomen— (See Abdomen, 
bloated.) 

Enlarged neck —Basedow’s disease, 
1055; Goitre, 1524. 

Erection, painful —Priapism, 1289. 

Eruption —(See Diseases of the skin, 
1255; also scarlet fever, 1229; 
Measles, 1225; Small-pox, 1233; 
and chicken-pox, 1224.) 

Eructations, ban smelting —Bilious 
dyspepsia, 937. 

Eructations, sour —Acid dyspepsia, 
937. 


Excessive thirst —Diabetes, 865; Gas¬ 
tritis, 887. 

Excessive quantity of urine —Diabe- 
tis, 865; Diabetes insipidis, 870. 

Excessive saliva —Glossitis, 876; Aph¬ 
thae, 873; Cancrum Oris, 874; 
Salivation, 877; Pharyngitis, 880. 

Expectoration —Catarrh of the larynx, 
989; Consumption, 1017; Chronic 
bronchitis, 1000. 

Expectoration, copious —Chronic bron¬ 
chitis, 1000; Advanced consump¬ 
tion, 1017. 

Expectoration, bloody —Congestion of 
the lungs, 1009; Croupous pneu¬ 
monia, 1014; Pulmonary hemor¬ 
rhage, 1011. 

Expectoration, frothy —Congestion of 
lungs, 1009. 

Expectoration, rusty —Croupous pneu¬ 
monia, 1014; Congestion of lungs, 
1009. 

Eyes, Hashes before —Catarrh of stom¬ 
ach, 888; Diseases of the eye, 1478. 

Eyes, spots before —Hypertrophy of 
the heart, 1046; Nervous exhaus¬ 
tion, 1071; Tumor in the brain, 
1089. 

Eyes, flashes before— Catarrh of stom¬ 
ach, 888; Diseases of the eye, 1478. 


Eyes, spots before —Hypertrophy of 
the heart, 1046; Nervous exhaus¬ 
tion, 1071; Tumor in the brain, 
1089; Congestion of the brain, 
1074; Torpid liver, 954. 

Eyes, staring —Basedow’s disease, 1055. 
Eyes, yellow —Jaundice, 960. 

Eyes, sensitive to light —Anaemia of 
of the brain, 1077; Brain, fever, 
1086; Congestion of brain, 1074; 
Diseases of eyes, 1478. 

Eyes, inability to wink —Facial paraly¬ 
sis, 1111. 

Eyes, blinking —mimetic spasm, 1112; 

Congestion of brain, 1074. 

Eyelids, inflamed —Scrofula, 854; Mea¬ 
sles, 1225; Conjunctivitis, 1480. 
Face, black in the —Spasm of the glot¬ 
tis. 995. 

Fainting or faintness —Fatty heart, 
1048; Anaemia of the brain, 1077 ; 
Pericarditis, 1044. 

Fear, morbid —Congestion of the brain, 
1074; Neurasthenia, 1071« 

Fecal matter, vomiting of —Intestinal 
obstruction, 914; Hernia, 1524. 
Feet, cold —Nervous dyspepsia, 941; 

Congestion of brain, 1074. 

Feeble pulse —Dilatation of the heart, 
1047; Fatty heart, 1048; Endo 
carditis, 1049; Anaemia, 836. 

Feet, pain in soles of —Locomotor 
ataxia, 1094. 

Feet, clumsy —Locomotor ataxia, 1094; 
Feet, swelling of —Bright’s disease, 
1156; Dilatation of the heart, 1047; 
Anaemia, 836. 

Fever —Croupous pneumonia, 1014; 
Consumption, 1017; Pleurisy, 1035; 
(See “Infectious Diseases” and 
“Fever,” 1179.) 

Fickle appetite —Chlorosis, 840; 
Round worms, 950; Dyspepsia, 
921; Pregnancy, 1339. 

Fingers, clumsy— Locomotor ataxia, 
1094. 

Flatulence —Chronic gastric catarrh, 
895; Dilatation of the stomach, 900; 
Diarrhea, 906; Tape-worm, 946; 
Congestion of the liver, 956; Ty¬ 
phoid fever, 1187; Colic, 910; Tor¬ 
pid liver, 954: Dyspepsia, 921; 
Bilious dyspepsia, 921. 



INDEX OF SYMPTOMS. 


1542 , 


Fissured tongue—Dyspepsia, 921; 
Acid dyspepsia, 937. 

Flabby tongue— Acid dyspepsia, 937. 

Flashes before the eyes —(See Eyes, 
flashes before.) 

Flushed face —Plethora, 843; Conges¬ 
tion of brain, 1074; Fever, 1179; 
Croupous pneumonia, 1014. 

Forehead, pain in —Cold in the head, 
981; Nervous dyspepsia, 941; 
Migraine, 1097. 

Foul breath —Aphthae, 873; Cancrum 
oris, 874; Pharyngitis, 880; Diar¬ 
rhea, 906; Lead colic, 94; Ozena, 
987; Constipation, 911. 

Frequent pulse —Fatty heart, 1048; 
Fever, 1179; Valvular disease of 
the heart, 1051. 

Frequent urination —Inflammation 
of the kidneys, 1155; Inflamma¬ 
tion of the testicles, 1289; Catarrh 
of bladder, 1163; Inflammation of 
prostate, 1287. 

Frothy urine —Bright’s disease, 1156. 

Frontal headache —Nervous dyspepsia, 
941; Congestion of liver, 956. 

Fullness of head —Congestion of the 
brain, 1074. 

Fullness of stomach —Chronic gastric 
catarrh, 895; Acute dyspepsia, 935; 
Congestion of the liver, 956. 

Furred tongue —Congestion of the 
liver, 956; Dyspepsia, 921; Torpid 
liver, 954; Fever, 1179. 

Gait, tottering —Softening of the brain, 
1087; Locomotor ataxia, 1094. 

Gas in the bowels —Congestion of the 
liver, 956 ; Dyspepsia, 921; Colic, 
910; Lead colic, 911; Flatulence, 
968. 

Glands, enlarged —Scrofula, 854; 
Mumps, 1200. 

Great thirst— Gastritis, 887; Diabetes, 
865; Fever, 1176. 

Grimaces, involuntary -M i m e t i c 

spasm, 1112. 

Grinding teeth at night —Acid dyspep¬ 
sia, 937; Worms, 950. 

Groins, pain in— Inflammation of tes¬ 
ticles, 1284; Ovaritis, 1304. 

Groins, tenderness in— Ovarian con¬ 
gestion, 1304. 


Gums, bleed ng —Scurvy, 864. 

Habitual cough— Chronic bronchitis, 
1000. 

Hacking cough —Pharyngitis, 880. 
Hallucinations —Delirium tre mens, 
1132; Insanity, 1121. 

Hands and feet, swelling of—Bright’s 
disease, 1156. 

Hands, twitching of in writing— 

Writer’s cramp, 1113. 

Hands and feet, cold —Nervous dys¬ 
pepsia, 941; Nervous exhaustion, 
1071; Congestion of the brain, 
1074. 

Head, pain in —Sun-stroke, 1086; Soft¬ 
ening of the brain, 1087; Indura¬ 
tion of the brain, 1088; Migraine, 
1097; Headache, 1100; Sick-head- 
ache, 888; Congestion of brain, 
1074; Fever, 1179. 

Head, drawing back of —Spinal menin¬ 
gitis, 1090; Hysteria, 1107. 

Head, fullness of —Congestion of the 
brain, 1074. 

Headache on one side— Migraine, 1097- 
Head, twisting of —Wry neck, 1113. 
Head, nodding of —Wry neck, 1113. 
Headache —(See 1100) Dyspepsia, 921; 
Ozena, 987; Congestion of brain, 
1074; Nervous exhaustion, 1071; 
Ansemia of brain, 1077; Brain fe¬ 
ver, 1086; Tumors of brain, 1089 ; 
Spinal irritation, 1092; Fever, 
1179. 

Headache, frontal —N ervous dyspepsia, 
941; Torpid liver, 954; Nasal ca¬ 
tarrh, 983. 

Headache at back part of head— 

Nervous dyspepsia, 941. 

Heart, pain in—Endocarditis, 1049; 
Valvular disease, 1051; Angina 
pectoris, 1054; Fatty heart, 1048 ; 
Pericarditis, 1049. 

Heart, heavy beating of—(See Palpi¬ 
tation of Heart.) 

Heartburn —Chronic gastric catarrh, 
895; Dilatation of stomach, 900; 
Dyspepsia, 921; Acid dyspepsia, 
937; Congestion of the liver, 965. 
Heart palpitation of- —(See Palpita¬ 
tion of Heart.) 

Heat in stomach— Gastritis, 887; Dys¬ 
pepsia, 921. 




IXBEX OF SYMPTOMS. 


1543 


Heart, pain in the region of —Slow di¬ 
gestion, 930; Intercostal neural¬ 
gia, 1099; (See Heart, pain in.) 

Heaviness at the stomach— Catarrh of 
the stomach, 888; Torpid liver, 
954. . 

Hemming cough— Pharyngitis, 880. 

Hemorrhoids —Congestion of liver, 956; 
Constipation, '911. 

Hemorrhage from the lungs —Con¬ 
sumption, 1017; Pulmonary apo¬ 
plexy, 1013. 

Hemorrhage from the bowels —Ty¬ 
phoid fever, 1187; Mesenteric con¬ 
sumption, 919; Piles, 1525. 

Hiccough —Cholera morbus, 893; Dys¬ 
pepsia, 921; Curvature of spine, 
1461. 

Hoarseness —Catarrh of larynx, 989; 
(Edema of the glottis, 984; Laryn¬ 
geal consumption, *996; Croup, 
992. 

Hollow chest —(See Chest, hollow,) 

Hunger, ravenous —Tape-worm, 946. 

Husky Voice—Pharyngitis, 880. 

Illusion —Insanity, 1121. 

Inactive bowels—-Chronic gastric ca¬ 
tarrh, 895; Constipation, 911. 

Inability to walk in the dark— Loco¬ 
motor ataxia, 1094. 

Incoherence —Insanity, 1121. 

Incurved >'ails—Consumption, 1017. 

Inflamed eyelids —Scrofula, 854; Con¬ 
junctivitis, 1480. 

Inspiration, diflicult —(See Difficult in¬ 
spiration.) 

Interruption of breathing— Spasm of 
glottis, 995; Choking, 1437. 

Involuntary dischat ges—Myelitis, 
1091. 

Involuntary laughing— Hysteria, 1107; 

Involuntary gri m ace s — M im e ti c 
spasm, 1112. 

Irregularity of the bowels —Bilious 
dyspepsia, 937 ; Torpid liver, 954; 
Tape-worm, 946; Consumption of 
the bowels, 919. 

Irregular pulse —Congestion of the 
liver, 956; Pulmonary apoplexy, 
1013 ; Fatty heart, 1048 ; Pericar¬ 
ditis, 1049 ; Valvular disease of 
the heart, 1051. 


Irregular respiral ion —Consumption, 
1017 ; Curvature of spine, 1461. 
Irritation of bladder —Gravel, 1167 ; 

Catarrh of bladder, 1163. 

Itching at the anus —Tape-worm, 946; 

Thread-worms, 951. 

Itching—Jaundice, 960 ; Itch, 1237 ; 
Eczema, 1263; Prurigo, 1269; 
Urticaria, 1259 ; Pruritis, 1273. 
Jaundice —Inflammation of the gall- 
ducts, 959 ; Gall-stones, 959 ; 
Valvular disease of the heart, 1051; 
Yellow fever, 1194. 

Large pupils —Nervous exhaustion, 
1071; Anmmia of the brain, 1077 ; 
Mydriasis, 1495. 

Lassitude — Chlorosis, 840; Torpid 
liver, 954 ; Dyspepsia, 921 ; Anae¬ 
mia, 836; Nervous exhaustion, 
1071. 

Laugh i ng, involu ntary —H y s t e r i a, 
1107. 

Light, eyes sensitive to —Anaemia of 
the brain, 1077 ; Brain fever, 1086;. 
Congestion of br; in, 1074 ; Iritis, 
1493; Ulceration of cornea, 1492. 
Legs, pain in —Fever, 1179; Ague,1244. 
Legs, twitching of —Softening of the 
brain, 1087 ; Paralysis, 1091; Con¬ 
gestion of brain, 1074. 

Legs, trembling ot —Induration of 
brain, 1088. 

Legs, numbness in —Paralysis, 1091; 

Locomotor ataxia, 1094. 

Legs, tingling in —Paralysis, 1091. 
Legs, shooting pains in —Locomotor 
ataxia, 1091. 

Legs, Distortion of —Mollites ossium, 
1178. 

Legs, deformity of —(See Deformity of 
Legs.) 

Little appetite —Slow digestion, 936 ; 

Fever, 1179 ; Consumption, 1017. 
Liver, pain in region of —Inflamma¬ 
tion of the liver, 958 ; Congestion 
of liver, 956. 

Looseness of bowels —(See Bowels, 
looseness of.) 

Loss of voice —Catarrh of the larynx, 
989 ; Laryngeal tuberculosis, 997 ; 
Paralysis of the glottis, 997 ; Hys¬ 
teria, 1107. 



1544 . 


INDEX OF SYMPTOMS. 


Loss of speech —Softening of the brain, 
1087 ; Apoplexy, 1078. 

LOSS of Memory —Softening of the 
brain, 1087; Congestion of the 
brain, 1074. 

Loss of Consciousness —(See conscious¬ 
ness, loss of.) 

Loss of strength —Wasting palsy, 1110; 
Paralysis, 1078. 

Lungs, hemorrhage from —(See hem- 
orhage from lungs.) 

Mania —Insanity, 1121. 

Melancholy—Nervous dyspepsia, 941; 
Nervous exhaustion, 1071; Indu¬ 
ration of the brain, 1088 ; Torpid 
liver, 954; Jaundice, 960 ; Con¬ 
gestion of the brain, 1074 ; Insan¬ 
ity, 1121. 

Memory, loss of —Softeningof the brain, 
1087; Congestion of the brain, 
1074. 

Menstrual period, chill at— Ovarian 
congestion, 1304. 

Menstruation, scanty —Ovarian dropsy, 
1305; Chlorosis, 840. 

Menstruation, profuse —Inflammation 
about the uterus, 1306; Menor¬ 
rhagia, 1309. 

Menstruation, painful — Stricture of 
the cervical canal, 1320 ; Ante ver¬ 
sion, 1311; Congestion of the ova¬ 
ries, 1304. 

Menstruation, suppressed —Chlorosis, 
840 ; Anaemia, 836. 

Mental depression— (See melancholy). 

Mind, confusion of —Dyspepsia, 921; 
Nervous dyspepsia, 941; Conges¬ 
tion of the brain, 1074. 

Mind, dullness of —Torpid liver, 954 ; 
Congestion of the brain, 1074; 
Anaemia of brain, 1077. 

Mouth, sore —Scurvy, 864; Catarrh of 
the mouth, 872 ; Aphthae, 873. 

Month, had taste in— (See bad taste in 
mouth.) 

Mouth, sour taste in —Acid dyspepsia, 
937 ; Rheumatism, 1169. 

Muscles, pain in —muscular rheuma¬ 
tism, 1175; Wasting palsy, 1110. 

Muscles, twitching of— Congestion of 
brain, 1074 ; Chorea, 1103. 

Nasal tone of voice —Pharyngitis, 880 ; 
Nasal catarrh, 983. 


Nausea—Gastritis, 887 ; Cancer of the 
stomach, 904; Dyspepsia, 921; 
Acute dyspepsia, 935. 

Nervousness—Dyspepsia, 921; Anae¬ 
mia, 836; Nervous exhaustion, 
1071; Spinal irritation, 1092. 
Neuralgia—(See 1095.) Nervous dys¬ 
pepsia, 941. 

Night sweats—Dyspepsia, 921 ; Tape¬ 
worm, 946 ; Consumption, 10i7 ; 
Miliary tuberculosis, 1034. 

Nodding of the lit ad—Torticollis, 1113. 
Noises id the ears—(See ears, noises in.) 
Nosebleed—Scurvy, 864 ; Pericarditis, 
1049 ; Congestion of brain, 1074. 
Nose, liekling at—Tape-worm, 946. 

Nose, Discharge from—Catarrh, 983 ; 
Glanders, 1224. 

Nostrils, twitching of—Mimetic spasm, 

1112 . 

Numbness—Tumor in brain, 1089; 
Myelitis, 1091 ; Paralysis, 1091 ; 
Locomotor ataxia, 1049. 

Paleness—Anaemia, 836 ; Bright’s dis¬ 
ease, 1156. 

Palpitation of the heart—Chlorosis, 
840; Obesity, 844; Slow diges¬ 
tion, 936 ; Nervous dyspepsia, 941; 
Tape-worm, 946; Congestion of 
the liver, 956; Bright's disease, 
1156; Spinal irritation, 1092; 
Hypertrophy, 1046; Pericarditis, 
1049 ; Endocarditis, 1049 ; Valvu¬ 
lar disease of the heart, 1051; 
Nervous exhaustion, 1071; Anae¬ 
mia of the brain, 1077. 

Palate, elongated — Catarrh of the 
mouth, 872 ; Pharyngitis ; 880. 

Palpitation at pit of stomach—Painful 

dyspepsia, 939; Torpid liver, 956. 
Pain in the head—Sunstroke, 1085 ; 
Softening of the brain, 1087. (See 
headache.) 

Pain in the bowels—Cholera infantum, 
894; Peritonitis, 917; Consump¬ 
tion of the bowels, 919 ; Diarrhoea, 
906 ; Dysentery, 907 ; Colic, 910; 
Curvature of spine, 1461. 

Pain at pit of stomach—Cancer of the 
stomach, 904; Acid dyspepsia, 937; 
Painful dyspepsia, 939 ; Inflamma- 
mation of the gall ducts, 959 ; Gall 
stones, 959. 



INDEX OF SYMPTOMS. 


1545 


Pain in the rectum —Dysentery, 908; 
Piles, 15135; Fissure of anus, 1525;. 
Fistula in ano, 1520. 

Pain in the muscles — (See muscles, 
pain in.) 

Paiu under shoulder Made —Dyspep¬ 
sia, 921; Slow digestion, 930 ; 
Nervous dyspepsia, 941 ; Inflam¬ 
mation of the liver, 958 ; Conges¬ 
tion of liver, 950. 

Pain in t he spine — Dyspepsia, 921; 
Spinal meningitis, 1090 ; Spinal ir¬ 
ritation, 1092; Myelitis, 1091; 
Curvature of spine, 1401. 

Pain in swallowing — Aphthse, 873;; 
Cancrum oris, 874; Thrush, 875; 
Pharyngitis, 880; Quinsy, 883; 
Enlarged tonsils, 884. 

Pain in small of hack —Abscess of the 
kidneys, 1158 ; Lumbago, 1098. 

Pain between the shoulders— Ulcer of 
the oesophagus, 885; Dyspepsia, 
921 ; Slow digestion, 930 ; Nerv¬ 
ous dyspepsia, 941; Spinal irrita¬ 
tion, 1092. 

Pain in region of the kidneys —Renal 
colic 1102; Abscess of kidney, 1158. 

Pain in the stomach —Gastritis, 887; 
Gastralgia, 901; Gastric ulcer, 902; 
Dyspepsia, 921; Bilious dyspepsia, 
937 ; Bilious attack, 888 ; Cancer 
of the stomach, 904 ; Acute dys¬ 
pepsia, 935. 

lb.in in the forehead —(See frontal 
headache.) 

Pain over bladder— Cystitis, 1103. 

Pain in region of the liver —Inflam¬ 
mation of the liver, 958; gall 
stones, 959 ; Congestion of liver, 
950. 

Pain in left side under ribs— Enlarged 
spleen, 907. 

Pain in the chest —Croupous pneu¬ 
monia, 1014 ; Consumption, 1017 ; 
Spinal irritation, 1092; Intercostal 
neuralgia, 1099 ; Pleurisy, 1035. 

Painful menstruation — (See menstru¬ 
ation, painful.) 

Pain in heart— (See heart, pain in.) 

Pain under right ribs— Bilious dys¬ 
pepsia, 937. 

Pain in the eyeballs—Nervous dyspep¬ 
sia, 941 ;* Disease of eye, 1497. 


Pain in the breast —Spinal irritation, 
1092; Hysteria, 1107; Ovaritis, 
1304. 

Pain in the thigh —Sciatica, 1099. 

Pain in the ovaries —Spinal irritation, 
1092; Hysteria, 1107 ; Ovarian 
irritation, 1304; Ovaritis, 1304. 

Pain in fork of the thighs— Inflamma¬ 
tion of the prostate gland, 1287. 

Painful urination—Spinal irritation, 
1092; Inflammation of the pros¬ 
tate gland, 1287 ; Enlarged pros¬ 
tate, 1287 ; Inflammation of the 
uterus, 1306 ; Stricture, 1529; Vas¬ 
cular growths, 1453. 

Painful cough —Pleurisy, 1035 ; Pneu¬ 
monia, 1014. 

Pain in the joints —Rheumatism, 1169 ; 
Gout, 1176. i 

Pain in the legs —Locomotor ataxia, 
1094 ; Nervous dyspepsia, 935. 

Pain in soles of feet —Locomotor ataxia, 

1094. 

Pain in groins —Inflammation of the 
testicle, 1289 ; Ovaritis. 1304. 

Pain, darting, shifting — Neuralgia, 

1095. 

Pain in the testicle —Inflammation of 
the testicle, 1289; Neuralgia of 
the testicle, 1296. 

Pain in the back —Lumbago, 1098 ; In¬ 
flammation of the uterus, 1306 ; 
Prolapsus of uterus, 1322; Mus- 
sular rheumatism, 1323. 

Pain in the bones, boring —Mollites 
ossium, 1178; Caries of bone, 1455. 

Pain in the back and limbs —Fever, 
1179. 

Paralysis— Tumor of the brain, 1089 ; 
Myelitis, 1091 ; Locomotor ataxia, 
1094; Apoplexy, 1078. 

Paralysis in different parts —Indura¬ 
tion of the brain, 1088. 

Patches in throat —Diphtheria, 1209. 

Perspiration, sour— Rheumatism, 1169, 

Perverted appetite —(See Appetite,per¬ 
verted. ) 

Persistent vomiting — Intestinal ob¬ 
structions, 914; Hernia, 1524; Preg¬ 
nancy, 1359. 

Pit of stomach, tightness at— Inflam¬ 
mation of the gall ducts, 959. 




1546 


INDEX OF SYMPTOMS. 


Piles—Congestion of the liver, 956; 
Constipation, 911. 

Prickling of limbs—Softening of the 
brain, 1087 ; Paralysis, 1079. 

Profuse menstruation—See menstru¬ 
ation, profuse.) 

Profuse sweating— Sweating sickness, 
1198; Consumption, 1017; Nerv¬ 
ous exhaustion, 1017. 

Pulse, irregular —Congestion of the 
liver, 956; Pulmonary apoplexy, 
1013 ; Fatty heart, 1048 ; Pericar¬ 
ditis, 1049 ; Valvular disease of 
heart, 1051. 

Pulse, feeble —Dilatation of the heart, 
1047 ; Pericarditis, 1049 ; Endo¬ 
carditis, 1049 ; Fatty heart, 1048. 

Pulse, slow —Fatty heart, 1048; Jaun¬ 
dice, 960. 

Pulse, freqnent —Fatty heart, 1048 ; 
Fever, 1179. 

Pulse, rapid —Basedow’s disease, 1055 ; 
Fever, 1179. 

Pulsation of veins in the neck —Dila¬ 
tation of the heart, 1047. 

Pulse full and quick —Fever, 1179. 

Pupils, contracted —(See 1495.) Loco¬ 
motor ataxia, 1094 ; Congestion of 
brain, 1074; Iritis, 1493. 

Pupils, large — Nervous exhaustion, 
1071; Anaemia of the brain, 1077. 

Purging —Cholera morbus, 893 ; Dys¬ 
entery, 908; Diarrhea, 906 ; Chol¬ 
era, 1202. 

Rectum, pain in —(See pain in rectum.) 

Retention of urine —Spasm of the blad¬ 
der, 1166 ; Paralysis of the blad¬ 
der, 1166; Inflammation of pros¬ 
tate gland, 1287; Stricture, 1529. 

Rice water discharges— Cholera, 1202. 

Ringing cough—Croupous pneumonia, 
1014. 

Ringing in ears— Hypertrophy, 1046 ; 
Anaemia of the brain, 1077 ; Con¬ 
gestion of the brain, 1074; Tu¬ 
mors of the brain, 1089. 

Saliva, excessive— Glossitis, 876; Aph¬ 
thae, 873; Cancrum oris, 874; Sal¬ 
ivation, 877; Pharyngitis, 880. 

Saliva, drooling —Glossitis, 876 ; Sal¬ 
ivation, 877. 


Scalp, tenderness of—Nervous exhaus¬ 
tion, 1071. 

Scanty menstruation—Chlorosis, 840; 
Ovarian dropsy, 1305. 

Scanty urine—Abscess of the kidneys, 
1138 ; Cystitis, 1163; Congestion 
of kidneys, 1153. 

Sense of suffocation—Angina pectoris, 
1054 

Sense of cord tied around the body— 

Myelitis, 1081; Locomotor ataxia, 
1094. 

Sensitiveness to noise—Anaemia of the 
brain, 1077; Congestion of the 
brain, 1074. 

Shallow breathing—(See Breathing, 
shallow.) 

Shooting pain in the head—Induration 
of brain, 1088. 

Shooting pain in legs — Locomotor 
ataxia, 1094. 

Short breath—(See Breath, short.) 

Sick headache—(See Headache, sick.) 

Skin, blueness of—Cyanosis, 1059. 

Skin, dry —Anaemia, 836; Diabetes, 
865 ; Dyspepsia, 921. 

Skin, yellow—Chlorosis, 840 ; Jaun¬ 
dice, 960; Ansemia, 836. 

Skin, sallow—Bilious dyspepsia, 937 ; 
Torpid liver. 954; Inflammation of 
the liver, 958; Enlarged spleen, 
967. 

Sleeplessness—Chi’onic gastric catarrh, 
895 ; Torpid liver, 954 ; Nervous 
dyspepsia, 941; Congestion of the 
liver, 956 ; Anaemia of the brain, 
1077; Delirium tremens, 1137. 

Sleepiness—Dyspepsia, 921 ; Slow di¬ 
gestion, 936 ; Nervous dyspepsia, 
941. 

Sneezing—Cold in the head, 981; Hay 
asthma, 1005. 

Snoring respiration—Apoplexy, 1078 ; 
Sunstroke, 1086; Pharyngitis, 888 ; 
Catarrh of the larynx, 989. 

Sore mouth—Scurvy, 864 ; Catarrh of 
the mouth, 872; Aphthae, 873; 
Dyspepsia, 921. 

Sour taste in the month— Acid dyspep¬ 
sia, 937 ; Rheumatism, 1169. 

Sour stomach—Acid dyspepsia, 937. 



INDEX OF SYMPTOMS. 


1547 


Sour eructations— Acid dyspepsia, 937. 

Sour saliva— Rheumatism, 1109 ; Acid 
dyspepsia, 937. 

Sour perspiration —Rheumatism, 1169. 

Spinal tenderness— (See Pain in Spine.) 

Spine, pain in — See Pain in Spine.) 

Spots before the eyes— Hypertrophy, 
1046 ; Nervous exhaustion, 1071 ; 
Tumor of the brain, 1089 ; Con¬ 
gestion of the brain, 1074 ; Torpid 
liver, 954 ; Muscae volitantes, 1498. 

Staring Eyes—Basedow’s disease, 1055. 

Stitch in the side— Pleurisy, 1035. 

Stomach, beating at —(See Palpitation 
at Pit of Stomach.) 

Stomach, weight at —Acute dyspepsia, 
935 ; Congestion of the liver, 950 ; 
Catarrh of the stomach, 888. 

Stomach, pain in —(See Pain in Stom¬ 
ach.) 

Stomach, heaviness at —Catarrh of the 
Stomach, 888. 

Stomach, fullness of —(See Fullness of 
Stomach.) 

Stomach, tenderness of— Chronic gas¬ 
tric catarrh, 895 ; Painful dys¬ 
pepsia, 939; Gastritis, 837. 

Straining after urinating — Irritable 
bladder, 1100 ; Catarrh of the Blad¬ 
der, 1103. 

Sudden unconsciousness —(See Uncon¬ 
sciousness.) 

Sugar in urine —Diabetes, 805. 

Suppr< ssed menstruation —(See Men¬ 
struation, suppressed.) 

Suppr ssion of urine —Inflammation of 
the kidneys, 1155 ; Abscess of the 
kidneys, 1158 ; Congestion of kid¬ 
neys, 1153. 

Swallowing, difficulty in— Quinsy, 
883; Enlarged tonsils, 884 ; Strict¬ 
ure of the oesophagus, 885. 

Swallowing, pain in — Cancrum oris, 
874; Thrush, 875; Pharyngitis, 
880 ; Quinsy, 883 ; Enlarged ton¬ 
sils, 884. 

Sweating profusely — Sweating sick¬ 
ness, 1198. 

Sweats, night — Consumption, 1017 ; 
Miliary tuberculosis, 1034; Dys¬ 
pepsia, 921. 


Swelling of feet— Anaemia, 836; In¬ 
flammation of the kidneys, 1155; 
Bright’s disease, 1150; Dilatation 
of the heart, 1047. 

Swollen joints —Rheumatism, 1109; 
Rheumatic gout, 1174. 

Swollen tongue— Glossitis, 876. 

Swollen abdomen —(See abdomen en¬ 
larged. ) 

Te» th, Discolored— Lead colic, 911. 

Teeth, grinding at night— Acid dys¬ 
pepsia, 937; Round worms, 950. 

Temples, pain in— Catarrh of the stom¬ 
ach, 888. 

Tender spine — Nervous exhaustion, 
1071 ; Myelitis, 1091 ; Spinal irri¬ 
tation, 1092. 

Tender joints —Rheumatism, 1169. 

Tender scalp — Nervous exhaustion, 

ion. 

Tenderness in bowels —(See Bowels, 
tenderness in.) 

Testicles, pain in —Inflammation in 
the testicles, 1289. 

Thigh, pain in—Sciatica, 1099. 

Thick upper lip —Scrofula, 854. 

Thirst, excessive —Diabetes, 870 ; Gas¬ 
tritis, 887 ; Polydipsia, 944 ; Fe¬ 
ver, 1179. 

Throbbing pain in the temples —Con¬ 
gestion of the brain, 1074 ; Bil¬ 
ious dyspepsia, 937. 

Ticklishness — Nervous exhaustion, 
1071. 

Tickling at nose—Tape-worm, 946. 

Tickling in throat —Pharyngitis, 880 ; 
Catarrh of the larynx, 989; Hay 
asthma, 1005. 

Tightness in the chest —Acute bron¬ 
chitis, 998 ; Hay asthma, 1005. 

Tingling in limbs —Paralysis, 1091. 

Tonsils, enlarged —Scrofula, 854. 

Tongue, swollen —Glossitis, 876. 

Tongue, coated —Gastritis, 887; Catarrh 
of the stomach, 888 ; Diarrhea, 
900 ; Dyspepsia, 921 ; Congestion 
of the liver, 956. 

Tongue, ridged— Gastric ulcer, 902. 

Tongue, fissured — Dyspepsia, 921 ; 
Acid dyspepsia, 937. 




1548 


INDEX OF SYMPTOMS. 


Tongue, coated white —Acid dyspep¬ 
sia, 937. 

Tongue, flabby and pale —Acid dys¬ 
pepsia, 937. 

Tongue Assured crosswise —Acid dys¬ 
pepsia, 937. 

Tongue, coated yellow —Bilious dys¬ 
pepsia, 937 ; Torpid liver, 954. 

Tottering gait—Softening of the brain, 
1087 ; Locomotor ataxia, 1094. 

Trembling —Paralysis agitans, 1109. 

Trembling of legs —Induration of the 
brain, 1088. 

Twitching of legs —Softening of the 
brain, 1087; Paralysis, 1091; Con¬ 
gestion of the brain, 1074. 

Twitching of muscles —Congestion of 
the brain, 1074 ; Chorea, 1103. 

Twitching of nostrils —Mimetic spasm, 
1112 . 

Twisting head —Wry neck, 1113. 

Twitching of the hand in writing— 

Writer’s cramp, 1113. 

Urine, dribbling of— Cystitis, 1103 ; 
Spasm of the bladder, 1160 ; Pa¬ 
ralysis of the bladder, 1166. 

Urine, bloody —Hemorrhage from the 
bladder, 1164 ; Hemorrhage from 
the kidneys, 1154. 

Urine, retention of— Spasm of the 
bladder, 1166; Paralysis of the 
bladder, 1166. 

Urinating, straining after— Irritable 
bladder, 1166. 

Urine, excessive quantity of— Diabetes, 
865, 870. 

Urine, sugar in—Diabetes mellitus, 
865. 

Urine, cloudy— Pyelitis, 1161. 

Urination, painful— (See Painful Urin¬ 
ation. 

Urine, scanty— (See Scanty Urine.) 

Urine, dark— Jaundice, 960. 

Urine, suppression of— (See Suppres¬ 
sion of Urine.) 

Vertigo—Dyspepsia, 921; Jaundice, 
960 ; Spinal irritation, 1092 ; Anae¬ 
mia of the brain, 1077 ; Congestion 
of the liver, 956; Torpid liver, 
954; Nervous dyspepsia, 941; 
Congestion of brain, 1074. 


Urination, frequent—(See Frequent 

Urination. 

Urine, frothy —(See Frothy Urine.) 

Voice, isasal toue of —Pharyngitis, 880. 

Voice, husky —Pharyngitis, 880. 

Voice, weak —Emphysema, 1006. 

Voice, loss of— (See Loss of Voice.) 

Vomiting—Abscess of the kidneys, 
1158 ; Penal colic, 959 ; ^Spinal ir¬ 
ritation, 1092 ; Tumor in the brain, 
1089; Gastritis, 887 ; Catarrh of 
the stomach, 888 ; Cholera mor¬ 
bus, 805 ; Chronic gastric catarrh, 
895 ; Gastralgia, 901 ; Gastric ul¬ 
cer, 902 ; Diarrhea, 906 ; Dysen¬ 
tery, 908 ; Colic, 910 ; Dyspepsia, 
921; Acute dyspepsia, 935 ; Chol¬ 
era infantum, 894; Peritonitis, 
917; Gall-stones, 959. 

Vomiting of bile —Bilious dyspepsia, 
957 ; Bilious attack, 888 ; Bilious 
typhoid, 1193; Yellow fever, 1194. 

Vomit'ng of blood— Gastric ulcer, 902 ; 
Cancer of the stomach, 904. 

Vomiting fecal matter —Intestinal ob¬ 
structions, 914 ; Hernia, 1524. 

Vomiting persistent —Intestinal ob¬ 
structions, 914; Hernia, 1524; Preg¬ 
nancy 1359 

Voracious appetite—(See Appetite, 
voracious.) 

Visible pulsation of arteries—(See Ar¬ 

teries, etc ) 

Wakefulness —(See Sleeplessness.) 

Water-brash —Dyspepsia, 921 ; 

Chronic gastric catarrh, 895 ; Dila¬ 
tation of the stomach, 900. 

Weak pulse —(See Pulse, weak.) 

Weight at the stomach—(See Stomach, 
weight at.) 

Wheezing respiration —Asthma, 1003, 

Whistling breathing— Croup, 992. 

Yawning —Ague, 1244. 

Yellow complexion— Cancer of the 
stomach, 904; Jaundice 960; Chlo¬ 
rosis, 840. 

Yellow eyes —Jaundice, 960. 

Yellow skin— Jaundice, 960; Chlo¬ 
rosis, 840. 

Yellow-coated tongue —Bilious dys¬ 
pepsia, 937 ; Torpid liver, 954. 



GENERAL INDEX 


Abdomen, enlarged, 1338. 
Abdominal dropsy, 917. 
Abdominal pregnancy, 1358. 
Abortion, 356. 

Abortion, criminal, 356. 
Abscess, alveolar, 1522. 
Abscess, 1446. 

Abscess in auditory canal, 
1507. 

Abscess in ear, 1507. 
Absinthe, 455, 538. 
Absorption, 263. 

Abstinence, 735. 

Acarus seabiei, 1277. 
Accommodation of hearing, 
180. 

Accommodation of sight, 190. 
Acetabalum, 59. 

Acetic acid, poisoning by, 
1444. 

Aconite, 749, 783. 

Aconite, poisoning by, 1444. 
Acne, 1265. 

Acne of eyelids, 1485. 
Accidents, 1394. 

Acidity, 933, 968. 

Acids, poisoning with, 1442. 
Active - passive movements, 
712. 

Acute bronchitis, 998. 
Addison’s disease, 1161. 
Adhesive plaster, 806. 
Adipose tissue, 41. 
Adulteration, modes of, 415. 
Adulteration of alcohol, 475, 
Adulteration of baking pow¬ 
ders, 422. 

Adulterations of food, 415. 
Aerotherapy, 681. 

, Affusion, 648. 

After-birth, retention of, 
1355. 

After-images, 191. 
After-pains, 1357. 

Ague, 1244. 

Ague-cake, 967, 1250. 
Ag-nails, 1466. 


Air, amount necessary for 
health, 563. 

Air-bath, 681. 

Air, composition of, 238. 

Air, compressed, 681. 

Air, examination of, 563. 

Air, hygiene of, 539. 

Air, impurities, 541. 

Air, moistening of, 575. 
Air-passages, 231. 

Air, remedial applications of, 
681. 

Albinism, 1275. 

Albinoes, 185. 

Albumen, 362. 

Alcohol, 452. 

Alcohol as food, 487. 

Alcohol a narcotic, 457. 
Alcohol an irritant, 457. 
Alcohol and force, 480. 
Alcohol, cause of disease, 462. 
Alcohol, effects of, 456. 
Alcohol, effects on blood, 457. 
Alcohol, effects on heart, 459. 
Alcohol, hereditary effects of, 
471. 

Alcohol, medical propei'ties 
of, 476. 

Alcohol, medical uses of, 475. 
Alcohol wash, 797. 

Alcohol, posioning by, 1444. 
Alcoholic beverages, 451. 
Alcoholic consumption, 464. 
Alcoholic insomnia, 465. 
Alcoholic poisoning, 478. 
Alcoholism, 1131. 

Alexis St. Martin, 257. 
Alimentary canal, 246. 
Alimentary canal, relation to 
diet, 381. 

Alkalies, 292. 

Alkaline bath, 808. 

Alkalies, poisoning with, 
1441. 

Allopathy, 587. 

Allspice, 745. 

Aloes, poisoning by, 1444. 


Aloes, 786. 

Alteratives, 761. 

Alum, 773. 

Alum in bread, 416. 

Alum, poisoning by, 1444. 
Alveolar process, 55. 
Amaurosis, 1498. 
Amenorrhoea, 1307. 
Ammonia, 748. 

Ammonia liniment, 799. 
Ammonia, poisoning by, 1444. 
Ammoniac, 785. 

Ammonium, chloride of, 785. 
Amphoric resonance, 976. 
Amputation, 1454. 
Amyl-nitrate, 758. 

Anal fistula, 1527. 

Anaemia, 836. 

Anaemia of the brain, 1077. 
Anaemic headache, 1101. 
Anaesthetics, 754. 

Anaesthetics in child-birth, 
1357. 

Anaesthetics, poisoning by, 
1444. 

Anatomy, 25. 

Anatomy, comparative, 25. 
Anatomy, general, 38. 
Anatomical elements, 39. 
Anchylosis, 1457. 

Aneurism of the heart, 1055. 
Aneurism, 1453. 

Angina pectoris, 1054. 

Ankle, 62. 

Ankle, caries of, 1460. 

Ankle, dislocation of, 1430. 
Animal food, 380. 

Animal food, Pavy on, 389. 
Animal heat, 314. 

Animal parasites, 409. 
Anodynes, 752. 

Ante-natal influences, 342. 
Anteversion, 1321. 
Anthelmintics, 789. 
Antimony, 749. 

Antimony, fed to fowls, 400. 
Anti-spasmodic, 751. 

1549 





1550 


GENERAL INDEX. 


Antimony, poisoning by, 
1444. 

Antrum of Highmore, 54. 
Anterior nares, 231. 
Antiseptics, 577. 

Anus, fissure of, 1525. 

Anus, artificial, 15^8. 

Anus, absence of, 1528. 

Aorta, 205. 

Aphthongia, 1143. 

Aphonia, 997. 

Aphasia, 1138. 

Aphthae, 873. 

Apomorphia, 775. 

Apoplexy, 1078. 

Apoplexy caused by alcohol, 
464. 

Apoplexy, pulmonary, 1013. 
Appetite, depraved, 944. 
Appetite, perverted, 293. 
Appetite, voracious, 972. 
Apple, composition of, 370. 
Apples, time for digestion of, 
927. 

Apple water, 742. 

Apricot, composition of, 370. 
Aqua-ammonia, 748. 

Aqueous humor, 186. 

Aqua Fortis, posioning by, 
1444. 

Aqua Regia, poisoning by, 
1444. 

Arabian physicians on baths, 
616. 

Arctic explorers, diet of, 387. 
Arcus senilis, 1493. 

Arm, 60. 

Arm bath, 658. 

Arm-bone, fractures of, 1419. 
Arnica, 750. 

Arrack, 453. 

Arrow-root, composition of, 
370. 

Arsenic, 761, 

Arsenic, test for, 562. 
Arsenic, poisoning with, 1442. 
Arsenic, poisoning by, 1444. 
Arsenical paper, 561. 
Arsenious acid, poisoning by, 
1444. 

Arteries, disease of, 1055. 
Arterial system, 205. 
Artificial respiration, 1432. 
Ascaris lumbricoides, 950. 
Ascending douche, 657. 
Ascites, 910. 

Aspiration, 1038. 

Assafoetida, 751. 

Astringents, 771. 


Asthma, hay, 1005. 
Astragalus, 62. 

Astigmatism, 1504. 

Atlas, 56. 

Atoms, 28. 

Atomizer, 803. 

Atrophy, 814. 

Atrophy of brain, 1089. 
Atrophy of the breast, 1332. 
Atrophia, poisoning by, 1444. 
Auditory bones, 63. 

Auditory sense, 174. 

Auditory canal, inflammation 
of, 1509. 

Audiphone, 1515. 

Auditory canal, abscess in, 
1507. 

Auricles of the heart, 203. 
Auricular muscles, 78. 
Australians, diet of, 387. 
Auscultation, 976. 
Axis-cylinder, 46. 

Baby foods, 1370. 

Back, pain in, 970. 
“Back-door” fracture, 1420. 
Bad books, 349. 
Baking-powders, adulteration 
of, 422. 

Balanitis, 1288. 

Baldness, 1284. 

Balsam of Tolu, 785. 

Banana, composition of, 370. 
Bandy-legs, 1476. 

Bandages, 1415. 

Bandage, starch, 1415. 
Bandages, plaster of Paris, 
1415. 

Barber’s itch, 1281. 

Barley, time of digestion, 927. 
Barley meal, composition of, 
370. 

Barium, poisoning by, 1444. 
Barn-yards, 556. 

Basedow’s disease, 1055. 
Baths, classification of, 632. 
Baths, temperature of, 631. 
Bathing customs, 617. 
Bathing, in pregnancy, 1343. 
Bathing of infants, 1372. 
Bathing, rules for, 633. 
Battery, care of, 688. 

Beans, time for digestion, 927. 
Beans, composition of, 370. 
Beaumont’s experiments, 257. 
Bed-bug, 1407. 

Bed-sores, 1448. 

Beef, time for digestion, 927. 
Beef tea, 741. 


Beef-tea and eggs, 739. 

Beer, 1452. 

Bees, 1408. 

Beet, composition of, 370. 

Bell on diet, 382. 

Belladonna, 754. 

Belladonna, poisoning by, 
1444. 

Benzoin, 785. 

Betel-nut, 454. 

Bible Christians, 380. 
Bichromate of Potash, poi¬ 
soning by, 1445. 

Bile, 254, 313. 

Bile, action of, 258. 

Bile ducts, inflammation of, 
159. 

Bilious attack, 888. 

Bilious beasts, 400. 

Bilious fever, 1252. 

Bilious headache, 1102. 

Bilious typhoicL 1193. 
Biliousness and animal food, 
389. 

Biliousness in animals, 400. 
Bismuth, 775. 

Bismuth, poisoning by, 1444 
Bitartrate of Potash, poison¬ 
ing by, 1445. 

Bites of animals, 1403. 

Bites of insects, 1408. 

Bitter Almonds, poisoning 
by, 1444. 

Bitter Sweet, poisoning by, 
1444. 

Black death, 1197. 

Black hellebore, 786. 

Black tongue, 1198. 
Blackberry, composition of, 
370. 

Blackberry root tea, 807. 
Blackberry root, 772. 

Bladder, catarrh of, 1163. 
Bladder, hemorrhage of, 1164. 
Bladder, tumors of, 1168. 
Bladder, irritability of, 1166. 
Bladder, paralysis of, 1166. 
Bladder, stone in, 1168. 
Bladder, spasm of, 1166. 
Bladder, extroversion, 1528. t 
Blanc-mange, 740. 

Blear eyes, 1486. 

Bleeding from lungs, 1011. 
Blisters, 787. 

Blind spot, 191. 

Blindness, color, 1506. 

Blood, 215. 

Blood corpuscles, 216. 

Blood, composition of, 215. 






GENERAL INDEX. 


1551 


Blood-drinking, 1058. 

Blood, effects of alcohol on, 
457. 

Blood, effects of tobacco on, 
513. 

Blood glands, 314. 

Blood, supply, regulation of, 
214. 

Blood-vessels of the heart, 204. 
Blood-vessels, ligation of, 
1520. 

Bloody tumor of the scalp, 
1388. 

Bloody urine, 1152. 

Blushing, 144, 215. 

Blue disease, 1059. 

Blue Vitriol in bread, 416. 
Blue Vitriol, poisoning by, 
1444. 

Blurred sight, 1499. 

Bodek, 393. 

Body-louse, 1279. 

Boils, 1447. 

Bones, 50. 

Bones, hygiene of, 67. 

Bones of the ear, 63. 

Bones of foot, fracture of, 
1425. 

Bones, physiology of, 63. 
Bones, structure of, 50. 
Bones, resection of, 1456. 
Bone, necrosis of 1456. 

Bone, caries of, 1455. 

Bone, inflammation of, 1455. 
Bony tissue, 42. 

Bony tumors, 1519. 

Boneset, 745. 

Borax wash, 798. 

Bowels, constipation of, 911. 
Bowels, consumption of, 919. 
Bowels, hemorrhage from, 
1399. 

Bowels, neglect of, 206. 
Bowels of infants, 1371. 
Bowels, pain in, 970, 1389. 
Bowels, weakness in, 972. 
Bow-legs, 1476. 

Bran coffee, 739. 

Bran tea, 739. 

Brachial artery, 205. 

Brain, anaemia of, 1077. 
Brain, anatomy of, 116. 
Brain, atrophy of, 1089. 
Brain, dropsy of, 1383. 

Brain, false dropsy of, 1384. 
Brain fever, 1086. 

Brain, hygiene, 156. 

Brain, hypertrophy of, 1089. 
Brain, hypertemia of, 1074. 


| Brain, hardening of, 1088. 

1 Brain, induration of, 1088. 
Brain labor, 165. 

Brain, physiology of, 122. 
Brain, softening of, 1087. 
Brain, tumors of, 1089. 
Brain-workers, food for, 375. 
Brandy, 452. 

Break-bone fever, 1199. 
Bread, adulteration of, 416. 
Bread, a perfect food, 372. 
Bread, black, 367. 

Bread, composition of, 370. 
Bread-fruit, composition of, 
370. 

Bread, time of digestion, 927. 
Breathing in disease, 977. 
Breathed air, 243. 

Breath, foul, 1044. 

Breath, shortness of, 1041. 
Breasts, care of, 1352. 
Breasts, care of in pregnancy, 
1343. 

Breasts, enlargement of, 1340. 
Breast, atrophy of the, 1332. 
Breast, cancer of, 1333. 
Breast, tibrous tumors of, 
1334. 

Breast, inflammation of the, 

1331, 1352. 

Breast, overgrowth of the, 

1332. 

Bright’s disease, acute, 1155. 
Bright’s disease, chronic, 
1156. 

Broiling, 927. 

Bromine, 789. 

Bromide of potash, 758. 
Bromine, poisoning by, 1444. 
Bronchocele, 1524. 
Bronchioles, 233. 
Broncophony, 978. 
j Bronze-skin, 1161. 

| Bronchial croup, 1002. 
Bronchial tubes, 232. 
Bronchitis, acute, 998. 
Bronchitis, capillary, 999. 
Bronchitis, chronic, 1000. 
Bronchitis, croupous, 1002. 
Bruises, 1409. 

Buchu, 779. 

Buffalo fly, 1408. 

Bunions, 1470. 

Buttermilk, composition of, 
370. 

j Butter, adulteration of, 417. 
Butter, time for digestion, 
927. 

Burns, 1411. 


Burns, thymol for, 1412. 

Cabbage, composition of, 370. 
Cabbage, time of digestion, 
927. 

Calabar bean, 758. 

Calculus, 1168. 

Calisthenics, 96. 

Calabar Bean, poisoning by, 
1444. 

Calomel, poisoning by, 1444. 
Callosities, 1450. 

Callus, 1277. 

Calculus, salivary, 1522. 
Calculus, urinary, 1528. 
Camphor, 751. 

Camphor, poisoning by, 1444. 
Camphor liniment, 799. 
Canada pitch, 787. 
Canabalism, 392. 

Canaliculi, 42. 

Candy, composition of, 421. 
Candies, 1369. 

Canities, 1285. 

Cancer of the breast, 1333. 
Cancer of the kidneys, 1160. 
Cancer of the stomach, 904. 
Cancer, 1519. 

Cancer, black, 1519. 

Cancer, stone, 1519. 

Cancer, skin, 1519. 

Cane sugar, 363. 

Caustic soda, poisoning by, 
1455. 

Cancellous tissue, 51. 

Canker of the mouth, 874. 
Cantharides, poisoning by, 
1444. 

Cantharides, 779. 

Canned fruits, adulteration 
of, 423. 

Canned meats, adulteration 
of, 425. 

Capillaries, 206. 

Capillary bronchitis, 999. 
Captain Hall, diet of, 387. 
Carrot, composition of, 370. 
Carnivorous animals, diet of, 
381. 

Cartilage, 51. 

Cartilaginous tissue, 42. 
Carpus, 61. 

Cardamoms, 745. 

Carotid artery, 205. 

Carbolic acid, 785. 

Carbolic acid, inhalations of, 
805. 

Carbonate of magnesia, 777. 
Carbonic acid, 238. 











1552 


GENERAL INDEX. 


Carbolic acid, poisoning by, 
1444. 

Carbonic Acid Gas, poisoning 
by, 1444. 

Carbonic Oxide Gas, poison¬ 
ing by, 1444. 

Carbonic acid gas, 541. 
Carbuncles, 1448. 

Caries of bone, 1455. 
Cartilage, floating, 1458. 
Caries of knee, 1460. 

Caries of ankle, 1460. 
Cartilaginous tumors, 1519. 
Carbonic oxide, 541. 
Carbolated vaseline, 1401. 
Care of infants, 1366. 

Castor Oil Seeds, poisoning 
by, 1444. 

Carriage riding, 96. 

Castor, 751. 

Casts, 1152. 

Castration, 1531. 

Catheter, use of, 1528. 
Catalepsy, 1108. 

Cataract, 1495. 

Cataract douche, 648. 
Catarrhal fever, 1199. 

Catarrh nasal, 983. 

Catarrh of ear, acute, 1509. 
Catarrh of ear, chronic, 1510. 
Catheter, Eustachian, 1512. 
Catarrh of the bladder, 1163. 
Catarrh of the larynx, 989. 
Catarrh of the mouth, 872. 
Catarrhal pneumonia, 1017. 
Catarrhal, chronic pneu¬ 
monia, 1017. 

Catarrh of the urethra, 1288. 
Catarrh, uterine, 1315. 
Cathartics, 776. 

Cancrum oris, 874. 

Cauda equina, 59, 120. 

Causes of disease, 817. 
Caustics, poisoning by, 1444. 
Caustic potash, 788. 

Cayenne pepper, 430, 787. 
Cellars, 552. 

Centipede, 1407. 
Cephalhgematoma, 1388. 
Cerumen, 175. 

Cerebro - spinal meningitis, 
1232. 

Cerebro-spinal meningitis, 
cause of, 408. 

Cerebellum, functions of, 128. 
Cerebrum, functions of, 130. 
Cesspools, 558, 559. 
Chamomile, 745. 

Chancroid, 1299. 


Chapped hands, lotion for, 
798. 

Charcoal, 577, 792. 

Charcoal poultice, 794. 
Chastity, 346. 

Cherry, composition of, 370. 
Cheese, 423. 

Cheese, poisoning by, 403. 
Cheese mite, 413. 

Cheese, time of digestion, 
927. 

Chemistry of digestion, 255. 
Chenopodium, 789. 

Chest, dropsy of, 1037. 

Chest, pain in the, 1041. 
Chest pack, 656. 

Chest wrapper, 656. 

Chicken pox, 1224. 
Chickensnake, bite of, 1406. 
Childbirth, 1344. 

Child, washing of, 1348. 
Chica, 453. 

Chin cough, 1207. 

Chilblains, 1261. 

Chimpanzee, diet of, 381. 
Chills and fever, 1244. 
Chinese, diet of, 380. 

Chinese lady’s foot, 103. 
Chloral, 538, 759. 

Chloral, poisoning by, 1444. 
Chloroform, poisoning by, 
1444, 

Chloride of Iron, poisoning 
by, 1444. 

Chloasma, 1275. 

Chloroform, 755. 

Chlorine Gas, poisoning by, 
1444. 

Chloroform liniment, 799. 
Chloride of ammonia, 785. 
Chloride of lime, 578. 
Chloride of zinc, poisoning 
by, 1445. 

Chloride of zinc, 788. 

Chlorine gargles, 796. 
Chlorine gas, 578. 

Chlorinated soda, 806. 
Chocolate, 453, 519. 

Cholera, 1202. 

Cholera infantum, 894. 
Choking, 1437. 

Chopping movement, 716. 
Choroid, diseases of, 1496. 
Chorea, 1103. 

Chronic gastritis, 895. 
Chromium, poisoning by, 
1444. 

Chromic acid, 789. 

I Chronic bronchitis, 1000. 


j Chronic nasal catarrh 983. 
Chronic rheumatism, 1172. 
Chronic hydrocephalus, 1383. 
Chylous urine, 1152. 

Cicatrix, 1401. 

Cider, 452. 

Cider, artificial, 430. 
Cinamon, 745. 

Cinchona, 745. 

Circumcision, 1530. 
Circulatory apparatus, 202. 
Circulatory organs, diseases 
of, 1044. 

Circassians, diet of, 380. 
Circulation, regulation of, 214. 
Circulation, hygiene of, 224. 
Circulation, effects of food 
on, 227. 

Citric acid, 749. 

Citric acid, poisoning by, 
1444. 

Citrate of potash, 783. 
Clapping movement, 716. 
Claw-like nails, 1467. 
Clavicle, fractures of, 1419. 
Classification of fevers. 1181. 
Cleft spine, 1386. 

Cleft-palate, 1521. 
Clergyman’s sore throat, 878, 
880. 

Clothing, 309. 

Clothes on fire, 1436. 

Clothing of infants, 1372. 
Clothes-louse, 1279. 

Clubbed hands, 1472. 
Club-foot, 1472. 

Coal Gas, poisoning by, 1444. 
Coccyx, 58. 

Coeculus Indicus, 454, 1444. 
Cochlea, 176. 

Cocoa, 453. 

Cocoanut oil, 800. 
Coccyodynia, 1338. 

Cod-liver oil, 767. 

Coffee, 453, 751. 

Coffee, adulteration of, 429. 
Colcliicum, 770. 

Cold in the eye, 1480. 

Cold, application of, 679. 
Cold in the head, 981. 

Cold bath, rationale of, 605. 
Cold, effects of on pulse, 604. 
Cold meat, 927. 

Cold sores, 1262. 
Color-blindness, 1506. 
Colcliicum, poisoning by, 
1444. 

Color of the urine, 1147. 
Colic, 910. 





Collar-bone, fractures of, 

14 IS. 

Colles’s fracture, 1420. 

Colic, lead, 911. 

Colon, 252. 

Colombo, 745. 

Composition of the air, 238. 
Compresses, 664. 

Comedo, 1267. 

Compound fractures, 1413. 
Congestion, 816, 826. 
Congestion of the lungs, 1009. 
Congestion of the kidneys, 
1153. 

Congestion of the ovary, 1304. 
Congestion of the brain, 1074. 
Congestive chills, 1251. 
Conception, 323. 

Condiments, 286. 

Connective tissue, 40. 
Conjunctivitis, purulent, 
1480. 

Congestion of Conjunctiva, 

1479. 

Conjunctivitis, catarrha 1, 

1480. 

Conjunctiva, 182. 

Contrast, 192. 

Consumption, 1017. 
Consumption, alcoholic, 464. 
Consumption of the bowels, 
919. 

Consumption of the kidneys, 
1160. 

Consumption of the throat, 
996. 

Consumptive constitution, 
1387. 

Contracted tendons, 1465. 
Contracted muscles, 1465. 
Continence, 350. 

Conium, 758. 

Constipation, 934. 
Constipation of the bowels, 
911. 

Convulsions, 1378, 1395. 
Conversation tube, 1515. 
Convulsions, puerperal, 1364. 
■ Contracted pupils, 1495. 
Contused wounds, 1400. 
Cookery, bad. 282. 
Copperhead, bite of, 1406. 
Copperas, 579. 

Copper, poisoning by, 1444. 
Copperas, poisoning by, 1444. 
Copper, sulphate, 775. 
Coi’yza, 981. 

Corrosive Sublimate, poison¬ 
ing by, 1444. 


GENERAL INDEX. 

Cornea, inflammation of, 
1492. 

Cornea, ulcers of, 1492. 
Cornea, opacities of, 1492. 
Cornea, 184 
Corns, 1468. 

Corrugator supercilia, 73. 
Corsets, 242. 

Corset-wearing, 99. 

Cotton Root, poisoning by, 
1444. 

Cotton-mouth, bite of, 1406. 
Cough, 1040. 

Cough, stomach, 1040. 

Cough, painful, 1040. 

Cough, whooping, 1040. 
Cough, to relieve, 1028. 
Cough, chin, 1040. 

Cough, nervous, 1040. 

Cough, hacking, 1040. 
Coughing, 236. 

Countenance, expression cf in 
children, 1375. 

Counter irritation, 787. 
Crab-louse, 1279. 

Cracks between toes, 1470. 
Cracked nipple, 1332. 

Cranial nerves, functions of, 
136. 

Cramp, 1115. 

Crazy-bone, 60. 

Cross-eye, 1491. 

Creosote, 785. 

Creosote, poisoning by, 1444. 
Cream, 365. 

Cream of Tartar, poisoning 
by, 1444. 

Cream, composition of, 370. 
Crepitus, 1413. 

Crises, 626. 

Criminal abortion, 356. 
Croton Oil, poisoning by, 
1444. 

Croupous bronchitis, 1002. 
Croupous pneumonia, 1014. 
Croup, bronchial, 1002. 
Crushed fractures, 1413. 
Crural neuralgia, 1100. 
Cubebs, 779. 

Cupping, dry, 791. 

Currie on water, 620. 
Curvature of Spine, 1461, 
1463. 

Currant, composition of 370. 
Cuspid teeth, 248. 

Cuticle, 166. 

Cut throat, 1397. 

Cyanide of Potash, poisoning 
by, 1445. 


1553 

Cyanide of Potash, poisoning 
by, 1444. 

Cyanosis, 1059. 

Cyanide of potash, 749. 
Cystocele, 1329. 

Cystitis, 1163. 

Cysticercus, 947. 

Cystic tumors, 1519. 

Dandruff, 1271. 

Dandruff, lotion of, 798. 

Date, composition of, 370. 
Deaf and Dumb alphabet, 
1517. 

Deafness, nervous, 1513. 
Death of the fetus, 1363. 
Deadly Nightshade, poison¬ 
ing by, 1444. 

Decayed food, 410, 284. 
Decaying fruits, 414. 
Decaying vegetables, 414. 
Decaying wood, 559. 
Decoctions, 807. 

Defecation, painful, 971. 
Deformed liver, 965. 
Definition of disease, 581. 
Deforming rheumatism, 1174 
Deformities of feet, 1472. 
Deformities of hands, 1472. 
Degeneration, 815. 

Delusion, 1123. 

Delirium, 1123. 

Deltoid muscle, 82. 

Delirium tremens, 485, 1132. 
Dementia, 1125. 

Demodex folliculorm, 307. 
Density of the urine, 1149. 
Dengue, 1199. 

Dentaphone, 1516. 

Dentine, 247. 

Deodorants, 577. 

Depraved appetite, 944. 
Depression, 817, 828. 
Depuration, 435. 

Development of infants, 1377. 
Development, 324. 

Diabetes insipidis, 870. 
Diabetes mellitus, 865. 
Diabetic bread, 743. 
Diagnosis, 819. 

Diagnostic tube, 1512. 
Diaphoretics, 782. 

Diaphragm, 82. 

Diaphragm, spasm of, 1004 
Diarrhea, 906. 

Diet, errors relating to, 373. 
Diet in Arctic regions, 387. 
Diet in pregnancy, 1342. 

Diet of Arctic explorers, 387. 




1554 

Diet of Icelanders, 301. 

Diet of Chinese, 380. 

Diet of Circassians, 380. 

Diet of Swedes, 380. 

Diet of Norwegians, 380. 

Diet of Egyptians, 382. 

Diet of Romans, 382. 

Diet of Grecians, 382. 

Diet of chimpanzee, 381. 

Diet of gorilla, 381. 

Diet of Irish, 380. 

Diet of Scotch, 380. 

Diet of Italians, 380. 

Diet of Swiss, 380. 

Diet of East Indians, 380. 
Diet of Terra del Fuegians, 
387. 

Diet of Abyssinians, 392. 

Diet of infants, 1306. 

Diet, unseasonable, 294, 361. 
Digits, 61. 

Digastric muscle, 87. 
Digestion, articles easy of, 
736. 

Digestion, articles not easy of, 
736. 

Digestion, chemistry of, 255. 
Digestion, hygiene of, 266. 
Digestion, length of time for, 
927. 

Digestion, physiology of, 255. 
Digestion, slow, 936. 
Digestive apparatus, 246. 
Digestive organs, diseases of, 
872. 

Digestive process, 259. 
Digestive juices, 252. 
Digitalis, 749. 

Digitalis, poisoning by, 1444. 
Dilatation of the stomach, 
900. 

Dilatation of the heart, 1047. 
Dilatation of the oesophagus, 
886 . 

Dilated pupils, 1495. 

Diploe, 52. 

Diphtheria, 1209. 

Diphtheric inflammation of 
the mouth, 874. 

Dirt in eye, 1438. 
Districhiasis, 1489. 
Disinfectants, 577. 
Displacements of the womb, 
1321. 

Displacements of the uterus, 
1321. 

Displacement of the liver, 
.964. > 

Disease, Basedow’s, 1055. 


GENERAL INDEX. 

Disease, breathing in, 977. 
Disease, causes of’ 817. 
Disease, definition of, 581. 
Disease germs, 548. 

Disease of the veins 1056. 
Disease of the arteries, 1055. 
Disease of the skin, 1255. 
Disease, symptoms of, 819. 
Disease, the voice in, 977. 
Disease of the eye, 1478. 
Disease of bones, 1455. 
Disease of joints, 1455. 
Disease of hands, 1466. 
Disease of feet, 1466. 

Diseases of the liver, 953. 
Diseases of the stomach, 887. 
Diseases of the oesophagus, 
885. 

Diseases of the male genera¬ 
tive organs, 1287. 

Diseases of the circulatory or¬ 
gans, 1044. 

Diseases of the nervous sys¬ 
tem, 1060. 

Diseases of the digestive or¬ 
gans, 872. 

Diseases of the mouth, 872. 
Diseases of the respiratory or¬ 
gans, 973. 

Diseases of women, 1300. 
Diseases of children, 1374. 
Diseases of the urinary or¬ 
gans, 1145. 

Diseases of the locomotive or¬ 
gans, 1169. 

Diseases of the hair, 1255. 
Diseases of optic nerve, 1497. 
Diseases of choroid, 1496. 
Diseases of retina, 1497. 
Diseases of the ear, 1506. 
Diseased eggs, 412. 

Diseased food, 393. 

Diseased milk, 403. 

Diseased state of liver due to 
animal food, 389. 
Dislocations, 1425. 
Dislocations, treatment of, 
1425. 

Dislocation of jaw, 1426. 
Dislocation of shoulder, 1426. 
Dislocation of elbow, 1428. 
Dislocation of thumb, 1429. 
Dislocation of wrist, 1428. 
Dislocation of fingers, 1429. 
Dislocation of hip, 1429. 
Dislocation of knee-joint, 
1430. 

Dislocation of ankle, 1430. 
Dislocation of toe, 1431. 


Dislocation of bones of foot, 

1430. 

Dissection wounds, 1402. 
Disorders of pregnancy, 1359. 
Disorders of the speech, 1137. 
Diuretics, uses of, 779. 
Double heart of dugong, 203. 
Drains, 558. 

Dreams, 146. 

Dress in pregnancy, 1342. 
Drinkers, nervous disease of, 
466. 

Drinks, 735. 

Drinking at meals, 267. 

Drop bath, 657. 

Dropsy, abdominal, 917. 
Dropsy, ovarian, 1305. 

Dropsy of the chest, 1037. 
Dropping tube, 1494. 
Dropsical swelling, 1361. 
Drowning, treatment for, 

1431. 

Drum membrane, 175. 

Drum membrane, perfora¬ 
tion of, 1514. 

Drunkenness, treatment of, 
729. 

Dry cupping 791. 

Dry earth, 577. 

Dry heat, applications of, 678. 
Dry sheet packs, 644. 

Dry skin, 1271. 

Dry tetter, 1264. 

Dugong, heart of, 203. 

Dust, 550. 

Dysentery, acute, 908. 
Dysentery, chronic, 910. 
Dysmenorrhcea, 1311. 
Dyspepsia, 921. 

Dyspepsia and alcohol, 514. 
Dyspepsia, acute, 935. 
Dyspepsia, acid, 937. 
Dyspepsia, bilious, 937. 
Dyspepsia foul, 937. 
Dyspepsia, infantile, 1390. 
Dyspepsia, nervous, 941. 
Dyspepsia of drunkards, 462. 
Dyspepsia, painful, 939. 
Dyspepsia, simple, 936. 

Ear, 175. 

Earache, 1507. 

Ear, acute catarrh, of, 1510. 
Ear bath, 660. 

Ear bones, 63, 176. 

Ear, chronic catarrh of, 1510. 
Ear-wax, 175. 

Ear-wax, hardened, 1508. 
Ear, hygiene of, 198. 





GENERAL INDEX. 


1555 


Ear, physiology of, 182. 

Ear, diseases of, 1506. 

Ear, discharge from, 1506. 
Ear, abscess in, 1507. 

Ears, ringing in, 1508. 
Ear-trumpets, 1515. 

Ears, taking cold in, 200. 
Ears, exposure of, 200. 

Ear, foreign bodies in, 1439. 
Ear-cockle, 409. 

Eating between meals, 268. 
Eating too frequently, 268. 
Eating tetter, 1276. 

Earth bath, 675. 

Ecthyma, 1268. 

Eczema, 1263. 

Effects of diet, 361. 

Effects of cooking, 361. 

Egg, entire, composition of, 
370. 

Egg-nog, 741. 

Egophony, 978. 

Egyptians, diet of, 382. 
Egyptian bath, 614. 

Elastic, 101. 

Elastic tissue, 40. 

Elaterium, poisoning by, 
1444. 

Elbow, dislocation of, 1428. 
Electricity, 687. 

Electricity, effects of, 692. 
Electricity, surgical uses of, 
703. 

Electric bath, 697. 

Electric battery, 688. 
Electrodes, 691. 
Electro-vapor bath, 699. 
Elements of food, 255, 362. 
Elephantiasis, 1269. 
Embolism, 1052. 

Emetics, 775. 

Emergencies, 1394. 
Emmenagogues, 786. 
Emphysema, 1006. 
Empyema, 1036. 

Enamel, 247. 

Enema, 663. 

Endocarditis, 1049. 
Endocardium, 204. 
Endosteum, 51. 

Endometitris, 1315. 

Enlarged abdomen, 1338. 
Enlarged tonsils, 884. 
Enlargement of the spleen, 

967. 

Enlargement of the liver, 961. 
Enlargement of prostate, 

1287. 

Ensiform cartilage, 58. 


Enteralgia, 910. 

Enuresis, 1164. 

Epidermis, 167. 

Epiglottis, 232. 

Epilepsy, 1104. 

Epistaxis, 987. 

Epispastics, 786. 

Epithelioma, 1519. 
Epithelium, 46. 

Epithelium, ciliated, 46. 
Equinus, 1472. 

Ergot, 407, 786. 

Ergot, how to detect, 408. 
Ergot, use in child-birth, 

1357. 

Ergot, poisoning by, 1444. 
Ergotism, 407. 

Errors in ventilation, 572. 
Eruptions of the skin, 1393. 
Eruption from compresses, 
664. 

Erysipelas, 1260. 
Erysipelatous fever, 1198. 
Erythema, 1259. 

Escharotics, 788. 

Ether, 538, 756. 

Ether, poisoning by, 1444. 
Ethmoid bone, 53. 

Eustachian tube, 175. 
Eustachian catheter, 1512. 
Evolution and diet, 388. 
Excretion, 300. 

Excessive sweating, 1272. 
Exercise, 94. 

Exercise of infants, 1373. 
Exercise in pregnancy, 1341. 
Exhaustion of vitality, 1290. 
Exophthalmic goitre, 1055. 
Expectoration, 979. 
Expectorants, 784. 
Expression of countenance in 
children, 1375. 

Expiration, 235. 
Extra-uterine pregnancy, 

1358, 338. 

Exudations, 815. 

Eyes, color of, 185. 

Eye, anatomy of, 182. 
Eyelids, 182. 

Eye, accommodation of, 190. 
Eyeball, 184. 

Eye-washes, 798. 

Eye sympathetic inflamma¬ 
tion of, 1483. 

Eve, diphtheric inflammation 
of, 1483. 

Eye, inflammation in newly 
born, 1482. 

Eye, lime in, 1439. 


Eye, dirt in, 1438. 

Eye, pain in, 1499. 

Eyes, oscillation of, 1492. 
Eye, weeping, 1490. 
Epiphora, 1490. 

Eyelids, twitching of, 1490. 
Eye, inability to open, 1487. 
Eye, inability to close, 1488. 
Eye, paralysis of, 1488. 

Eye, wild hairs in, 1488. 
Eyelids, tumors of, 1487. 
Eyelids, spasm of, 1489. 
Eyelids, granular, 1483. 
Eyelids, inflammation of 
edges of, 1485. 

Eyelids, acne of, 1485. 

Eyes, blear, 1486. 

Eye, disease of, 1478. 

Eye, cold inj 1480. 

Eye, suppurative inflamma¬ 
tion of, 1480. 

Face, wash for, 798. 

Face pimples, 1265. 
Face-ache, 1098. 

Facial paralysis, 1111. 
Faradic electricity, 687. 
Faradization, local, 696. 
Faradization, general, 693. 
Fat cells, 364. 

Fats, 364, 731. 

Fats, excessive use of, 285. 
Fatigue, 91. 

Fatty degeneration of nerves, 

1137. 

Fatty degeneration of the kid¬ 
neys, 1159. 

Fatty degeneration of the 
muscles, 1178. 

Fatty tumors, 1518. 

Fainting, 1394. 

False ribs, 57. 

False hair, 311. 

False pregnancy, 1363. 

False dropsy of the brain, 
1384. 

Feather-beds, 560. 

Febricula, 1187. 

Fecundation, 322. 
Fecundation in flowers, 323. 
Fecundation in animals, 323. 
Feet, deformities of, 1472. 
Feet, disease of, 1466. 

Feet, abuse of, 73. 

Feeding of infants, 1366. 
Felon, 1467. 

Femur, 61. 

Fermentation, 413. 
Fermentation test, 443. 











1556 


GENERAL INDEX. 


Fetus, death of, 1363. 

Fetid feet, wash for, 797. 
Fever, 817, 1179. 

Fever, bilious, 1252. 

Fevers, classification of, 1181. 
Fever, catarrhal, 1199. 

Fever, erysipelatous, 1198. 
Fevers, general treatment of, 
1182. 

Fever, intermittent, 1244. 
Fever, masked intermittent, 
1243. 

Fever, milk, 1351. 

Fever, puerperal, 1365. 
Fever, pernicious intermit¬ 
tent, 1251. 

Fever, remittent, 1252. 
Fever, relapsing, 1192. 

Fever, scarlet, 1229. 

Fever sores, 1262. 

Fever, spotted, 1232. 

Fever, typhoid, 1187. 

Fever, typhus, 1191. 

Fever, yellow, 1194. 
Fibro-cartilage, 56. 

Fibula, 62. 

Fibrilke, 45. 

Fibrous tissue, white, 40. 
Fibrous tumors, 1518. 
Fibrous tumors of the breast, 
1334. 

Filters, care of, 446. 

Filters, how to make, 447. 
Filtration, 445. 

Fingers, fracture of, 1421. 
Fingers, dislocation of, 1429. 
Fire-places, 574. 

Fissure of anus, 1525. 

Fistula in ano, 1527. 
Fish-skin disease, 1275. 

Fish not brain food, 376. 
Fish-hook in flesh, 1400. 
Flatulence, 933. 

Flat-foot, 1473. 

Flaxseed tea, 741. 

Flea, 1407. 

Flesh, needle in, 1400. 

Flesh, fish-hook in, 1400. 
Flexions, 1327. 

Flint, on water, 620. 

Floating kidney, 1160. 
Floating cartilage, 1458. 
Floating ribs, 57. 

Flour, adulterations of, 416. 
Flour, mustiness of, 417. 
Flukes, 953. 

Foot, 62. 

Foot, dislocation of, 1430. 
Foot bath, 655. 


Food, 361. 

Food, regurgitation of, 969. 
Foods, combinations of, 371. 
Food, classification of, 362. 
Foods, digestibility of, 736. 
Food, definition of, 362. 
Food, elements of, 255, 362. 
Food, errors in quantity of, 
275 

Food, fried, 283. 

Food, relation to muscles, 
115. 

Foods, nutritive value of, 370. 
Food, necessary amount of, 
372, 

Food, laxative, 776. 

Food, adulterations of, 415. 
Food proper quantity of, 276. 
Fool’s-parsley, poisoning by, 
1444. 

Fomentations, 665, 809. 
Fontanel, 53. 

Foramen ovale, 1059. 
Foramen magnum, 53. 
Fore-arm, 61. 

Force, 28. 

Force, vital, 29. 

Fore-arm, fractures of, 1420. 
Foreign bodies swallowed, 
1437. 

Foreign bodies in ear, 1439. 
Foreign bodies in nose, 1439. 
Foul breath, 1044. 

Fowls, time for digestion of, 
927. 

Fox-glove, poisoning by, 
1444. 

Fractures, 1412. 

Fracture, general treatment 
of, 1414. 

Fractures, healing of, 1413. 
Fractures, compound, 1413. 
Fractures, crushed, 1413. 
Fractures, impacted, 1413. 
Fractures, treatment of, 1414. 
Fractures, setting of, 1414. 
Fractures of skull, 1417. 
Fractures of spine, 1417. 
Fractures of nose, 1417. 
Fractures of lower jaw, 1417. 
Fractures of upper jaw, 1418. 
Fractures of collar-bone, 1418. 
Fractures of ribs, 1419. 
Fractures of the humerus, 
1419. 

Fractures of arm-bone, 1419. 
Fractures of fore-bone, 1420. 
Fractures of bones of hand, 
1421. 


Fractures of lingers, 1421. 
Fractures of thigh, 1421. 
Fracture of knee-pan, 1423. 
Fractures of leg, 1424. 
Fractures of bones of foot, 
1425. 

Fracture box, 1424. 

Fruits, 733. 

Frugivorous animals, diet of, 
381. 

Frequent urination, 1146. 
Freckles, 1274. 

Freezing, 1455. 

Frequent pulse, 1045. 

Fried food, 283. 

Frontal bone, 53. 

Fruits, canned, 423. 

Fruits, preserved, 423. 

Fruit jars, poisoning from, 
431. 

Full bath, 645. 

Fulling movement, 714. 
Fungi, 35. 1 

Fungi, poisoning by, 1444. 
Functional derangements, 
816. 

Funny bone, 60. 

Furuncles, 1447. 

Galactorrhoea, 1331. 

Gallic acid, 771. 

Gamboge, poisoning by, 1444. 
Gangrenous sore mouth, 876. 
Gangrene, 1452. 

Gangrene, senile, 1452. 
Ganglion, 1464. 

Ganglia, 45. 

Garbage, 559. 

Gargles, 795. 

Gargles, alum, 795. 

Gargles, lime, 795. 

Gargle, chlorate of potash, 

795. 

Gargle, brandy and water, 

796. 

Gargle, permanganate of pot¬ 
ash, 796. 

Gargle, carbolic acid, 796. 
Gargle, chlorine solution, 796. 
Garden nightshade, poison¬ 
ing by, 1444. 

Gasses, poisoning by, 1444. 
Gastritis, chronic, 895. 
Gastralgia, 901. 

Gastritis, 887. 

Gastric juice, 253. 

Gastric juice, action of, 256. 
Gelatine baths, 808. 
Gelsemium, 761. 






GENERAL INDEX. 


Gelsemium, poisoning by, 
1444. 

General faradization, C93. 
General anatomy, 38. 

General paralysis of insane, 
1125. 

Genitals, itching in preg¬ 
nancy, 13C0. 

Genitals, itching of the, 1330. 
Generation, 316. 

Gentian, 745. 

Genu-valgum, 1477. 
Geranium, 772. 

German measles, 1228. 
Germs, 548. 

Germ theory, 1179. 

Gestation, 324. 

Gestures in children, 1375. 
Gestation, duration of, 327. 
Gin, 452. 

Gin liver, 465. 

Glanders, 1224. 

Glasses, 1505. 

Glaucoma, 1497. 

Glenoid fossa, 60. 

Glottis, oedema of, 994. 
Glottis, spasm of, 995. 
Glossitis, 876. 

Glottis, paralysis of the, 997. 
Gluten, 362. 

Glutei muscles, 84. 

Glucose, 363. 

Gnappee, 411. 

Goitre exophthalmic, 1055. 
Goitre, 1524. 

Gold-thread, 745. 

Goneness in the stomach, 
970. 

Goose-flesh, 76. 

Gooseberry, composition of, 
370. 

Gorilla, diet of, 381. 

Gout, 1176. 

Gout and animal food, 389. 
Gray hair, 1285. 

Grape cure, 1010. 

Gravel in the kidneys, 1162. 
Grains, 732. 

Grape, composition of, 370. 
Granular inflammation of the 
lips of the womb, 1328. 
Granular lids, 1483. 

Grape sugar, 364. 

Graham flour, 367. 

Gravel, 1167. 

Grecian bath, 615. 

Grecians, diet of, 382. 

Green Vitriol, poisoning by, 
1444. 


Great sympathetic nerve, 

121 . 

Gross on mercury, 764. 
Grubs, 1267. 

Guaiac, 786. 

Gullet, 249. 

Gum-arabic water, 742. 
Gum-boil, 1522. 

Gums, hemorrhage from, 
1398. 

Gymnastics, lung, 720. 

Hacking cough, 1040. 
Haemophilia, 863. 
Hemoptysis, 1011. 

Hair dyes, 311. 

Hair, diseases of, 1255. 

Hair, overgrowth of, 1283. 
Half pack, 665. 

Half-bath, 647. 
Hallucination, 1123. 

Hands, diseases of, 1466. 
Hands, deformities of, 1472. 
Hand, fracture of, 1421. 
Hang-nail of finger, 1466. 
Hands, wash for, 798. 

Hare lip, 54, 1521. 

Hard water, 292, 437. 

Hard water, to soften, 440. 
Hardened ear-wax, 1508. 
Hardening of brain, 1088. 
Hartshorn* poisoning by, 
1444. 

Hasty eating, 266. 

Hashish, 454. 

Haversian canals 42. 

Hay fever, 1005. 

Health-lift, 96. 

Heart, 202. 

Hearing, accommodation of, 
179. 

Heart, action of, 207. 

Heart, sounds of, 207. 

Heart, force of, 208. 

Heart stimulants, 748. 

Heart, effects of alcohol on, 
459. 

Heating, 573. 

Heart disease and tobacco, 
514. 

Health, definition of, 585. 
Heat, applications of, 676. 
Heart sedatives, 749. 

Head of tape-worm, 949. 
Heaviness in stomach, 970. 
Heart, hypertrophy of the, 
1046. 

Heart, overgrowth of, 1046. 
Heart, dilatation of, 1047. 


1557 

Heart-case, inflammation of, 

1050. 

Heart, inflammation of, 1050. 
Heart, organic diseases of, 

1051. 

Heart, valvular disease of, 
1051. 

Heart, rupture of, 1053. 
Heart, aneurism of, 1055. 
Heart, palpitation of, 1053. 
Headache, 1100. 

Headache, anaemic, 1101. 
Headache, sick, 1102. 
Headache, bilious, 1102. 
Headache, sympathetic, 1102. 
Headache, nervous, 1103. 
Heat, rash, 1260. 

Head louse, 1279. 

Headache in pregnancy, 1362. 
Healing of fractures, 1413. 
Hellebore, poisoning by, 
1444. 

Hemlock, poisoning by, 1444. 
Hemorrhoids, 1525. 

Henbane, poisoning by, 1444. 
Hernia, 1524. 

Hemorrhagic diathesis, 863. 
Hemorrhage of the stomach, 
903. 

Hemorrhage of the intestines, 
914. 

Hemorrhage, as a symptom, 
1046. 

Hemorrhage from the lungs, 

1011 . 

Hemicrania, 1097. 
Hemorrhage of the kidneys, 
1154. 

Hemorrhage of the bladder, 
1164. 

Hematurea, 1152. 
Hemorrhoids, 1359. 
Hemorrhage, 1396. 
Hemorrhage from the arm, 

1397. 

Hemorrhage from the leg, 

1397. 

Hemorrhage from the palm 
of the hand, 1398. 
Hemorrhage, turpentine for, 

1398. 

Hemorrhage from varicose 
veins, 1399. 

Hemorrhage from the gums, 
1398. 

Hemorrhage from the stom¬ 
ach, 1398. 

Hemorrhage from the lungs, 
1398. 




1553 


GENERAL INDEX. 


Hemorrhage after labor, 1355. 
Hemorrhage from bowels, 
1399. 

Hemorrhage, tannin for, 1398. 
Hen-coops, 556. 

Hepatic veins, 207. 

Hepatitis, 958. 

Heredity, 341. 

Herbivorous animals, diet of, 

381. 

Hereditary effects of alcohol, 
471. 

Herpes, 1262. 

Hiccough, 236, 1043. 
Highmore, antrum of, 54. 

“ High ” meat, 410. 

Hip, dislocation of, 1429. 
Hip-joint disease, 1458. 
Hirsutes, 1283. 

Histology, 38. 

Hives, 1259. 

Homeopathy, 587. 
Home-sickness, 1120. 

Honey, adulteration of, 420. 
Hops, 454, 751. 

Horse-back riding, 96. 
Hordeolum, 1486. 

Horny tumols, 1519. 
House-maid’s knee, 1464. 
Hose douche, 649. 

Hot bath, effects of, 607. 
Hot-air bath, 678. 

Hot baths, rational, of, 608. 
Howe, Sir. Everard, on diet, 

382. 

Humerus, 60. 

Humerus, fractures of, 1419. 
Hybrids, 340. 

Hydatids, 396. 

Hydropathy, 589. 
Hyclro-therapeutics, 611. 
Hydro-therapeutics, history 
of, 614. 

Hydrate of chloral, 759. 
Hydatid tumor of the liver, 
963. 

Hydrothorax, 1037. 
Hydrocele, 1530. 

Hydrocyanic acid, poisoning 
by, 1445. 

Hydrocyanic or prussic acid, 
poisoning by, 1444. 
Hydrochloric acid, poisoning 
by, 1445. 

Hydrocephalus, acute, 1382. 
Hydrocephalus, chronic, 
1383. 

Hydrophobia, 1403. 

Hygiene, 25. 


Hygiene of the bones, 69. 
Hygiene of the muscles, 93. 
Hygiene of the brain and 
nerves, 156. 

Hygiene of the special senses, 
193. 

Hygiene of the eye, 194. 
Hygiene of the ear, 198. 
Hygiene of the teeth, 297. 
Hygiene of the respiration, 
241. 

Hygiene of the digestion, 266. 
Hygiene of the air, 540. 
Hygieo-therapeutics, 590. 
Hygienic agents, 599. 
Hygiene of pregnancy, 1341. 
Hymen, imperforate, 1331. 
Hyoscyamus, 752. 
Hyoscyamus, poisoning by, 
1445. 

Hypospadias, 1529. 
Hyperopia, 1502 
Hypertrophy, 814. 
Hypertrophy of the heart, 
1046. 

Hypodermic injection, 1066. 
Hypersemia of the brain, 
1074. 

Hypertrophy of the brain, 
1089. 

Hypochondria, 1120. 
Hyperidrosis, 12721 
Hysteria, 1107. 

Hysterical joints, 1463. 

Ice, applications of, 667. 

Ice, 443. 

Icelanders, diet of, 391. 
Ichthyosis, 1275. 

Idiocy, alcoholic, 466. 

Idiocy, 1128. 

Ileo-coecal valve, 252. 

Illusion, 1122. 

Illness, sudden, 1394 
Imagination, influence on, 
149. 

Imagination, curative effects 
of, 721. 

Imbecility, 1128. 

Impetigo, 1268. 

Impacted fractures, 1414. 
Imperforate hymen, 1331. 
Impotence, 1295. 

Impure air, 244. 

Impurities in water, 443. 
Inactivity of the womb, 1355. 
Incisors, 248. 

Incus, 63. 

Incontinence of urine, 1164. 


Incoherence, 1123. 

Indigestible food, 737. 

Indian corn, composition of, 
370. 

Indian hemp, 752. 

Indian Tobacco, poisoning by, 
1445. 

Indigo, poisoning by, 1445. 

Induration of brain, 1088. 

Inebriety, 946. 

Infectious diseases, 1179. 

Infants, care of, 1371. 

Infants diet, 1366. 

Infants, feeding of, 1366. 

Infantile dyspepsia, 1390. 

Infantile paralysis, 1385. 

Infantile trismus, 1380. 

Influenza, 1199. 

Inflammation, 831. 

Inflammation of the nerve, 

1110 . 

Inflammation of the tongue, 
876. 

Inflammation of the stomach, 
887. 

Inflammation of bile ducts, 
959. 

Inflammation of lymphatics, 
1057. 

Inflammation of the spinal 
cord, 1091. 

Inflammation of the womb, 
1317. 

Inflammation of the vagina, 
1328. 

Inflammation of the breast, 
1352, 1331. 

Inflammation of the testicles, 
1289. 

Inflammation of the prostate 
gland, 1287. 

Inflammation of cornea, 1492. 

Inflammation of iris, 1493. 

Inflammation of tendons, 
1465. 

Inflammation of the ovary, 
1304. 

Inflammation about the uter¬ 
us, 1306. 

Influence on imagination, 
149. 

Inflammation of the heart- 
case, 1049. 

Inflammation of the heart, 
1050. 

Inflammation of the kideys, 
1155. 

Inflammation of the pelvis, 
1161. 





GENERAL INDEX. 


1559 


Inflammation of bone, 1455. 
Inflammation of the luniks, 
1014. 

Ingluvine, 790. 

Ingrowing toe-nails, 1471. 
Inhalations, 801. 

Innominate artery, 205. 
Innominate vein, 200. 
Inorganic matter, 33. 
Insanity, alcoholic, 460. 
Insanity, 1121. 

Insolation, 684. 

Insomnia, 1116. 

Insomnia, alcoholic, 465. 
Insects, stings of, 1408. 
Insalivation, 261. 

Instep, 62. 

Inspection, 973. 

Inspiration, 235. 
Intermittent fever, 1244. 
Intermittent pulse, 1046. 
Internal strangulation, 915. 
Intestinal digestion, 261. 
Intestinal hemorrhage, 914. 
Intestinal parasites, 946. 
Intestinal twisting, 915. 
Intestinal juice, 254. 
Intussusception, 915. 
Intermaxillary bone, 54. 
Intemperance, causes of, 502. 
Intemperance, cure of, 504. 
Inunction, 673. 

Involuntary muscular tissue, 
45. 

Involuntary muscles, 76. 
Inward fits, 1379. 

Iodine, 766. 

Iodide of potash, 767. 

Iodide of potash, poisoning 
by, 1445. 

Iodine, poisoning by, 1445. 
Iodoform, 767. 

Iodine stains, to remove, 810. 
Ipecacuanha, 775. 

Irish, diet of, 380. 

Iris, 185. 

Iris, inflammation of, 1493. 
Iridectomy, 1493. 

Iritis, 1493. 

Irritable breast, 1334. 
Irritability of the bladder, 
1166. 

Iron, 745. 

Irregular pulse, 1045. 
Irritation, 816, 825. 

Italians, diet of, 380. 

Itch, 1277. 

Itch ointments, 800. 

Itch mite, 1277. 


Itching, 1273. 

Itching genitals in pregnancy, 
1360. 

Itching of the genitals, 1330. 

Jaborandi, 782. 

Jalap, poisoning by, 1445. 
Jaundice, 960. 

Jaundice in animals, 400. 
Jaw, dislocation of, 1426. 
Jelly, bread, 742. 

Jelly, sago, 742. 

Jelly, tapioca, 742. 

Jellies, adulteration of, 424. 
Jigger, 1407. 

Joints, 51. 

Joints, hysterical, 1463. 
Joint, ball and socket, 51. 
Joint, hinge, 51. 

Joint, planiform, 51. 

Joint, stiff - , 1457. 

John Wesley, vegetarian, 
380. 

Jugular vein, 206. 

Junod’s boot and arm, 683. 

Keloid, 1276. 

Kidney disease and alcohol, 
465. 

Kidneys, abscess of, 1159. 
Kidneys, congestion of, 1153. 
Kidneys, cancer of, 1160. 
Kidneys, consumption of, 
1160. 

Kidneys, fatty degeneration 
of, 1159. 

Kidneys, gravel in, 1162. 
Kidneys, hemorrhage of, 
1155. 

Kidneys, inflammation of, 
1154. 

Kidneys, inflammation of the 
pelvis of, 1161, 

Kidneys, parasites in, 1162. 
Kidneys, waxy degeneration 
of, 1160. 

King’s evil, 854. 

Kneading, 714. 

Knee-pan, fracture of, 1423. 
Knee, dislocation of, 1430. 
Knee, caries of, 1460. 

Knee, House-maid’s, 1465. 
Knocking, 717. 

Knock-knee, 1477. 

Koosso, 790. 

Koumiss, 453. 

Labor, 1344. 

Labor, management of, 1345. 


Labor, stages of, 1345. 

Labor, hemorrhage after, 
1355. 

Labor, premature, 1363. 
Labyrinth, 174. 

Lacunae, 42. 

Lachrymal bone, 54. 
Lachrymal apparatus, 183. 
Lachrymal fluid, 183. 
Lachrymal gland, 183. 
Lactose, 364. 

Lactucarium, 751. 

Lentigo, 1274. 

Land scurvy, 1274. 

Larynx, 231. 

Larynx, catarrh of, 989. 
Laryngeal tuberculosis, 996. 
Laryngismus stridulus, 995. 
Laryngotomy, 1523. 

Late suppers, 273. 

Lattissimus dorsi, 82. 
Laudanum, poisoning by, 
1445. 

Laughing, 236. 

Laughing gas, 757. 

Law of sex, 340. 

Laxative food, 776. 

Lead, 773. 

Lead poisoning, 774. 

Lead colic, 911. 

Lead glazing, 431. 

Lead, poisoning of water 
with, 431. 

Lead palsy, 1130. 

Lead, poisoning by, 1445. 
Lean mutton, composition of, 
370. 

Lean beef, composition of, 
370. 

Leg bath, 654. 

Leg pack, 656. 

Leg bones, 61. 

Leg, fractures of, 1424. 
Lehman’s experiments on 
diet, 389. 

Lemon juice, adulteration of, 
427. 

Lemonade, 742. 

Lemon juice, 750. 

Length of time for digestion, 
927. 

Lenses, properties of, 187. 
Lentils, composition of, 370. 
Leprosy, 391. 

Leprosy, cause of, 411. 
Leprosy, 1269. 

Lettuce, 454. 

Leucluemia, 1057. 
Leuchorrhoea, 1327. 




1560 


GENERAL INDEX. 


Lice, 1279. 

Lids, adhesion of, 1490 
Liebig, on water drinking, 
668 . 

Ligamentum nuchse, 40. 
Lightning-stroke, treatment 
for, 1436. 

Light, properties of, 187. 
Lime, 577. 

Lime, chloride of, 578. 

Lime, 804. 

Lime, inhalation of, 804. 
Lime, poisoning by, 1445. 
Lime-water, 810. 

Linnaeus on diet, 381. 
Liniments, 799. 

Litharge, poisoning by, 1445. 
Liver, displacement of, 964. 
Liver, diseases of, 953. 

Liver fluke, 399. 

Liver spots, 1275. 

Liver, waxy, 962. 

Liver, contraction of, 963. 
Liver, diseases of, 954. 

Liver, deformed, 965. 

Liver, hydatid tumor of, 
963. 

Lobelia, 758. 

Lobelia, poisoning by, 1445. 
Locomotive organs, diseases 
of, 1169. 

Locomotor ataxia, 1094. 
Lockjaw, 1108. 

Lochia, 1351. 

Longevity of brainworkers, 
159. 

Longevity and alcohol, 469. 
Long-siglit, 1502. 

Loss of appetite, 972. 

Loss of voice, 997. 

Lotions, 796. 

Lotion for dandruff, 798. 
Lotion for chapped hands, 
798. 

Lower limbs, paralysis of, 
1091. 

Lower jaw, fractures of, 1417. 
Lunar Caustic, poisoning by, 
1445. 

Lung exercise, 241. 

Lung parasite, 400. 

Lung gymnastics, 720. 

Lungs, 233. > 

Lungs, lobes of, 233. 

Lungs, capacity of, 236. 
Lungs, collapse of, 1008. 
Lungs, congestion of, 1009. 
Lungs, to develop, 1030. 
Lungs, inflammation of, 1014. 


Lumbago, 1098. 

Lupus, 1276. 

Lymphatics, 221. 

Lymphatic glands, 221. 
Lymphatic vessels, 222. 
Lymphatic glands, enlarge¬ 
ment of, 1453. 

Lymphatics, functions of, 
223. 

Lymphatics, inflammation of, 
1057. 

Magnesia carbonate, 777. 
Magnetism, animal, 148. 
Magnetic rubbers, 151. 

Male generative organs, dis¬ 
eases of, 1287. 

Malarial diseases, 1241. 
Malleus, 63. 

Malacia, 945. 

Male fern, 790. 

Malaria, 1242. 

Malar bones, 54. 

Mammae, 777. 

Manual motion, 89. 
Management of labor, 1345. 
Mania a potu, 466. 

Mania, sudden, 1395. 

Mania, 1124. 

Manual alphabet, 1517. 
Marmalades, adulteration, of 
424. 

Masked intermittent fever, 
1253. 

Massage, 718. 

Mastication, 260. 

Mastitis, 1331. 

Masturbation, 356. 

Matter, 26. 

Matter, constitution of, 26. 
Matter, nature of, 28. 
Matter, inorganic, 33. 

Matter, organized, 33. 
Matastasis, 1200. 

Mate', 454, 520. 

Maxillary bones, 54. 

Meals, irregularity of, 269. 
Meals, proper number of, 
270. 

Meals, too frequent, 377. 
Meat, 728. 

Meat, a stimulant, 390. 

Meat, exciting effects of, 391. 
Meat, canned, 425. 

Meat diet, 730. 

Meat solution, 738. 

Meal mite, 410. 

Meat-pipe, 248. 

Measles, 1225. 


Meconium, 1350. 

Mechanism of thought, 139. 
Medical agents, 743. 
Medicinal eruptions, 1270. 
Medical use of alcohol, 475. 
Medical pathies, 586. 

Medical gymnastics, 704. 
Medical dietetics, 727. 
Medicated baths, 808. 
Medicated fomentations, 809. 
Medulla-oblongata, functions 
of, 54. 

Medullary canal, 50. 
Melancholia, 1125. 
Membrane, 46. 

Membrane, mucous, 46. 
Membrane, synovial, 51, 46. 
Membrana tympana, 175. 
Memory, 143. 

Mental exercise, 156. 

Mental unchastity, 346. 
Mental therapeutics, 721. 
Mensuration, 975. 
Menstruation, 333. 
Menstruation, painful, 1311. 
Menstruation, profuse, 1309. 
Menopause, 1338. 

Mental conditions in preg¬ 
nancy, 1343. 

Menorrhagia, 1309. 

Mercury, 762. 

Mercury, poisoning by, 1445. 
Mesenteric consumption, 919. 
Mesmer, 724. 

Mesmerism, 147. 

Metacarpal, 60. 

Metacarpus, 61. 

Metartarsus, 62. 
Metrorrhagia, 1311. 

Metritis, 1317. 

Mexicans, vegetable diet of, 
392. 

Midge, 1408. 

Midwifery, 1339. 

Migraine, 1097. 

Milk bath, 675. 

Milk and lime-water, 739. 
Milk porridge, 740. 

Milk, 731, 365. 

Milk, adulteration of, 418. 
Milk, from farrow cows, 418. 
Milk, unwholesome, 418. 
Milk gruel, 740. 

Milk, diseased, 403. 

Milk, poisoned, 403. 

Milk beer, 453. 

Milk, time for digestion, 927. 
Milk fever, 1351. 

Milk cure, 1010. 




GENERAL INDEX. 


1561 


Milk, to check secretion of, 
1353. 

Milk, to promote secretion of, 
1353. 

Milk, poisoning of, 1370. 
Milk, sour, 1370. 

Milk, mental influence on, 
1370. 

Miliary fever, 1198. 

Milia, 1272. 

Miliary tuberculosis, 1034. 
Mimetic spasm of face, 1112. 
Mineral tonic, 747. 

Mineral water baths, 671. 
Mind, 137. 

Mind reading, 152. 
Miscarriage, 1362. 
Miscellaneous remedies, 743. 
Moderate drinking, 470. 
Moist tetter, 1263. 

Mold, 414. 

Mole, 1275. 

Molar teeth, 248. 

Molar pregnancy, 1363. 
Monk’s-hood, poisoning by, 
1445. 

Morphia, 752. 

Morphia, poisoning by, 1544. 
Morning sickness, 1359. 
Motor nerves, 122. 

Mothers’mark, 1275. 
Moth-patches, 1275. 

Mouth, diseases of, 872. 
Mouth, catarrh of, 872. 
Mouth, ulcers of, 874. 

Mouth, scalds of, 1412. 
Mouth, diphtheritic inflam- 
tion of, 874. 

Movements, remedial value 
of, 704, 705. 

Movements, passive, 712. 
Movements, active-passive, 
712. 

Mud bath, 675. 

Muguet, 875. 

Mulberry, composition of, 
370. 

Mumps, 1200. 

Muriatic acid, 745. 

Muriatic or hydrochloric acid, 
poisoning by, 1444. 
Muriatic acid, poisoning by, 
1445. 

Musk, 751. 

Muscse volitantes, 1498. 
Muscles, 76. 

Muscles of the nose, 78. 
Muscles of the mouth, 78. 
Muscles of expression, 79. 


Muscles of mastication, 80. 
Muscles of the eye, 80. 
Muscles of the ear, 80. 
Muscles of the neck, 81. 
Muscles of the trunk, 81. 
Muscles within the trunk, 82. 
Muscles of the upper extrem¬ 
ities, 82. 

Muscles of the wrist, 83. 
Muscles of the thumb and 
fingers, 83. 

Muscles of the lower extremi¬ 
ties, 83. 

Muscles of the thigh, 83. 
Muscles of the leg, 84. 
Muscles of the foot, 84. 
Muscles, voluntary, 76. 
Muscles, involuntary, 76. 
Muscles, physiology of, 84. 
Muscles, contraction of, 1465. 
Muscular tissue, 44. 

Muscular tissue, involuntary, 
45. 

Muscular electricity, 92. 
Muscular sense, 169, 93. 
Muscular degeneration, 94. 
Muscular strength and al¬ 
cohol, 461. 

Muscle-beating, 720. 

Mustard, 787. 

Mustard baths, 808. 

Mustard, flour, 775. 

Mustard, plaster, 794. 
Muscular rheumatism, 1175. 
Muscles, fatty degeneration 
of, 1178. 

Muscular atrophy, 1110. 
Musquito, 409, 1408. 

Mutton, time for digestion, 

927. 

Mydriasis, 1495. 

Myelitis, 1091. 

Myopia, 1503. 

Myosis, 1495. 

Myrrh, 786. 

Nsevus, 1275, 1453. 

Nails, claw-like, 1467. 
Narcotics, poisoning with, 
1442. 

Narcotic nostrums, 536. 
Narcotics, poisoning by, 1445. 
Nasal bone, 54. 

Nasal douche, 660. 

Nasal duct, 183. 

Natural diet of man, 381. 
Nausea, 968. 
Near-sightedness, 196. 
Necrosis of bone, 1456. 


Nerve cells, 45. 

Nerve fibres, 45. 

Nerve force, 45. 

Nerve ganglia, 45. 

Nerve tissue, structure of, 
116. 

Nerves, anatomy of, 116. 
Nerves, fatty degeneration of, 
1137. 

Nerves, hygiene of, 156, 159. 
Nerves, motor, 122. 

Nerves, physiology of, 122. 
Nervousness, 1070. 

Nervous cough, 1040. 
Nervous dyspepsia, 941. 
Nervous exhaustion, 1071. 
Nervous headache, 1103. 
Nervous system, 116, 117. 
Nervous system, diseases of, 
1060. 

Nervous deafness, 1513. 
Nettle rash, 1259. 

Neuritis, 1110. 

Neuralgia, 1095. 

Neuralgia, crural, 1100. 
Neuralgia, facial, 1098. 
Neuralgia, intercostal, 1099. 
Neuralgia of the testicle, 
1296. 

Neuralgia of the stomach, 
901. 

Neurasthenia, 1071. 

New milk, composition of, 
371. 

Nicotine, poisoning by, 1445. 
Nictitation, 1490. 

Night air, 575. 

Night sweats, 1028. 

Night terrors, 1381. 
Nightmare, 1381. 

Nightshade, poisoning by, 
1445. 

Nine-day fits, 1380. 

Nipples, sore, 1352. 

Nitric acid, poisoning by, 

1444. 

Nitrate of Silver, poisoning 
by, 1445. 

Nitrate of Potash, poisoning 
by, 1445. 

Nitrate of Mercury, poison- 
by, 1445. 

Nitre, poisoning by, 1445. 
Nitric Acid, poisoning by, 

1445. 

Nitro-Benzol, poisoning by, 
1445. 

Nitrous-Oxide Gas, poisoning 
by, 1445. 




1562 


GENERAL INDEX. 


Nitro-muriatic acid, poison¬ 
ing by, 1445. 

Nitrogen, 238. 

Nitric acid, 745, 789. 

Nitrous oxide, 757. 

Nitrate of silver stains, to re¬ 
move, 810. 

Nitrate of silver, 775. 
Nocturnal emissions, 1290. 
Noma, 876. 

Norwegians, diet of, 380. 
Nosebleed, 987, 1397. 
Nostalgia, 1120. 

Nose, restoration of, 1521. 
Nose, polypus of, 1522. 

Nose, fractures of, 1417. 
Nose, foreign bodies in, 1439. 
Novel baths, 675. 

Nursing, 329. 
Nursing-bottles, 1367. 
Nursing during menstruation, 
1369. 

Nursing during pregnancy, 
1369. 

Nutrition, diseases of, 836. 
Nutritive injections, 737. 
Nux Yomica, poisoning by, 
1445. 

Nymphomania, 1313. 
Nystagmus, 1492. 

Oak-bark, 771. 

Oatmeal, composition of, 371. 
Oatmeal gruel, 740. 
Obstructions, intestinal, 915. 
Obesity, 844. 
Occipito-frontalis, 77. 
Occipital bone, 53. 

Odontoid process, 57. 

Odor of the urine, 1147. 
(Edema of glottis, 994. 
(Esophagus, 249. 

(Esophagus, dilatation of, 

886 . 

(Esophagus, disease of, 886. 
(Esophagus, inflammation of, 
886. 

(Esophagus, paralysis of, 887. 
(Esophagus, stricture of, 885. 
(Esophagus, ulceration of, 
885. 

Offensive perspiration, 1273. 
Oil bath, 673. 

Oily skin, 1270. 

Ointment, carbolic acid, 800. 
Ointments, 799. 

Ointments, itch, 800. 
Oleomargarine butter, 417. 
Oleander, poisoning by, 1445. 


Olfactory organs, 173. 
Olfactory sense, 173. 
Old-sight, 1502. 

Omnivorous animals, diet of, 
381. 

Onychia, 1467. 

Opacities of cornea, 1492. 
Optic nerve, diseases of, 1497. 
Opium, 453, 536, 752. 

Opium habit, 1133. 

Opium habit, causes of, 537. 
Opium habit, effects of, 537. 
Opium, poisoning by, 1445. 
Orbicularis palpebrarum, 78. 
Organs of special sense, 166. 
Organs of smell, 173. 
Organization, 29. 

Organic diseases of the heart, 
1051. 

Organic diseases and alcohol, 
464. 

Organic poison, 550. 

Organic nerves, 117. 

Os calcis, 62. 

Ossa innominata, 58. 

Osseous tissue, 42. 
Osteo-malachia, 1178. 
Otoliths, 177. 

Ovary, 322. 

Ovary, congestion of, 1304. 
Ovary, inflammation of, 1304. 
Ovarian dropsy, 1305. 

Ovarian irritation, 1304. 
Overfeeding infants, 1368, 
Overgrowth of the breast, 
1332. 

Overeating, 275. 

Overtraining, 98. 

Ovid on diet, 383. 

Ovum, 322. 

Oxalic Acid, poisoning by, 
1445. 

Oxygenation, 264. 

Oxygen, 803, 238. 

Oxytoxies, 786. 

Oxyuris vermicularis, 951. 
Oxalate of lime, 1151. 
Oysters, diseased, 406. 

Ozena, 987. 

Ozone, 803. 

Ozone, how to make, 580. 

Pail douche, 648. 

Painful urination, 1146. 
Painful menstruation, 1311. 
Painful sitting, 1338. 

Pain in the eye, 1499. 

Pain in bowels, 1389, 970. 
Pain, 144, 1063. 


Pain in small of back, 970. 
Pain beneath shoulder-blade, 
970. 

Pain in the chest, 1041. 
Painful cough, 1040. 
Palpitation of the heart, 1053. 
Palpation, 974. 

Palm wine, 453. 

Palate bones, 54. 

Pannus, 1492. 

Pancreatic juice, 254. 
Pancreatic juice, action of, 
259. 

Pancreas and cream, 739. 
Parturition, 328. 

Paresis, 1125. 

Paralysis agitans, 1109. 
Paralysis of rectum, 1528. 
Paralysis of the lower limbs, 
1091. 

Paralysis of the bladder, 
1166. 

Parasites of auditory canal, 
1509. 

Paraphimosis, 1530. 

Paris Green, poisoning by, 
1445. 

Paris green, poisoning by, 

1444. 

Parotitis, 1200. 

Parsnip, composition of, 370. 
Parturition without pain, 
1341. 

Paralysis of soft palate, 1385. 
Paralysis, infantile, 1385. 
Parasites in wild game, 400. 
Parasites in ducks, 401. 
Parasites, intestinal, 946. 
Paralysis of the oesophagus, 
887. _ 

Paralysis and tobacco, 515. 
Paraguay tea, 454. 

Parsley, 786. 

Paralysis of the glottis, 997. 
Paraphlegia, 1091. 

Passive movements, 712. 
Patella, 62. 

Pate de fois gras, 400. 

Pavy on animal food, 389. 
Pear, composition of, 370. 
Pearlash, poisoning by, 1445. 
Peach, composition of, 370. 
Peach-pits, poisoning by, 

1445. 

Peas, composition of, 370. 
Pectoralis major, 82. 
Pectoriloquy, 978. 

Pelvis, 55. 

Pellagra, 408. 





GENERAL INDEX. 


1563 


Pemphigus, 1267. 

Pennyroyal oil, poisoning by, 
1445. 

Peptic glands, 250. 

Pepsin, 790. 

Pepper-brand, 408. 
Pepper-corn, 409. 

Peptic glands, inflammation 
of, 905. 

Pepper, 745. 

Peruvian bark, 745. 
Percussion, 975, 718. 
Permanent teeth, 248. 
Pertussis, 1207. 

Persian baths, 615. 

Pernicious intermittent feA r er, 
1251. 

Permanganate of potash test, 
442. 

Perry, 451. 

Perinseum, rigidity of, 1356. 
Persimmon, 772. 

Pericarditis, 1049. 

Peritonitis, 917. 

Periosteum, 50. 

Pericardium, 204. 

Phalanges, 60. 

Pharynx, 231. 

Phrenology, 153. 

Pharyngitis, 878. 

Phimosis, 1530. 

Phosphorus 745. 

Phosphoric acid, 767. 
Phosphates, 768, 1151. 
Phosphorus, poisoning by, 
1445. 

Physiology, 25. 

Physiology, vegetable, 25. 
Physiology, animal, 25. 
Physiology, human, 25. 
Physiology, comparative, 25. 
Physiology of the bones, 63. 
Physiology of the muscles, 
84. 

Physiology of the brain, 122. 
Physiology of the nerves, 122. 
Physiology of the eye, 186. 
Physiology of the ear, 177. 
Physiology of respiration, 
234. 

Physiology of digestion, 255. 
Physical diagnosis, 973. 
Pickles, adulteration of, 426. 
Pica, 945. 

Piebald skin, 1275. 
Pilo-carpine, 784. 

Piles, 1359, 1525. 

Pink-root, 789. 

Pityriasis, 1268. 


Plasma, 218. 

Pleura, 233. 

Pleurisy, 1035. 

Plaster - of - Paris bandage, 
1415. 

Plasters, adhesive, 806. 
Plethora, 843. 

Pleximeter, 976. 

Plum, composition of, 370. 
Plunge baths, 638. 

Pneumatic cabinet, 682. 
Pneumonia, 1013. 
Pneumonia, croupous, 1014. 
Pneumonia, chronic, 1017. 
Poisoned milk, 403. 

Poisoned cheese, 404. 
Poisoning of milk, 1370. 
Poisoning, accidental, 1440. 
Poisoning, treatment for, 
1441. 

Poisons, 1444. 

Poisoned wounds, 1402. 

Poke, poisoning by, 1445. 
Polydipsia, 945. 

Politzer’s bag, 1511. 

Polypus of rectum, 1527. 
Pomegranate rind, 790. 
Portal veins, 207. 

Portal circulation, 212. 

Pork, time of digestion, 927. 
Positions, 106. 

Posterior nares, 231. 

Post nasal douche, 661. 

Post partum hemorrhage, 
1355. 

Posture of children, 1376. 
Position of fetus, 1344. 
Potato, composition of, 370. 
Potash, 779. 

Potash, permanganate of, 579. 
Potash, poisoning by, 1445. 
Potato sprouts, poisoning by, 
1445. 

Potato balls, poisoning by, 
1445. 

Potatoes, time for digestion, 
927. 

Poultiy, composition of, 370. 
Poultices, 792. 

Poultice, bread and water, 
793. 

Poultice, bread and milk, 793. 
Poultice, bran, 793. 

Poultice, starch, 794. 
Poultice, slippery elm, 794. 
Poultice, linseed meal, 794. 
Poultice, mustard, 794. 
Poultice, charcoal, 794. 

Pox, 1297. 


Pregnancy, abdominal, 1358. 
Pregnancy, extra- uterine, 
338, 1358. 

Preserves, adulteration t f, 
424. 

Primitive trace, 325. 

Privies, 554. 

Priessnitz, 624. 

Priapism, 1289. 

Primary union, 1400. 
Pregnancy, signs of, 1339. 
Pregnancy, hygiene of, 1341. 
Presentation of fetus, 1344. 
Premature labor, 1363. 
Pregnancy, molar, 1363. 
Pregnancy, false, 1363. 
Pregnancy, disorders of, 
1359. 

Presbyopia, 1502. 
Protoplasm, 30. 

Prognosis, 820. 

Prostate gland, inflammation 
of, 1287. 

Prostatitis, 1286. 

Prostate gland, enlargement 
of, 1287. 

Prolapus of the womb, 1323. 
Proud flesh, 1401. 

Prussic acid, 750. 

Prurigo, 1269. 

Pruritus, 1273, 1330. 

Prussic Acid, poisoning by, 
1445. 

Psoriasis, 1264. 

Pterygium, 1487. 

Ptosis, 1487. 

Puberty, 330. 

Puberty, influence of diet on. 
331. 

Pubic louse, 1279. 

Pneumatic apparatus, 682. 
Puerperal convulsions, 1364. 
Pneumo-thorax, 1039. 
Puerperal fever, 1365. 
Pulmonary veins, 207. 

Pulse, 209. 

Pulsatilla, poisoning by, 
1445. 

Pulmonary circulation, 211. 
Pulmonary artery, 205. 
Pulque, 453. 

Pulse, effect of cold on, 604. 
Pidmonary apoplexy, 1012. 
Pidse, frequent, 1044. 

Pidse of fetus, 1340. 

Pulse of children, 1375. 
Pumpkin seed, 790. 
Punctured wounds, 1399. 
Pupil, 185. 




1564 

Pupils, dilated, 1495. 

Pupils, contracted, 1495. 
Purples, the, 1274. 

Pus in the urine, 1151. 
Pyaemia, 1416. 

Pyelitis, 1161. 

Pylorus, 251. 

Pythagoras on diet, 383. 

Quacks, hydropathic, 626. 
Quassia, 745. 

Quicklime, poisoning by, 
1445. 

Quickening, 1340. 

Quinine, 745. 

Rabies, 1403 
Rachitis, 1387. 

Radius, 60. 

Radial artery, 205. 

Rales, 977. 

Ranula, 1423. 

Rarefied air, 681. 

Raspberry, composition of, 
370. 

Raspberry, wild, composition 
of, 370. 

Rattlesnake, 1406. 

Rational medicine, 592. 

Raw flesh diet, 392, 395. 
Reaction of the urine, 1148. 
Rectocele, 1330. 

Refrigerants, 783. 

Resection of bone, 1456. 
Rectum, prolapsus of, 1527. 
Rectum, polypus of, 1527. 
Rectum, paralysis of, 1528. 
Rectum, stricture of, 1527. 
Rectum, ulcer in, 1527. 

Red rag, 408. 

Red gum, 408. 

Red blood corpuscles, 218. 
Red blood corpuscles, func¬ 
tions of, 219. 

Red precipitate, 1445. 
Regurgitation of food, 969. 
Relapsing fever, 1192. 
Remedies for disease, 581, 
599. 

Remedial agents, 594. 
Remittent fever, 1252. 

Renal colic, 1162. 
Reproduction, 316. 
Reproductive elements, 320. 
Respiration, frequency of, 
236. 

Respiration, hygiene of, 241. 
Respiration, movements of, 
235. 


GENERAL INDEX. 

Respiration of children, 1375. 
Respiration, physiology of, 
234. 

Respiratory apparatus, 231. 
Respiratory organs, diseases 
of, 973. 

Retina, diseases of, 1497- 
Retention of the urine, 1145. 
Retroversion, 1322. 
Retention of after-birth, 
1355. 

Retching, 266. 

Retina, 186. 

Rheumatic gout, 1174. 
Rheumatism, acute, 1169. 
Rheumatism, chronic, 1172. 
Rheumatism deforming, 1174 
Rheumatism, muscular, 1175. 
Rhubarb, poisoning by, 1445. 
Ribs, 55, 57. 

Ribs, false, 57. 

Ribs, floating, 57. 

Ribs, fractures of, 1419. 

Ribs, true, 57. 

Rice, 740. 

Rice and apple, 740. 

Rice, composition of, 370. 
Rice gruel, 740. 

Rice, time for digestion, 927. 
Rickets, 1387. 

Rigidity of the womb, 1356. 
Rigidy of perinaeum, 1356. 
Rigor mortis, 93. 

Ringworm, 1281. 

Ringing in ears, 1508. 

Roaring in ears, 1508. 

Roman bath, 616, 677. 
Romans, diet of, 382. 

Rose, 772. 

Rose rash, 1230. 

Rotten cheese, 412. 

Round worms, 950. 

Rowing, 96. 

Rubbing wet-sheet, 639. 
Rubeola, 1228. 

Rubefacients, 786. 

Rue, 786. 

Rum, 452. 

Jtun-around, 1467. 

Rupture, 1524. 

Rupture of the heart, 1053. 
Rupture of the neck of the 
womb, 1335. 

Russian bath, 652. 

Rust, 408. 

Rye, composition of, 370. 

Sacrum, 58. 

Salt, 287, 734. 


Salt bath, 671. 

Salt as an emetic, 776. 
Salt-rheum, 1263. 

Salivary calculus, 1522. 
Salivary glands, 247. 

Saliva, 253. 

Salivation, 877. 

Saliva, action of, 256. 
Salmon, composition of, 370. 
Salicin, 745. 

Santonine, 790. 

Sarsaparilla, 770. 

Sartorius muscle, 84. 
Sassafras, 771. 

Savine, 786. 

Savine, poisoning by, 1445. 
Savine oil, poisoning by, 
1445. 

Saw-dust, decaying, 559. 
Sawing, 717. 

Scapula, 60. 

Scabbing, 1401. 

Scar, 1401. 

Scall, 1263. 

Scalds, 1411. 

Scalds of mouth, 1412. 
Scabies, 1277. 

Scarlet fever, 1229. 

Scanty urination, 1146. 
Scarlatina, 1229. 
School-cramming, 163. 
Sciatica, 1099. 

Sclerodema, 1276. 

Sclerotic, 184. 

Scorpion, 1407. 

Scotch, diet of, 380. 

Scrofula, 854. 

Scurvy, 864. 

Scurvy from animal food, 391. 
Sea bathing, 670. 

Seasickness, 1143. 

Sebaceous glands, 303. 

Secret vice, 358. 

Secretion, 300. 

Self-poHution, 358. 

Self-abuse, 358. 

Self-abuse, treatment of, 
1293 - 

Seminal losses, 1290. 

Sense of weight, 93. 

Sense of touch, 167. 

Sense of temperature, 170. 
Sense of taste, 171. 

Sense of smell, 173. 

Sense, auditory, 174. 

Seneka, 785. 

Septicaemia, 1416. 

Sesamoid, 63. 

Setting fractures, 1414. 







GENERAL INDEX. 


1565 


Sexual organs of plants, 320 
Sexual organs of animals, 321. 
Sexual hygiene, 344. 

Sexual precocity, 344. 

Sexual crimes, 355. 

Sexual excesses, 350. 

Sex, 317. 

Sex in plants, 318. 

Sex in animals, 318. 

Shaking palsy, 1119. 

Shallow bath, G47. 

Ship fever, 1191. 

Shortness of breath, 1041. 
Shower bath, 649. 

Shock, 1395. 

Shoulder, dislocation of, 
1426. 

Short-sight, 1503. 

Short-leg, 1478. 
Sick-headache, 1102. 

Sight, accommodation of, 190. 
Sight, loss of, 1500. 

Sight, old, 1502 
Sight, long, 1502. 

Sight, short, 1503. 

Sighing, 236. 

Sign language, 1516. 

Signs of pregnancy, 1339. 
Sight, disturbances of, 1362. 
Silver, nitrate, 775. 

Sitting shallow, 647. 

Sitz bath, 653. 

Skating, 96. 

Skeleton, divisions of, 51. 
Skin, respiration of, 240. 
Skin, to clear, 798. 

Skin, 166. 

Skim-milk, composition of, 
370. 

Skin eruptions, 1257, 1393. 
Skull, 52. - 

Skull, fractures of, 1417. 
Sleep, 146. 

Sleeplessness, 1116. 

Sleeping of infants, 1372. 
Sloughing, 1401. 

Small-pox, 1233. 

Small of the back, pain in, 
970. 

Smut-bolls, 409. 

Snake bites, 1406. 

Sneezing, 236, 1043. 

Soap baths, 808. 

Sobbing, 236. 

Soda, chlorinated, 806. 

Soft spot, 1378. 

Softening of the bones, 1178. 
Softening of the brain, 1087. 
Soft palate, paralysis of, 1385. 


Soiled clothing, 560. 

Solar rays, 686. 

Solar plexus, 121. 
Somnambulism, 146, 1119. 
Soothing syrups, poisoning 
by, 1445. 

Sore throat, smokers’, 513. 
Sore nipples, 1352. 

Sore throat, clergyman’s, 878. 
Sore mouth, gangrenous, 876. 
Sound, nature of, 177. 

Sour milk, 1370. 

Spasm of the bladder, 1166. 
Spasm of the glottis, 995. 
Spasm of the diaphragm, 
1004. 

Spaying, 1531. 

Spermatozoa, 321. 

Specks before the eyes, 1498. 
Special senses, 166. 

Special senses, hygiene of, 
193. 

Spectacles, 1505. 

Speaking, 90. 

Spermatorrhoea, 1294. 

Speech, disorders of, 1137. 
Speech, stammering, 1139. 
Sphenoid bone, 53. 
Sphygmograph, 209. 

Spine, fractures of, 1417. 
Spinal column, 56. 

Spinal curvature, 69. 

Spinal cord, 120. 

Spinal cord, functions of, 135, 
Spinal irritation, 1092. 
Spirometer, 241. 

Spinal nerves, functions of, 
136. 

Spinal meningitis, 1090. 
Spinal anaemia, 1092. 

Spinal cord, inflammation of, 
1091. 

Spina-bifida, 1386. 

Spider, 1408. 

Spirit of mindererus, 782. 
Spigelia, 789. 

Spigelia, poisoning by, 1445. 
Splints, 1415. 

Splay-foot, 1472. 

Spleen, 314. 

Spleen, enlargement of, 967. 
Spotted fever, 1232. 

Sponge bath, 638. 

Spray bath, 650. 

Sprains, 1411. 

Sputum, 980. 

Squills, 779. 

Squint, 1491. 

Starch, 363. 


Standing shallow, 647. 

Stages of labor, 1345. 

Starch bandage, 1415. 

Stapes, 63. 

Stale eggs, 412. 

Sternum, 55, 58. 

Sterility, 1296, 1314. 

Stitch in side, 1035. 
Stimulants and narcotics, 451. 
Stimulants, pernicious effects 
of, 165. 

Stings of insects, 1408. 
Stimulants, 481. 

Stiff’ joint, 1457. 

Stomach digestion, 261. 
Stomach, effects of pressure 
on, 295. 

Stomach, dilatation of, 900. 
Stomach, neuralgia of, 901. 
Stomach, ulcer of, 902. 
Stomach, hemorrhage of, 903. 
Stomach, cancer of, 904. 
Stomach, catarrh of, 889. 
Stomach-pump, 898. 

Stone in the bladder, 1168. 
Stone-bruises, 1470. 

Stomach, pain in, 970. 
Stomach, heaviness of, 970. 
Stomach, goneness in, 970. 
Stomach, inflammation of, 
887. 

Stomach cough, 1040. 
Stove-pipe ventilator, 570. 
Stramonium, 454. 

Strains, 1410. 

Stricture of urethra, 1529. 
Stricture of rectum, 1527. 
Stricture of the uterine canal, 
1320. 

Stroking, 715. 

Structural derangement, 812. 
Stricture of oesophagus, 885. 
Stuttering, 1140. 

Strongylus filaria, 400. 
Strongylus duodenalis, 952. 
Strychnia, 745. 

Strychnia, poisoning by, 
1445. 

Stramonium, poisoning by, 
1445. 

Strawberry, composition of, 
370. 

Strawberry, wild, composi¬ 
tion of, 379. 

Strabisums, ..491. 

Stye, 1486. 

St. Anthony’s fire, 1260. 

St. Vitus’ dance, 1103. 
Sudden illness, 1394. 






1566 


GENERAL INDEX. 


Sudden mania, 1305. 

Sugar, 734. 

Sugar, 363. 

Sugar mite, 410. 

Sugar, excess in the use of, 
285. 

Sugar, adulteration of, 418. 
Sugar, composition of, 370. 
Sugar of lead, poisoning by, 
1445. 

Sulphate of copper, poison¬ 
ing by, 1445. 

Sulphate of iron, poisoning 
by, 1445. 

Sulphate of zinc, poisoning 
by, 1445. 

Sulphureted hydrogen, poi¬ 
soning by, 1445. 
Sulphurous acid gas, poison¬ 
ing by, 1445. 

Sulphate of potash, poisoning 
by, 1445. 

Sulphurous acid, 579. 
Sulphuric acid, 745. 

Sulphate of zinc, 776. 
Sulphur, 777. 

Sulphuric acid, 788. 

Sulphate of copper, 775. 
Sulphuric acid, poisoning by, 
1444. 

Sun-stroke, 1086. 

Sun bath, ancient use of, 606. 
Sun bathing, 685. 

Sun-burn ointment, 801. 
Sun-stroke, use of water in, 
622. 

Sunlight, 686. 

Suppression of the urine, 
1145. 

Suppuration, 1446. 

Surgery, 1446. 

Sutures, 52. 

Swallowing air, 969. 

Swedes, diet of, 380. 

Sweat glands, 301. 

Swedish movements, 707. 
Sweating sickness, 1198. 
Sweating pack, 645. 

Sweet gale, 454. 

Sweet potato, composition of, 
370. 

Sweet spirits of nitre, 779. 
Swill milk, 361, 406. 

Swiss, diet of, 380. 
Swimming, 637. 

Sycosis, 1281. 

Sylvester’s method of artifi¬ 
cial respiration, 1435. 
Sympathetic nerves, 117,121. 


Sympathetic headache, 1102. 
Sympathetic system, func¬ 
tions of, 137. 

Synovitis, 1451. 

Synovia, 51. 

Syncope, 1394. 

Syphilis, 1297. 

Syphon syringe, 662. 

Syrup, adulteration of, 419. 
Systemic circulation, 211. 

Tuning fork, in disease of ear, 
1513. 

Turpentine, 779. 

Turnip, composition of, 370. 
Turpentine for hemorrhage, 
1398. 

Turkey, time of digestion, 
927. 

Turkish baths, 676. 

Twins, 1357. 

Two meal system, 270. 
Tympanum, 174. 

Typhoid fever, 1187. 

Typhus fever, 1191. 

Tactile sense, 167. 

Taenia solium, 394. 

Talipes, 1472. 

Tannic acid, 771. 

Tan, to remove, 798. 

Tannin for hemorrhage, 1398. 
Tansy oil, poisoning by, 1445. 
Tartar, 1522. 

Tartar emetic, poisoning by, 
1445. 

Tape-worm, 395, 946. 
Tape-worm, eggs of, 947. 
Tape-worm, origin of, 394. 
Tape-worm, head of, 949. 
Tartaric acid, poisoning by, 
1455. 

Taraxacum, 771. 

Tarsus, 62. 

Tartar emetic, 749, 776. 

Tar, 785, 806. 

Tarantula, 1408. 

Taste of the urine, 1148. 
Taxis, 1524. 

Tear gland, 183. 

Tea, adulteration of, 427. 

Tea, 453. 

Tea-drinkers’ disorder, 24. 
Tea and coffee, 289, 427, 

519. 

Tea and coffee habit, 1136. 
Teething, 1373. 

Teeth, decay of, 1523. 

Teeth, ulcerated, 1522. 
Temporary teeth, 248. 0 


Temperature, application ( of, 
679. 

Temperature, to determine 
without thermometer, 632. 
Temperature, 1180. 
Temperature, effects of cold 
on, 604. 

Temperature, regulation of, 
629. 

Tendo Achillis, 62. 

Tendons, 76. 

Tendons, inflammation of, 
1465. 

Tendons, contraction of, 
1465. 

Tenesmus, 972. 

Testicle, tumors of, 1296. 
Testicle, neuralgia of, 1289. 
Testicle, inflammation of, 
1289. 

Test types, 1501. 

Tetanie, 1380. 

Tetanus, 1108. 

The mind, 137. 

The will, 140. 

The skin, 166, 301. 

The orbit, 182. 

The enema, 779. 

The voice in disease, 977. 

The larynx, catarrh of, 989. 
The liver, enlargement of, 
961. 

The shower pack, 644 
The mouth, 247. 

The teeth, 247. 

Therapeutic agents, 599. 
Theine, 522. 

Thermo-electric bath, 700. 
The sputum, 980. 

The purples, 1274. 

The fontanel, 1378. 

The eye in children, 1376. 

The tongue in children, 1376. 
The cry of children, 1376. 

The plague, 1196. 

The binder, 1350. 

The stomach, 250. 

The liver, 251. 

The small intestines, 251. 

The pancreas, 251. 

The spleen, 314. 

The peritoneum, 251. 

The duodenum, 251. 

The colon, 252. 

The hair, 302. 

The hair, sudden blanching 
of, 303. 

The teeth, hygiene of, 297. 
The nails, 303. 





GENERAL INDEX. 


1567 


The kidneys, 312. 

The liver, 313. 

The uterus, 324. 

The atmosphere, 539. 

The mouth, canker of, 874. 
The pulse, 1044. 

Thirst, 433. 

Thigh bone, Gl. 

Thigh, fracture of, 1421. 
Thought, mechanism of, 139. 
Thorax, 57. 

Thorn-apple, poisoning by, 
Thrombosis, 1052. 

1445 

Thrush, 875. 

Thread-worm, 951. 

Thumb, dislocation of, 1429. 
Thymol for burns, 1412. 
Tibia, 61. 

Tick, 1407. 

Tight-lacing, 99. 

Tight-shoes, 102. 
Tight-lacing, effects on liver, 
966. 

Tight-lace fissure of liver, 966. 
Tin, adulteration of, 430. 
Tinea versicolor, 1282. 
Tinnitus aurium, 1508. 
Toadstool, poisoning by, 1445. 
Tobacco and consumption, 
513. 

Tobacco, 291, 506, 453, 760. 
Tobacco, cause of eye diseases, 
195. 

Tobacco using, origin of, 506. 
Tobacco, nature of, 508. 
Tobacco, nervousness from, 
516, 517. 

Tobacco, laws against, 507. 
Tobacco, effects on blood, 511 
Tobacco habit, 1135. 

Tobacco, poisoning by, 1445. 
Toe-nails, ingrowing, 1471. 
Toes, dislocation of, 1431. 
Tomatoes, 732. 

Tongue forks, 1143. 
“Tongue-bridle,” 1143. 
Tonics, 744. 

Tonsilitis, 883. 

Tongue, inflammation of, 876. 
Tongue, removal of, 1523. 
Tongue-tie, 1523. 

Tooth powders, 807. 
Tortucolis, 1113. 

Torn wounds, 1400. 

Torpid liver, 954. 

Touch, 167. 

Trachea, 232. 

Transfusion, 1058. 


Transudations, 815. 
Trachoma, 1484. 
Tracheotomy, 1523. 

Treacle, composition of, 370. 
Treatment of self-abuse, 1293. 
Trichina, 396. 

Trichinosis, 399. 
Tricocephalus dispar, 952. 
True ribs, 57. 

Tuberculosis, laryngeal, 996. 
Tubercular meningitis, 1382. 
Tuberculosis, miliary, 1034. 
Tumors, 1518. 

Tumors, bony, 1519. 

Tumors, cystic, 1519. 

Tumors, cartilaginous, 1519. 
Tumors, fibrous, 1518. 
Tumors, fatty, 1518. 

Tumors, horny, 1519. 

Tumors of eyelids, 1486. 
Tumors of the bladder, 1168. 
Tumors of the brain, 1089. 
Tumor of the scalp, bloody, 
1388. 

Tumors of the testicle, 1296. 
Turbinated bone, 54. 
Tympanitic resonance, 976. 

Ulceration of oesophagus, 886 
Ulcers, 1449. 

Ulcer of rectum, 1527. 

Ulcers of cornea, 1492. 

Ulcers of the mouth, 874. 
Ulcers of the stomach, 902. 
Ulnar artery, 205. 

Unguents, 799. 

Upper jaw, fractures of, 1418. 
Urates, 1150. 

Urethra, catarrh of, 1288. 
Urethra, stricture of, 1529. 
Urethritis, 1288. 

Urine, taste of, 1148. 

Urine, bloody, 1152. 

Urine, chylous, 1152. 

Urine, color of, 1147. 

Urine, odor of, 1147. 

Urine, reaction of, 1148. 
Urine, density of, 1148. 
Urine, suppression of, 1145. 
Urinary, calculus, 1528. 
Urinary deposits, 1149. 

Uric acid, 1149. 

Urnation, painful, 1146. 
Urine, scanty, 1146. 

Urine, pus in, 1151. 

Urine, incontinence of, 1164. 
Urticaria, 1259. 

Use of electricity, 688. 

Ut line douche, 661. 


Uterus, inflammation of, 
1306. 

Uterine hemorrhage, 1311. 

Uterine catarrh, 1315. 

Uva ursi, 779. 

Uvula, elongated, 1522. 

Vacuum treatment, 683. 

V agina, inflammation of, 
1328. 

Vaginismus, 1329. 

Vaginitis, 1328. 

Vaginal discharges in preg¬ 
nancy, 1360. 

Vaginal douche, 662. 

Valvular disease of heart, 
1051. 

Valerian, 751. 

Valves of the veins, 206. 

Valves of the heart, 204. 

Valgus, 1472. 

Valsalva’s method to inflate 
ear, 1511. 

Vapor bath, 651. 

Vapor, local applications of, 
669. 

Varicella, 1224. 

Varicose veins in pregnancy, 
1361. 

Varicose veins, 1056, 1452. 

Varus, 1472. 

Varicocele, 1529. 

Vascular growths, 1453. 

Vaseline, 799. 

Vaseline, carbolated, 1401. 

Veal, composition of, 370. 

Veal, time of digestion, 927. 

Vegetables, 732. 

Vegetarianism in Scotch pris¬ 
ons, 389. 

Vegetarianism in English 
prisons, 390. 

Vegetarianism, testimony re¬ 
lating to, 388. 

Vegetarians, 380. 

Vegetable diet, Carpenter on, 
388. 

Vegetable diet, Parkes on, 388 

Vegetable acids, 749. 

Vegetarian Society, 380. 

Veins, 206. 

Vegetable diet of Mexicans, 
392. 

Veins, varicose, 1452. 

Veins, varicose, hemorrhage 
from, 1399. 

Veins, disease of, 1056. 

Veins enlarged in pregnancy, 

1361. 




15G8 


GENERAL INDEX. 


Vena cava, 206. 

Venous system, 206. 
Ventricles of the heart, 203. 
Ventilation, 563. 

Ventilation, plans of, 564. 
Ventilation, window, 567. 
Ventilation, chimney, 569. 
Ventilating shafts, 571. 
Ventilation of drains, 558. 
Vertigo, 1395, 1069. 
Veratrum viride, 749. 
Vertebrae, 55. 

Verdigris, poisoning by, 
1445 

Veratrum, poisoning by, 
1445. 

■ Vermilion, poisoning by, 
1445. 

Vestibule, 176. 

Vibrations, 717. 

Vinegar wash, 797. 

Vinegar, adulteration of, 426. 
Vinegar, 289. 

Vinegar, inhalations of, 804. 
Virginia snake-root, 745. 
Vision, weak, 1499. 

Vision, loss of, 1500. 

Visible speech, 1517. 

Vitrious humor, 186. 

Vital force, 29. 

Vitriol, oil of, poisoning by, 
1445. 

Vocal cords, 231. 

Voice, loss of, 997. 

Voluntary muscles, 76. 
Vomiting, 205, 933,969,1389. 
Vomer, 55. 

Vomiting in pregnancy, 1340. 
Voracious appetite, 972. 

Wall-eye, 1491. 

Waldenberg’s apparatus, 682. 
Warm bath, 608. 

Warts, 1468. 

Wash for the hands, 798. 
Wash for the face, 798. 
Washing out the stomach, 898. 
Waste water, 742. 

Wasting palsy, 1110. 

Water, 000, 433. 

Water as a dissolvent, 613. 
Water as a sedative, 612. 
Water as a laxative, 613. 
Water as a diluent, 601. 
Water, applications of, 629, 
637. 

Water as an emetic, 613. 
Water as an alterative, 614. 
Water as a derivative, 616. 


Water as a refrigerant, 612. 
Water as a tonic, 612. 

Water as an anti-spasmodic, 
612. 

Water as an anodyne, 613. 
Water as an anesthetic, 613. 
Water as a styptic, 613. 
Water, bad, how to test, 442. 
Water blebs, 1267. 

"Water, composition of, 436. 
Water, contamination of, 441. 
Water, distilled, 441. 
Water-drinking, 668. 

Water emetic, 669. 

Water, errors in use of, 623. 
Water, eliminative effects of, 
613. 

Water, effects of, 601. 

V 7 ater gruel, 740. 

Water, hygienic value of, 433. 
Water in surgery, 670. 

Water in sunstroke, 622. 
Water-moccasin, 1406. 

Water, medical uses of, 618. 
Water on the brain, 1383. 
Water, organic impurities in, 
441. 

Whiter, proportion of in tis¬ 
sues, 436. 

Water, pure, 436. 

Water poisoned with lead, 
431. 

Water hemlock, poisoning 
by, 1445. 

Water, purification of, 444. 
Water, the best, 448. 

Water-trap, 558. 

Watery eye, 1490. 

Whixy degeneration, 962. 
Waxy liver, 962. 

Weak vision, 1499. 

W 7 eak ankles, 1476. 

Weakness in bowels, 972. 
Weaning, 1370. 

Weeping sinew, 1464. 
Weeping eye, 1490. 

Weevil, 409. 

Wens, 1272. 

W r et girdle, 657. 

Wet head cap, 665. 

W T et-sheet packs, 641. 

Wheat coffee, 739. 

W T heat flour, composition of, 
370. 

Wheat, structure of, 367. 
Whey cure, 1010. 

White oak bark, 807. 

White vitriol, poisoning by, 
1445. 


Whisky, 452. 

White-fish, composition of, 
370. 

White of egg, 741. 

White of egg and milk, 741. 
White of egg, composition of, 
370. 

Whitlow, 1467. 

Whip-worms, 952. 

White lead, poisoning by, 
1445. 

White fibrous tissue, 40. 
White blood corpuscles, 219. 
White precipitate, poisoning 
by, 1445. 

Whites, 1327. 

Whooping-cough, 1207, 1041. 
Will, nature of, 140. 

Wild cherry bark, 745. 

Wine, 451. 

Wind-pipe, 231. 

Wind-pox, 1224. 

Winter cough, 1002. 

Wisdom teeth, 248. 
Wolf’s-bane, poisoning by, 
1445. 

Women, diseases of, 1300. 
Womb, granular inflamma¬ 
tion of lips of, 1328. 

Womb, inactivity of, 1355. 
Womb, inflammation of, 1317. 
Womb, prolapsus of, 1323. 
Womb, rupture of the neck 
of, 1335. 

Womb, rigidity of, 1356. 
W T omb, tumors of, 1321. 
Worms, 1392. 

Wormian bones, 63. 

Worms, round, 950. 

Worm seed, 790. 

Writer’s cramp, 1113. 

Wrist, dislocation of, 1428. 
Wrist-drop, 1130. 

Wry neck, 1113. 

Wounds, 1399. 

Wounds, contused, 1400. 
Wounds, punctured, 1399. 
Wounds, poisoned, 1402. 
Wounds, torn, 1400. 

Xiphoid cartilage, 58. 
Yawning, 236. 

Yeast fungus, 413. 

Yellow elastic tissue, 40. 
Yellow fibrous tissue, 40. 
Yellow fever, 1194. 

Yew, poisoning by, 1445. 
Yolk of egg, composition of, 
370. 

Zinc-poisoning of water, 431. 






X 


APPENDIX, 


CONTAINING 




COMMON POISONS and THEIR ANTIDOTES, 


FORMULAS OF 

4 

Famous Nostrums and Patent Medicines, 


AND 


140 CHOICE PRESCRIPTIONS 





PUBLISHED BY THE AUTHOR. 

BATTLE CREEK, MICH. 


1885 . 











CONTENTS OF APPENDIX 


PAGE. 

Aconite, Wolf’s Bane, or Monk’s Hood... 1595 


Ague, or Chills and Fever. 1615 

A Healthy Building Site. 1575 

Allen’s Lung Balsam. 1610 

Ammonia Gas. 1587 

Anti-Chill Pills . 1599 

Anti-Constipation Pad. ...^. 1605 

Arnica Liniment. 1600 

Artificial Essences and Extracts. 1606 

Artificial Wines, Whiskies, Bitters, etc... 1607 

August Flower. 1609 

Ayer’s Ague Cure. 1604 

Ayer’s Cathartic Pills. 1603 

Beach's Diaphoretic. 1610 

Best Kind of Soil to Build upon. 1516 

Best Location for a Home. 1574 


Black Hellebore, or Christmas Rose.1592 

Black Oil Liniment. 1600 

Black or Garden Nightshade, and Woody 

Nightshade, or Bitter-Sweet. 1594 

Black Salve . 1601 

Bladder Difficulties. 1615 

Blancard's Pills. 1604 

Brandreth’s Pills. 1603 

Brandy . 1607 

Bright’s Disease of the Kidneys. 1615 

Bromidia . 1609 

Bromo-Chloraltim. 1610 

Brown's Bronchial Troches. 1609 

Butter Color. 1609 

Buttercup. 1593 

California Liniment. 1600 

Carbonic-Acid Gas. 1588 

C'arbonic-Oxide Gas. 1588 

Carlsbad Water. 1607 

Carpenter’s Liniment. 1599 

Castor-Oil Seeds. 1595 

Catarrh. 1618 

Catarrh and Croup Pad.1605 

Cellars and Basements. 1585 

Chapman's Liniment. 1599 

Chlorine. 1587 

Chlorodyne. 1609 

Cholera Infantum.1614 

Cholera Morbus. 1614 

Christie’s Ague Mixture. 1604 

Claret Wine. 1608 

Coal Gas... 1588 

Coe’s Dyspepsia Cure. 1609 

Colic. 1613 

Compound Oxygen. 1601 

Congress Water. 1607 

Constipation. 1612 

Construction of a Dwelling-House in Re¬ 
lation to Health. 1578 

Consumption. 1617 

Consumptive Cure. 1609 

Cook’s Electro-MagneticLiniment. 1600 

Cook’s Pills. 1599 

Corn Cure. 1610 

Croup. 1617 

Dalby’s Carminative. 1602 

Darnel. 1593 

Day’s Kidney Pad. 1605 


PAGE. 


D. C. Frese and Co.’s Imported (?) Ham¬ 
burg Tea. 1604 

Deadly-Nightshade. 1594 

Dehaut’s Purgative Pills. 1604 

Diarrhea. 1621 

Disinfectant Lotions. 1624 

Dr. Alberty’s Anti-Bilious Pills. 1599 

Dr. Kryeder’s Ague Pills. 1599 

Dysentery. 1613 

Dyspepsia. 1611 

Eclectic Liver Pills. 1599 

Elixir of Life. 1608 

English Curry Powder. 1609 

Essence of Apple. 1606 

Essence of Banana. 1606 

Essence of Pear. 1606 

Essence of Quince. 1606 

Extract of Apricot. 1606 

Extract of Vanilla. 1606 

Favorite Liniment. 1600 

Fluid Lightning. 1599 

Fool’s Parsley. 1595 

Fox Glove, or Digitalis. 1592 

Franc’s Life Pills. 1604 

French Absinthe. 1608 

French Uterine Pad. 1605 

German Bitters. 1608 

German Liniment . 1599 

German Rheumatic Remedy. 1610 

German Syrup. 1609 

Gin. 1607 

Godfrey’s Cordial. 1606 

Gonorrhoea and Gleet.;. 1623 

Good Samaritan Liniment . 1599 

Great African Wonder. 1600 

Great London Liniment. 1600 

Green Mountain Salve. 1601 

Ground Air and Water. 1576 

Haarlem Oil. 1609 

Hamburg Tea. 1603 

Hamlin’s Wizard Oil. 1600 

Head Pad. 1605 

Hemlock, Poison or Spotted Hemlock.... 1593 

Hemorrhoids, or Piles. 1612 

Henbane.'.. 1596 

Hiccough. 1621 

Holland Gin. 1607 

Holloway’s Pills. 1599 

Hooper’s Pills. 1599 

Hop Bitters. 1608 

How to Heat a Home. 1580 

How to Ventilate a Home. 1578 

Hunyadi Janos Water. 1607 

Hydrochloric Acid. 1587 

Incense Powder. 1609 

Indian Poke.. 1592 

Indian Turnip, Dragon Root, Wake Robin, 

or Jack in the Pulpit. 1594 

Irish or Scotch Whisky. 1607 

Irritable Vulva. 1623 

Jackson’s Cough Syrup. 1610 

Jayne’s Ague Mixture. 1604 

(1571) 



























































































































1572 


CONTENTS OF APPENDIX. 


Jane’s Expectorant. 1609 

John F. Henry’s Carbolic Healing Salve... 1604 
John Hills’ Pectoral Balsam of Honey.... 1602 

Kissingen Water. 1607 

Uver Pad. 1605 

Living and Sleeping Booms should be 

Light and Airy. 1578 

Lobelia, or Indian Tobacco. 1593 

Loomis’s Liniment. 1599 

Loomis’s Tonic. 1610 

Lotions for the Skin. 1624 

Lumbago. . 1619 

Lung Pad. 1605 

Maderia Wine. 1608 

Magnetic Liniment. 1599 

Malaga Wine. 1608 

May-Apple, or Mandrake. 1597 

Medicated Pads. 1605 

Mineral Waters. 1606 

Morison’s Pills. 1604 

Mother’s Cordial. 1608 

Mouth and Throat Diseases. 1616 

Mrs. Winslow’s Soothing Syrup. 1602 

Mushroom Poisoning. 1596 

Nerve and Bone Liniment. 1600 

Nettle Sting. 1620 

Neuralgia. 1619 

Novel Devices for Ventilation. 1582 

Oil of Spike. 1600 

Ointment of Iodoform. 1601 

Old Bourbon Whisky. 1607 

Oleander.’ 1595 

Opodeldoc Liniment. 1600 

Osgood’s Chologogue or Celebrated Ague 

Cure. 1610 

Pain Belief Liniment. 1600 

Palpitation of the Heart. 1620 

Papier Fayard-Blayn. 1604 

Paptonized Gruel. 16H 

Peach Brandy.. [[ 1607 

Peach Extract.’ ’’ 1606 

Perry Davis's Pain Killer. 1600 

Petit’s Eye Salve. 1601 

Phosphorus. 1589 

Pierce’s Favorite Prescription. 1603 

Pierce's Golden Medal Discovery. 1603 

Pine-Apple Extract. 1606 

Piso’s Consumption Cure. 1609 

Pneumonia ;. I 619 

Poke, Scoke, or Garget. 1594 

Poison Ivy. 1591 

Poison Ivy or Poison Sumach. 1620 

Poison Oak. 1591 

Poisonous Cosmetics. 1590 

Poisonous Fabrics. . 1589 

Port Wine. 1608 

Potato Balls and Sprouts. 1595 

Prepared Cider. 1607 

Pride of India Liniment. 1600 

Pulsatilla, or Field Anemone. 1597 

Pure and Plentiful Water Supply. 1586 

Radway’s Beady Belief . 1603 


Badway'sBegulating Pills. 1604 

Badway's Eenovating Besolvant. 1603 

Belation of Ground: Air and Water to 

Health. 1577 

Ehodes’s Fever and Ague Cure, or Anti¬ 
dote to Malaria. 1604 

Bochelle, or Bordeaux Whisky.. ... 1607 

Bourke’s Iodine Liniment and Wm. Gile’s 

Liniment of Iodide of Ammonia. 1605 

B. V. Pierce’s Pleasant Purgative Pellets. 1603 

Safe Kidney and Liver Cure. 1610 

Sage’s Catarrh Bemedy. 1603 

Sanative Ointment. 1601 

Sarsaparilla Extract. 1606 

Seeley’s Pile Ointment. 1601 

Seltzer Water. 1607 

Sheep-Laurel, Mountain-Laurel, or Big- 

Leaf Ivy. 1596 

Sherry Wine. 1508 

Smith’s Electric 0*1. 1609 

Sore Nipples '*. 1621 

Spiglia, Pink Boot, or Carolina Pink.1597 

St. Jacob’s Oil. 1600 

Stomach Bitters. 1608 

Stomach Pad . 1605 

Stoughton Bitters. 1608 

Stramonium, Jamestown Weed, or Thorn- 

Apple .1591 

Sulphuretted Hydrogen. 1588 

Sulphurous Acid Gas and Nitrous Acid 

Fumes. 1587 

Swamp Sumac, Poison Dog-Wood, or Poi¬ 
son Elder. 1591 

Syphilis. 1624 

Tarrant's Effervescent Seltzer Aperient.. 1603 

The Nettle . 1590 

Thompson’s Eye Water. 1610 

Tobias’s Venetian Liniment. 1605 

To Neutralize Whisky. 1607 

Torpid Liver. 1614 

Trask’s Magnetic Ointment. 1601 

Trix, or Jokes . 1609 

Tropic Fruit Laxative. 1608 

Tully Powder. 1610 

Tpham’s Asthma Bemedy. 1610 

Upham’s Pile Ointment. 1610 

Vaginal Lotions for Leucorrhoea. 1621 

Vaginal Pledget. 1622 

Vaginismus. 1623 

Van Buskirk’s Fragrant Sozodont. 1603 

Vichy Water. 1607 

Virginia Creeper, or American Ivy. 1597 

Walker's California Vegetable Vinegar 

Bitters. 1602 

Water-Hemlock, or Spotted Cow-Bane ... 1597 

W T ebster’s Dinner Pills. 1599 

What Constitutes a Healthy Home ?. 1574 

Wllhoft’s Antiperiodic Fever and Ague 

Cure. 1604 

Wistar’s Cough Lozenges. 1610 

Worcestershire Sauce. 1610 

Yellow Jasmine. 1597 

Yew. 1597 
















































































































HEALTHY HOMES. 


The homo is the nursery of the nation ; and unless its inmates are 
provided with the conditions requisite for health, the nation, as well as 
its constituent families, must languish and deteriorate in physical stamina. 
This fact seems to have been overlooked, or at least imperfectly appreci¬ 
ated, by many writers on general hygiene, and a disproportionate stress 
has been laid upon what is termed “public hygiene,” a subject of vast 
importance, and worthy of all the attention it has received, and more; 
but still, in our opinion, it is of secondary importance when compared 
with that branch of the great subject of hygiene which may be termed 
domestic hygiene. 

The able advocates of the need of general sanitary reforms, such as 
chiefly concern cities of sufficient size to require water and sewerage 
systems, cite with great confidence as a conclusive evidence of the para¬ 
mount importance of public sanitation, the fact that in countries in which 
statistical records have been carefully kept for a long series of years, it 
is possible to show an increase in the average length of life which is 
commensurate with the improvements made in the general sanitary 
arrangements of cities during the same length of time. It is claimed 
that the average length of life has been thus increased from about twenty- 
five years to nearly forty years. 

This appears at first sight to be a conclusive showing ; but when we 
carefully investigate the matter, we find that this increase in average lon¬ 
gevity is wholly the result of the lessened frequency of such infectious or 
contagious disorders as typhoid and typhus fevers, small-pox, cholera, 
plague, etc., which a century ago were responsible for a large part of the 
entire mortality of cities and thickly settled country districts. While 
these disorders are by no means exterminated, they now hold a much 
less conspicuous place in the mortality tables ; but consumption and vari¬ 
ous other constitutional and structural disorders have come to the front 
as the leading causes of human mortality. At the present time, nearly 
one-fifth of the total number of deaths occurring annually in this country, 
is due to consumption,—a very great increase over the death rate from 
this cause half a century ago. 

Another noticeable fact which bears directly upon this question is 
the lessened number of centenarians now to be found in our city and 
town communities ; while the average length of life has been increased, 
the chance of an individual’s living to great age has been diminished. 

( 1573 ) 




1574 


APPENDIX. 


The average length of life has been increased by increasing the longevity 
of the weak and feeble, rather than by adding to the lifetime of tho 
strong and vigorous. Indeed, it would seem that there has been a 
material lessening of the average longevity of the strong, although this 
loss is more than balanced by the additions to the lease of life of the 
feeble. A century ago, epidemics of various sorts, unrestrained by 
efficient quarantines and other sanitary measures, weeded out the sickly 
and physically inferior individuals, thus preserving in a purer state tho 
constitutional stock of the strong ; whereas, at the present time, the 
natural operation of epidemics being prevented, the feeble are preserved, 
and, mingling and intermarrying with the strong, deteriorate their vital 
stamina, and so lessen their longevity. 

This is the natural operation of those sanitary measures which are 
usually included in the term “ public hygiene ; ” and it seems evident 
to us that unless something more is done for the physical improvement 
of the individual, the ultimate effect of public sanitary measures—neglect¬ 
ing individual and domestic hygiene—will be to deteriorate, rather than 
to improve, the race. Epidemics and plagues act as a means of natural 
selection, which preserves the strong, and makes them still more vigor¬ 
ous, while sacrificing the weak. Public hygiene is certainly in the highest 
degree humanitarian and philanthropic, but it does not necessarily follow 
that its results to the race, considering man as an animal merely, are 
wholly beneficent. 

We trust it needs no further argument to demonstrate the necessity 
for the hygienic care of the individual, as well as of the community. By 
this means the feeble will not only be preserved alive, but will be so 
improved that the feebleness may be outgrown ; the hereditary tendency 
to pulmonary disease may be overcome ; the seeds of transmitted disor¬ 
ders may be kept from germinating until they are finally obliterated ; 
and thus the race may be improved, rather than deteriorated. 

It needs no argument to establish as a fact the statement that one 
of the most essential things for the maintenance of individual health 
is a healthy home. Let us now inquire— 

What Constitutes a Healthy Home ?—The essentials of such a home 
are, 1. A salubrious location as regards the surrounding country ; 2. A 
healthful site, as regards position, soil, etc. ; 3. A properly constructed 
house, with proper arrangements for heating, ventilation, and admission 
of sunlight; 4. A copious and pure water-supply. Some phases of these 
subjects have been so elaborately treated in the body of this work, we 
need not devote much space to their consideration here. 

Best Location for a Home. —The questions which usually come up for 
consideration in connection with selecting a location for a home are those 


HEALTHY HOMES. 


1575 


which relate to convenience or pecuniary profit, rather than health. 
The first question should be, Is this a healthful location? Are there in 
connection with this spot, either immediate or remote, any serious causes 
of illness or grave disease ? If the location is known to be especially 
malarious in character, this alone should be sufficient to condemn it, as 
this poison is one of those which produce, not only serious, but often 
fatal, acute diseases, such as ague, remittent or bilious fever, pernicious 
intermittent fever, but may lay the foundation for chronic constitutional 
disorders which may baffle the skill of the wisest physician so long as 
the patient remains exposed to the exciting cause. Malaria is, unfortu 
nately, not confined to a few sections of the country, but is more or less 
prevalent iri every part of the United States ; yet there are plenty of 
eligible locations for homes where this class of disorders does not prevail 
except under specially unfavorable conditions, and then infrequently, 
and not in the most severe foi’ms. A man can readily afford to sacrifice 
much pecuniarily rather than subject himself and his family for years to 
the influence of a subtle poison which may not only involve much incon¬ 
venience and suffering, but even loss of life. 

If circumstances compel the selection of a home in a malarious local¬ 
ity, care should be taken to ascertain the probable source of the poison,, 
which will very likely be marshy or low land covered with water in the 
spring and becoming dry during the summer. A mill-pond or a lake 
with much low, flat land adjoining should be regarded with suspicion. 
The direction of the prevailing wind should next be ascertained. In 
most parts of the United States, the most prevalent wind is that from 
the south-west, especially during the summer season. 

These two points having been satisfactorily settled, let the spot 
selected for building be located in such a manner that it shall be between 
the source of malaria and the prevailing wind ; that is, in most parts of 
this countiy, a house, if near a swamp, mill-pond, or other suspicious lo¬ 
cality, should be situated at the south-west of it, if possible, and under no 
circumstances at the north-east, as the south-west wind would then come 
to it across the malarial tract, and consequently be laden with the poison. 

As the wind does not always blow from any one direction, it is im¬ 
portant to take the further precaution of so situating the home as to 
have between it and any source of malaria a considerable space covered 
by a dense growth of trees, as it has been found that forests intercept 

and to some degree destroy the malarial poison. 

* 

A Healthy Building Site- —After the immediate locality for a home 
has been determined upon, the selection of the very spot upon which to 
place the house is still a matter of no small consequence. Shall the 
site be level, or upon a hill-side? Shall the house front east, south, 


1576 


APPENDIX. 


west, or north ? What sort of a soil is best to place it upon ? All these 
are questions of importance as regards the health of those who are to 
occupy the home. Let us answer each as concisely as possible. 

It is very important that there should be good surface drainage in 
the vicinity of a dwelling, not only to afford easy means of disposing of 
the waste water of the dwelling, but to carry away quickly the water 
which falls in heavy rains in excess of the ability of the soil to absorb, and 
the melted snow in spring, which the frozen ground cannot take up. No 
opportunity for stagnant water should be allowed about a dwelling. 
This being true, it is evident that the center of a knoll or gentle rise of 
ground, from which the surface slopes in every direction, is a most desira¬ 
ble spot for a dwelling-house. A south hill-side will be preferred by 
some, however, as it not only secures good drainage, but protection from 
the cold northern and north-eastern winds in winter, and a greater 
amount of sunlight and heat. 

A dwelling-house should always front the east or south, if constructed 
after the usual plan of dwelling-houses, so that each of the chief rooms 
of the house may receive a flood of sunlight at some time during the day. 

Best Kind of Soil to Build Upon. —A porous soil possesses great ad¬ 
vantages over any other, although such a soil is subject to some conditions 
out of which grow evils not presented by a less pervious soil. Perhaps it 
may be allowed that an absolutely impervious surface, as that of solid 
rock, would be best of all for a building site ; but aside from this, we must 
accord the chief advantages to a soil which is freely porous, as sand or 
gravel. Next in order are the several varieties of loam ; and last to be 
mentioned, as least salubrious—unless extraordinary advantages are 
afforded for surface and underground drainage—is clay and other soils 
which hold "water in great quantities. The reason for the different 
values of these various soils from a health standpoint becomes apparent 
when we study the properties of— 

Ground Air and Water. —Everybody knows that water is to be found 
in the earth in most localities, sometimes near the surface, and in other 
places and at other times far beneath the surface ; but all are not so well 
aware that air exists in the soil, usually in a much greater quantity than 
water. All soils, not excepting the most compact, and even the solid 
rocks, are pervious to both air and water in some degree. A loose, 
gravelly soil admits both air and water in very large quantities. 

The porosity of the soil may be readily shown by a simple experi¬ 
ment. In one end of a large glass tube eight or ten inches in length— 
an Argand lamp chimney will answer the purpose admirably—fit closely 
a new cork. Perforate the cork in the center, and insert a small glass 
tube. Now place in the end of the large glass tube next the cork a 


HEALTHY HOMES. 


1577 


small quantity of cotton, and fill the tube with earth. The latter should 
be perfectly dry. A little cotton may be placed in the open end of the 
tube to keep the earth from running out. If the open end of the tube is 
placed in the mouth while the small glass tube at the other end is held 
near a candle flame, it will be observed that by blowing into the open 
end of the tube the flame may bo made to flicker, showing that the 
earth in the tube is pervious to air. 

The air in the soil is known as ground air. After a heavy rain the 
earth may be saturated with water, which gradually settles, some por¬ 
tion being carried off underground, and much evaporating from the 
surface. The level of the water, which was immediately after the rain 
at the level of the omul, radually falls, and the air is drawn into the 
porous soil as the \ iter iniis. Another rain will raise the level of the 
water, and crowd out qual amount of air. This varying quantity of 
water in the soil is known as ground water. 

The bight of the ground water and its variations in any locality 
may be approximately determined by the measurement of the depth of 
water in wells, which usually values with the ground water. The water 
in the soil is usually in motion, the direction of movement being toward 
some neighboring stream or other large body of water. The rate of 
movement varies from a few inches to several feet daily. 

The ground air is also in constant motion. This is in part the result 
of the movements of the ground water, and is partly due to the action of 
the wind. Other causes also operate to produce movements in the 
ground air, as we shall see. When the wind blows against the side of a 
hill, a portion of the ground air in the hill is displaced by air driven into 
the ground by the wind, the old air being forced out at the opposite side 
of the hill at the same time. 

Relation of Ground Air and Water to Health. —Both ground air and 

ground -water are at best more or less impure. Ground air, especially, 
contains a number of impurities which are dangerous to health. Carbonic 
acid gas is present in very considerable quantities. These impurities are 
the result of organic decomposite »n. A great amount of animal and 
vegetable matter is constantly undergoing decay upon the surface, in the 
warm months of the year, and this is washed down into the soil by the 
rains, where the same processes of decay continue, being favored by the 
constant moisture and comparatively uniform temperature which exist a 
short distance below the surface in most soils. Every rain washes down 
into the ground water some of the products of decay, and brings other 
decomposing and decomposable substances to deposit in the soil. 

An understanding of the nature of ground air and water at once 
shows the importance of avoiding ground air as much as possible, and 


1578 


APPENDIX . 


regarding ground water with suspicion. As it is impossible entirely to 
avoid contact with either, it is important to protect from contamination 
the ground air and water in connection with dwellings so far as possible. 

Construction of a Dwelling-House in Relation to Health. —As regards 
health, the construction of a house should be such as to secure proper 
protection from cold in winter, excessive heat in summer, rain and wind 
at all times, and to secure an abundance of light and air. The materials 
of which a dwelling-house is constructed may be suited to the means 
and convenience of the builder. Wood, brick, and stone are in this 
climate the chief materials used, and it is a matter of comparatively little 
moment, so far as health is concerned, which one is employed, provided 
the materials used are properly put together. Brick and stone houses 
should always be constructed with hollow walls, and care should be taken 
that the space left between the courses of brick or stone is not filled up 
with fragments and mortar so as to become useless, as is often the case. 

Living and Sleeping Rooms should be Large and Airy. —Sleeping-rooms 

in particular are too often made quite too small for health. The hight 
of rooms should be not less than nine or ten feet, and not less than twelve 
hundred feet of space should be allowed in sleeping-rooms for each 
individual. This would require for a bedroom intended for one person, 
a room ten by twelve feet on the floor, and ten feet high. 

The window space, to insure an ample supply of light and sunshine, 
should be not less than one-third of the floor space. That is, a room 
10x12 feet on the floor should have three windows each 2£x5£ feet, or 
two windows each 3x7 feet. 

Chambers, sitting-rooms, parlors, and all rooms which are much 
occupied, should be so placed that they may receive daily an abundant 
supply of sunlight; and the direct rays of the sun should not be inter¬ 
cepted by overhanging trees, or by curtains or blinds. Curtains and 
blinds are not objectionable when properly used ; but the exclusion of 
sunlight is no part of their proper service, only under exceptional cir¬ 
cumstances. 

A light, airy, roomy kitchen is conducive to the health of those who 
are employed in this department of a dwelling. Pantries and closets 
are not objectionable if so situated that the sun may shine into them 
often. When dark, they speedily become musty and infected with mold 
and mildew. The fusty odor which so often haunts these places is 
indicative of the need of air and sunshine. 

How to Ventilate a Home. —In the construction of a dwelling, atten- 
tion should be given to ample provision for the adequate supply of fresh 
and pure air. It should be recollected that each person requires not less 
than forty to sixty cubic feet of pure, fresh air per minute, or 2400 to 


HEALTHY HOMES. 


1579 


3600 cubic feet per hour. To secure this amount of air requires for each 
person an opening not less than one-sixth of a square foot in area, and 
absolute safety requires a still larger area. Some fresh air will find its 
way in through cracks, between window sash, under and around doors, 
and even through brick walls; but this is an uncertain and inadequate 
supply, and openings should be provided at convenient places for this 
purpose. 

If provision for the proper ventilation of a house is made at the time 
of its construction, very little expense need be involved; hence the 
importance of giving this matter attention when planning a dwelling. 
The following is a brief summary of the principles of correct ventilation, 
which ought to be familiar to every one, whether interested in house¬ 
building or not:— 

1. For efficient ventilation of each room in a building, two openings 
are necessary, one for entrance of fresh air, and one for egress of foul air. 

2. When the fresh air enters a room warm, as when furnaces are 
used for heating, the foul air opening should be at the bottom, as the 
oldest air in the room, and consequently the most impure, will be that 
which has been in the room the longest, and has been gradually cooled 
by contact with outside walls and window surfaces. When a room is 
heated by stoves, the foul air opening should be near the ceiling. 

3. The size of openings depends upon the number of persons to be 
supplied with air. It may be laid down as a general rule that an open¬ 
ing of twenty-four square inches’ space in both inlet and outlet is required 
for each individual in a room. The openings should be of sufficient size 
to allow a passage of at least three thousand cubic feet of air per hour 
without creating too perceptible drafts. Air cannot travel through a 
room more rapidly than five feet a second without a current being per¬ 
ceptible. A sick room needs two or three times the ordinary amount of 
ventilation. 

4. The foul air openings of rooms should connect with heated venti¬ 
lating shafts. Cold-air shafts are uncertain ventilators. They are not 
to be relied upon. The amount of draft in the shaft depends upon the 
hight of the shaft and the amount of heat in it. Various methods of heat¬ 
ing the ventilating shaft may be adopted. In a building heated by steam, 
steam pipes may be employed. In ordinary dwellings, the waste heat of 
smoke-pipes or chimneys may be utilized for the purpose. An oil-stove 
or a gas-jet may be used for heating small shafts in dwellings ; or a 
small stove may be used to accomplish the same purpose in larger shafts. 

5. Booms on different stories should not open into the same venti- 
lating-shaft, as the upper rooms are certain, under various circumstances, 
i » receive the foul air from the rooms belov. 


1580 


APPENDIX. 


How to Heat a Home. —Proper heating, which is closely connected 
with ventilation, is by no means so simple a matter as may be supposed 
by those who have given the matter no special attention. A properly 
heated building is as rarely to be found as one which is efficiently venti¬ 
lated. Heating by stoves is the method in most common use, and as or- 



demned, unless some such devise as is described on page 575 of the body 
of this work is employed to remedy the defect. 

For ordinary use in dwelling-houses of any considerable size, the 
turnace is undoubtedly the most healthful and economical means of heat- 
ing. It should be mentioned, however, that a furnace is useless without 
efficient means oi ventilation. Air cannot be made to enter a room 
unless room is made for it by the removal of air. A plan which is 













































































































































































































HEALTHY HOMES. 


1581 


sometimes employed, and which has been highly recommended by those 
who have tried it, is the following: The furnace is placed in the cellar, 
from which the supply of air is taken. A hot air duct is led to the room 




Fig. 4. 


or rooms to be heated, and an¬ 
other register is put in the 
same room, at a distance from 
the hot-air register, through 
which the cold air of the room 
may be taken back to the cel¬ 
lar, and thence to the furnace. 
By this arrangement, the same 



Fig. 3. Fig. 5. 


air is made to travel round and round, and a very great economy in fuel 
is secured. Such an arrangement as this is the very worst possible, and 
cannot be too strongly condemned. Air to supply a furnace should come 
direct from out-of-doors, and the same should be said of stoves arranged 
after the methods shown in the accompanying cuts, for the dc. ' ;ns for 
which we are indebted to our friend, the Rev. IX C. Jacokes, who has 
devoted much time and patience to the development of simple means for 
providing efficient ventilation for common dwellings and country churches 
and school buildings.* 


* Dr. Jacokes contributed a valuable paper on this subject i-> the annual report of the State 
Board of health of Michigan for ireo, of w ; 'i he was i’ ’i . member. This paper was widely 
co A ' , ;nr;bc,s undoubtedly been the means of accomplishing untold good. The designs are taken 
from It. 





























































































































































1582 


APPENDIX. 


Novel Devices for Ventilation. —Fig. 1 shows how a common stove, 
A, by the addition of a sheet-iron jacket, D, which communicates with 
the open air through a pipe, P, and a wooden box, E, passing beneath 
the floor through the foundation wall, may be made to supply warm, 
fresh air to a room almost as efficiently as a furnace. 



Fig. 2. This is a similar arrangement applied to a box-stove. Any 
fcind of a stove may be arranged in the same manner. If preferred, the 
stove may be located in the basement, and completely inclosed by the 
jacket, when it becomes practically a furnace. When thus arranged, a 
pipe of ample size should lead from the top of the jacket to a register in 





















































































































































































HEALTHY HOMES. 


1583 


the floor of the room to be heated. 
With a good-sized stove thus ar¬ 
ranged, two or three rooms may be 
sufficiently heated, even in very 
cold weather. Care must be taken 
to arrange the fresh-air opening so 
that it will not be prevented from 
operating efficiently by adverse 
winds. 

Fig. 3 shows how the same prin¬ 
ciple may be applied in a jacket 
placed about a stove-pipe. It should 
of course be recollected that none 
of these methods are effective un¬ 
less some means is provided by 
which the foul air may escape from 
the room. 

Fig. 4 shows how a chimney may 
be so constructed as to operate both 
as a ventilator and a smoke flue. 
D represents the smoke flue; A, 
B, and C, the ventilating flues, 
which are separated from the 
smoke flue by a brick or sheet-iron 
partition, which is heated by the 
smoke and hot gases in the smoke 
flue, and thus secures a draft in 
the ventilating flues. The same 
result may be secured by carrying 
the .smoke off by means of a pipe 
or stack carried up through the 
center of the chimney (see Fig. 
190, page 569, of the body of this 
work), by means of which the air 
inside the chimney will be heated 
and an excellent draft secured. All 
that remains to be done is to con¬ 
nect each room to be ventilated 
with the chimney by means of a 
duct of proper size, which should 
open at the floor of the room. If 
two stories are to be ventilated, the 
chimney space may be divided by 
a partition, as shown in Fig. 5, C, 



Fig. 7. 

























































































































































































































1584 


APPENDIX. 




& 



i§»l 




I 


chimney ; P, pipe in center. One side should be used for the lower, the 
other for the upper story. 

Fig. 6. This cut illustrates a means by which a constant supply of 
warm, pure air may be obtained, and efficient ventilation secured by 
simple and inexpensive means which are applicable to any house. The 
arrangement of the jacket and fresh-air pipe are the same as shown in Fig. 
1. In addition is seen pipe Y, which starts near the floor behind the stove, 
and is connected with the chimney just below the entrance of the smoke 
pipe into the chimney. This arrangement gives perfect satisfaction 
when the chimney is large and the draft strong and constant. It cannot 
be relied upon when the draft is deficient, as it will diminish the draft of 
the stove so as to cause smoke to enter the room. 

Fig. 7 shows an ingenious 
method of heating two rooms 
and ventilating one of them, util¬ 
izing the heat of the stove-pipe 
in the second story to create a 
draft to ventilate the room be¬ 
low. It will be observed that 
only the lower room is supplied 
with fresh air. This defect might 
be remedied by a small register 
in the floor of the upper room 
just over the stove of the lower 
room. Yentilation for the upper 
room, with such an arrangement 
as this, must be provided in some 
other way. 

Fig. 8 shows how a room may 
be ventilated by taking the air 
down through a register in the 
floor through a pipe, B, to the chimney flue, A. It will be observed that 
the opening ot the ventilation pipe is below C, which represents the 
smoke pipe from a furnace. If the ventilation pipe were to enter the 
chimney above the smoke pipe, smoke would enter the room above. 
Both of the arrangements last described and illustrated by Figs. 7 and 8 
require a very strong draft. 

In constructing a dwelling-house with reference to health in the 
matter of heating and ventilation, we know of no better plan than to 
provide an improved form of furnace as a means of supplying warm, pure 
air, and a grate for every room or suite of rooms as a means of ventilation. 
In very cold weather, the draft in open grates will be sufficiently strong 


Fig. 8. 























































































HEALTHY HOMES. 


1585 


to secure ample ventilation, if the flues are in insido Avails ; but in spring 
and fall a little fire will often be needed to create a draft in the grate 
flue. 

For further information on this subject, see pages 563 to 576 of the 
body of this Avork, 

Cellars and Basements. —Inattention to the relation to health of cellars 
and basements, or the space under a house and between it and the ground, 
is a very prolific cause of a variety of serious ailments. Wo shall not noAv 
dAvell upon the eAdls resulting from contamination of the air through 
decomposable substances stored in cellars and basements, or accidentally 
deposited under a house, as this part of the subject has been fully con¬ 
sidered elsewhere in this work (see page 552). We Avish to call es¬ 
pecial attention to the danger which may arise from dampness and 
ground air entering by the cellar or basement. 

Unless the walls of a cellar or basement are made impervious, the 
groundwater and dampness from the soil will be sure to find its Avay 
through. Stone AA r alls several feet in thickness are readily penetrated 
by moisture. The Avails of basements are also kept moist by what is 
known as SAveating, which is really condensation of moisture upon the 
walls from the air, due to the walls being colder than the air Avhich 
comes in contact Avith them. The only remedy for these tAvo e\ r ils is to 
make the walls of basements impervious, and to make them good non-con¬ 
ductors by means of an air-space. The walls should be laid in good 
cement, and should be coated with cement outside as well as inside. The 
air-space may be made by means of an inside brick lining or a lining of 
lath and plaster. The air-space should in any case be ventilated, openings 
being made through the lining so as to alloAV a good circulation of air 
between the tAvo walls. A simple wainscoting of matched ceiling an¬ 
swers a very good purpose for use as a lining for basements. 

The floor of a cellar or basement must be made as impervious as pos¬ 
sible. A floor of asphaltum would undoubtedly fulfill the needed condi¬ 
tions most perfectly; but a portland cement floor, troweled down smooth 
and hard, or a tile floor, gives very satisfactory results. 

The use of a drain tile all around the building just outside and near 
the foot of the foundation wall is undoubtedly of great service as a means 
of disposing of surplus moisture in the soil, especially during and after 
heavy rains; but in heavy soils this alone is not sufficient. Drain 
pipes are no protection against ground air, which, as Ave have already 
learned, is always impure and unwholesome, and may be rendered in the 
highest degree noxious and deadly by contamination from privies, cess¬ 
pools, defective drains, etc. 


100 


1586 


APPENDIX . 


When the above precautions respecting the construction of cellar and 
basement walls are neglected, as they usually are, a dwelling is liable to 
be at any moment, or all the time, flooded with foul air from the sur¬ 
rounding soil. Every open door or window in such a house is a source 
of draft which sucks in through the cellar walls and bottom mephitic 
gases which do their work of death unseen and unsuspected. Every 
rain storm, every wind, drives into the house floods of these poisonous, 
subterranean gases. Typhoid fever, diphtheria, probably dysentery, 
cholera morbus, and possibly many other diseases, are communicated in 
this way. 

Cellars and basements should under all circumstances be well venti¬ 
lated, and this will do much toward lessening the danger of injury from 
ground air or ground water should they find entrance. Properly con¬ 
structed, a basement should add to the healthfulness of a dwelling. 

Pure and Plentiful Water Supply.—One of the most essential of all 
conditions requisite for a healthy home is an abundant supply of pure 
water. Whether the source of supply is a well, a spring, a lake, or a 
stream, is a matter of comparative indifference, so long as it is pure and 
soft. Spring-water justly stands high as a source of water supply, and 
yet the mere accident of its coming to the surface of the ground does not 
necessarily give it superiority over well-water. Both waters have es¬ 
sentially the same origin, and the same average composition. Yery hard 
water, and water impregnated with alkalies or other mineral elements, 
and especially water containing organic matter, cannot be used any 
length of time without grave injury to health. 

A family living in a home favorably located and properly constructed, 
and provided with an ample supply of pure air, pure water, and suitable 
food, with proper clothing, and such advantages for mental and moral 
culture as most civilized communities afford, ought to be both healthy 
and happy. The doctor will rarely visit such a home, and disease will 
long fail to make any successful attack upon the happy circle 



V 


\ 


POISONS. 

(SEE ALSO PAGES 1441-1445.) 


MINERAL POISONS. 

Chlorine.—This is a gas having a greenish yellow color and a' pun¬ 
gent, suffocating odor. It is frequently employed in fumigating build¬ 
ings, being an excellent disinfectant. It is also used for bleaching 
purposes. When inhaled, even in a diluted state, it excites great 
irritation of the air-passages, cough, difficulty of breathing, and subse¬ 
quent inflammation. 

Treatment.—If a person has been overcome by inhalation of chlorine, 
remove him at once to the open air. Apply ammonia to the nostrils as 
a chemical antidote, also allow the patient to inhale ether, and the vapor 
of warm water as soon as possible. Artificial respiration should be em¬ 
ployed if the breathing is suspended. 

Hydrochloric Acid possesses much the same properties as chlorine. It 
is of such an irritating nature, even in very greatly diluted form, that 
it is capable of dwarfing or destroying vegetable life, on which account 
the regions surrounding chemical works in which it is produced are 
often barren for some distance. Cases of poisoning by it should be 
treated the same as in chlorine poison. 

Sulphurous-Acid Gas and Nitrous-Acid Fumes may also prove fatal, the 
latter in quite small quantities. 

The patient should be taken into the open air as quickly as possible, 
and artificial respiration applied if breathing is suspended. To relieve 
the subsequent inflammation, have the patient inhale the vapor of warm 
water with a steam inhaler. In severe cases the inhalation should 
be kept up for several hours. 

Ammonia Gas.—When quite concentrated, this may produce violent 
inflammation of the air-passages, followed by pneumonia. Injury is most 
likely to be done in the use of ammonia in cases of fainting or of narcotic 
poisoning. If applied at once, the vapor of warm vinegar would be of 
service in neutralizing the effects of this caustic gas. The continued in¬ 
halation of steam constitutes the best treatment. When severo bronchi¬ 
tis or pneumonia follows, they should be treated as elsewhere directed. 
Ammonia should never be inhaled from a bottle. A few drops at a time 
should be placed on a handkerchief, so that it may be well mixed with 
air. 


(1587) 




1588 


APPENDIX . 


Carbonic-Acid Gas.—This gas, more properly known as carbon di-ox¬ 
ide, is not an infrequent source of death. It is the principal product of 
combustion. It possesses no irritating properties, but sometimes de¬ 
stroys life by depriving it of the proper amount of oxygen. It is found 
in large quantities in coal mines and many caves. It is also present in 
large quantities in beer vats, where fermentation is going on, and is given 
off in immense volumes from lime kilns. Human respiration is also an 
important source for this poison. In France the gas is frequently used 
for suicidal purposes. A person confining himself in a close room with an 
open charcoal fire is soon suffocated. When inhaled in a pure state, 
carbonic-acid gas produces death by asphyxia. When diluted with air, 
it produces giddiness, tendency to sleep, and great weakness. The face 
and hands are livid, the patient becomes comatose, and dies from pa¬ 
ralysis of the heart. 

Treatment.—Eemove the patient to the open air, or an airy room 
with windows open. Pour cold water upon the head and over the body, 
then rub briskly with flannel cloths. Make hot and cold applications 
to the spine. Employ artificial respiration. The application of galvan¬ 
ism, and the inhalation of oxygen gas should be employed when possible. 

Carbonic-Oxide Gas.—This gas is the product of imperfect combus¬ 
tion. It is always present in coal gas, and is its chief poisonous element. 
It is also produced in the burning of coal in stoves, and also in the 
burning of wood whenever the draft is checked, on which account 
dampers in stove-pipes, or anything which impedes the draft, should be 
looked upon as dangerous. This gas is so poisonous that it may produce 
deadly effects, even when very much diluted with air. Its effects some¬ 
times prove fatal two or three days after an individual has been rescued 
from its influence. 

Treatment.—There is no true antidote for the effects of this deadly 
gas. The patient should be treated the same as in poisoning by coal gas, 
which see. 

Sulphuretted Hydrogen.—This gas may be known by its peculiar odor, 
which is that of rotten eggs. It is present in large quantities in sewer 
gas, and is probably the cause of the nausea, giddiness, and weakness 
frequently suffered by workmen engaged upon old drains and sewers. 
When inhaled in considerable quantities, the only hope for recovery is by 
removal immediately to the open air, the application of artificial respira¬ 
tion, and friction to the surface. In severe cases no human aid is of any 
avail. 

Coal Gas. This gas is very poisonous when inhaled, even though con¬ 
siderably diluted with air. If the quantity inhaled is considerable, 
asphyxia is produced. If inhaled more slowly, the effects are intense 


POISONS. 


1589 


headache, labored respiration, increased action of the heart, nausea, and 
great debility There is great danger from poisoning by this gas in 
houses in •which there is a leak in the gas pipes. Many persons have 
been poisoned by blowing out the gas at night in a sleeping-room, instead 
of turning it off. Somo years ago a whole family in Strasbourg was 
poisoned by the escape of gas from a leaky pipe which passed under the 
cellar of the house. Probably the poisonous effects of coal gas are 
largely, if not chiefly, due to the carbonic oxide present in it. The new 
gas which is being largely introduced of late in the cities, known as 
“water gas,’' contains a very large proportion of carbonic oxide, and 
hence is more dangerous to health. Danger from this source of 
poisoning may be largely obviated by the use of gasoline gas, which may 
be inhaled in considerable quantities when diluted, without producing 
serious symptoms. 

Treatment.—Eemove the patient to the open air as quickly as possi¬ 
ble. Apply artificial respiration and appropriate measures for stimu' o- 
ing the circulation. Cold effusions should be applied to the head, and 
hot and cold applications to the spine. The application of the hot 
fomentation over the heart will be found useful in these cases. In 
attempting to rescue persons overcome by gas, it should be recollected 
that the amount of gas present in the air of the room may be sufficient 
to render it explosive; consequently, no light should be taken into the 
apartment until after the doors and windows have been ojiened to allow 
the gas to escape. Neglect of this precaution has sometimes resulted in 
serious explosions. This precaution should be borne in mind by a person 
awaking in the night, and finding his room filled with gas. 

Phosphorus.—Phosphorus is a constituent of many preparations used 
for poisoning rats, cockroaches, and other vermin. It is also contained 
in phosphorous matches, and is a violent poison, producing death in very 
small quantities. A child has died from sucking two matches. 

Treatment.—There is no antidote to this poison. When it has been 
swallowed, the stomach should be emptied as quickly as possible by an 
emetic consisting of one or two teaspoonfuls of powdered mustard or 
alum in a goblet of warm water, followed by large quantities of thin 
gruel. Oils should be avoided. 

Poisonous Fabrics.—Various compounds of arsenic are used in color¬ 
ing fabrics of various kinds, such as tarlatan, carpets, mats, etc., together 
with wall-papers, window curtains, toys, wafers, etc. The colors most 
apt to be poisonous are the different shades of green and drab, although 
Dr. Kedzie, professor of chemistry in the State Agricultural College of 
Michigan and late President of the State Board of Health, has shown 
that other colors are also sometimes poisonous. 


1590 


APPENDIX. 


Fabrics colored with aniline are often rendered poisonous by the use 
of arsenic in the coloring process. Poisonous effects are frequently 
derived from colored socks, flannel under garments, hat and boot linings. 

Poisoning is said to have been occasioned in a few instances by the 
use of American leather, which has been found to contain large quanti¬ 
ties of lead. The principal dangers from this source have arisen from its 
use for hat linings, and lining of baby carriages. 

Poisonous Cosmetics.—Hair dyes and restoratives are frequent sources 
of poisoning on account of the great quantities of lead which they 
almost always contain. We have met instances of lead palsy which had 
been occasioned by their use. Arsenic has also been used for coloring 
the hair yellow. No doubt serious results may follow the employment 
of arsenic in this way. 

Lotions and powders for the face generally contain lead in addition 
to various other substances. In some, corrosive sublimate, a compound 
of mercury, is the chief constituent. All of these are, of course, in the 
highest degree poisonous. If any preparation is to be used for the face, 
some simple and harmless substance, such as carbonate of magnesia, or 
wheat starch, should be employed. Starch and oxide of zinc, in propor¬ 
tion of eight parts of the former to one of the latter, makes a very excel¬ 
lent white powder for the face. Carbonate of magnesia, colored with one- 
fourth part of carmine red, will answer all purposes as a red powder. 
We have seen very serious cases of lead poisoning produced by the appli¬ 
cation of preparations of lead to the face. 


POISONOUS PLANTS. 

The Nettle.—This is a common name for a number of different plants 
which are covered with hairs capable of inflicting a stinging wound by 
means of an acrid juice which contains formic acid, a very irritating and 
poisonous substance. The same acid is also found in caterpillars and red 
ants, which are capable of producing the same kind of injury occasioned 
by the nettle. The virus of bees, wasps, and hornets contains the same 
substance. The nettle sting produces a white spot, surrounded with a 
red swelling, and is accompanied by a peculiar and very severe itching 
and tingling. 

Treatment.—Apply a solution of baking-soda, one teaspoonful to six 
tablespoonfuls of water. A still better preparation is the following: 
Carbolic acid, a teaspoonful; glycerine, two tablespoonfuls ; ammonia, a 
tablespoonlul ; and water, half a pint. This may be kept on hand in 
readiness for use. It is also excellent for the stings of bees and other 
insects. 




roitiONS. 


1591 


Poison Ivy.— Plate XVII. This is a climbing plant with three leaf¬ 
lets. It is also known as three-leaf ivy and poison vine. It is an 
exceedingly poisonous plant, many persons being affected by simply 
coming in its vicinity and without touching it. The symptoms very 
closely resemble those of erysipelas of the skin. There is swelling and 
redness, attended by intense burning and itching. In some cases, 
vesicles, or small blisters, are formed. The poisonous parts of the plant 
contain a volatile substance known as toxicodendric acid. 

Treatment.—Alkaline solutions of various sorts are the most effective 
remedies. Dilute ammonia water, a strong solution of baking-soda, weak 
lye, lime-water, and in the absence of anything better, soft soap may be 
employed. A remedy which is highly commended is equal parts of lime- 
water and a strong decpction of oak-bark. A bandage should be wet 
with the solution and applied to the parts, being removed as often as it 
becomes dry. A person who has been severely poisoned by ivy some¬ 
times suffers a frequent recurrence of an itching eruption. This is not 
due to a retention of the poison in the system, but is a form of eczema* 
or moist tetter, and should be treated by the remedies recommended for 
this disorder of the skin. See pages 1263-4. 

Swamp Sumac, Poison Dog-Wood, or Poison Elder.—These are different 
names for a branching shrub which grows in swamps. Its usual hight 
is from six to eighteen feet. It rarely grows over eighteen feet in 
hight. It has smooth branches, and a compound leaf composed of seven 
to thirteen leaflets. 

The symptoms are the same as in poisoning by poison-ivy. The 
treatment is also the same. 

Poison-Oak.—This is another variety of rhus, the symptoms of which 
are similar to those of the two preceding varieties. The treatment is 
also essentially the same. The extract of grindelia robusta , a California 
plant, is recommended for poisoning with poison-oak, which is a native 
of the same State. It should be rubbed upon the poisoned part. 

Stramonium, Jamestown Weed, or Thorn Apple.— Plate XVII. This 

is a very common plant, which grows to the hight of from three to five 
feet. It has a*largc white flower, and bears a fruit about as large as a 
small peach and covered with sharp spines. Parts of the plant are 
poisonous, particularly the fruits and seeds. Soon after any portion of 
the plant is taken, faintness, partial paralysis of sensation, dilatation of 
the pupils, and dimness of vision are experienced. The pulse is slow 
and the head congested. Very frequently there will be some delirium 
and various illusions. The patient is generally unable to walk, or walks 
with a staggering gait. 

Treatment.—Give a teaspoonful of ground mustard or powdered alum 


1592 


APPENDIX . 


in a goblet of water, and let the patient drink freely of warm water or 
strong tea. The tea is to be taken for the benefit of the tannin which 
it contains. A decoction of oak-bark is equally useful. Four to eight 
teaspoonfuls of powdered charcoal should be given. The charcoal may 
be powdered by pounding in a cloth. It is best taken by mixing with a 
little milk, or glycerine and water. If there are symptoms of collapse, 
hot and cold applications should be made to the spine, and the surface 
should bo vigorously rubbed with hot flannels, or hot alcohol or vinegar. 

Indian Poke.—This plant grows in wet soil to a hight of four to six 
feet. Its roots are of a bright green color, and its flowers a greenish 
yellow, appearing in May and June. The variety of the plant known as 
white hellebore, not a native of this country, is used for poisoning insects. 
The symptoms of poisoning with hellebore are a slow, feeble pulse, which 
sometimes becomes almost imperceptible, great prostration, cold moist 
skin, dizziness, nausea or vomiting, dimness of vision, faintness, and 
sometimes stupor. 

Treatment.—Administer an alum or mustard emetic. Make the 
patient drink copiously of hot teas; strong camphor or peppermint tea 
is especially useful. The patient should be kept quiet. Hot bricks or 
bottles should be applied to the extremities, and hot fomentations over 
the region of the heart. Alternate hot and cold applications to the 
spine, especially between the shoulders, are also very serviceable. 

Black Hellebore, or Christmas Rose.— Plate XVIII. The symptoms 
of poisoning by this plant are severe pains in the bowels, vomiting and 
purging, dizziness, cold sweats, and collapse similar to that of cholera. 
The infusion of this plant has been employed by quacks as a vermifuge, 
and in several instances with fatal consequences. Treatment the same as 
the preceding. 

Fox Glove, or Digitalis.— Plate XVIII. This plant is often culti¬ 
vated for its flowers. Its seeds, leaves, and roots are very poisonous. 
The symptoms arising from a poisonous dose are vomiting, purging, colic, 
headache, slow and irregular pulse, dilated pupils, dimness of vision, 
great prostration, convulsions, and coma. It is frequently used in medi¬ 
cine. Cases of poisoning not infrequently occur from it^ medicinal as 
well as from its accidental use, owing to its cumulative effects. 

Treatment. Give the patient an emetic at once, and afterward 
strong tea, or a decoction of oak-bark. The tannin contained in the 
infusion neutralizes the poisonous principle of the plant, and so renders 
it inert. Powdered charcoal may also be administered in milk. These 
remedies are of course useful only in antidoting that portion of the 
poison which still remains m the stomach. Other measures, the same as 
recommended for Indian Poke, should be employed. 


POISONS. 


1593 


Hemlock, Poison or Spotted Hemlock. —This is a shrub which grows to 

a bight of three to five feet, and very much resembles parsley in its 
appearance. The stem is hollow, and covered with purplish spots. It 
bears white flowers, which have a peculiar foetid odor. Tho seeds are 
the most poisonous part of the plant. Tho poisonous principle of hem¬ 
lock is conium. It is used in medicine. The symptoms of poisoning are 
great weakness, difficulty in breathing, dimness of vision, enlargement of 
the pupils, irregular and intermittent pulse, drowsiness or stupor. 

Treatment. —See Method 5 on page 1442. 

Darnel.—This is a bearded plant of the grass family, which is found 
growing with wheat or rye. The seeds are poisonous, and when mixed 
with the grains mentioned in considerable quantities, and made into flour, 
frequently, when eaten, give rise to severe giddiness, vomiting, purging, 
and symptoms of intoxication. Patients, while suffering from its influ¬ 
ence, state that all objects appear to be of a uniform green color. Horses 
and sheep are poisoned by the seeds of this plant, as well as men, though 
it is stated that pigs, chickens, and some other animals are not affected 
by it. There is some reason for thinking that the poisonous effects 
observed from eating seeds of the darnel are due to a diseased condition 
of the plant, similar to that known as ergot in rye and other grains. A 
wet season is said to encourage the growth of the darnel with green 
crops. 

No special treatment is required if the cause is recognized and 
removed. 

Lobelia, or Indian Tobacco. —The great use made of this plant by 
botanic and Thompsonian doctors might lead to the supposition that it 
is quite harmless. An infusion of a dram of the leaves has been known 
to produce death. The usual symptoms of poisoning are pain, severe 
vomiting, very feeble pulse, contraction of the bowels, and unconscious¬ 
ness. This plant is very closely related to tobacco in its effects. It 
should never be employed for medicinal purposes. 

Treatment. —Encourage vomiting by copious drinking of warm fluids. 
Strong tea, decoctions of oak-bark, and tannic acid in any form, are 
especially serviceable. The patient should be kept surrounded with hot 
bricks or bags filled with hot water. Hot fomentations applied over the 
heart, and alternate hot and cold applications to the spine are service¬ 
able. Cold applications should be made to the head to relieve cerebral 
congestion. 

Buttercup. —This plant is not a very violent poison, but generally 
produces severe smarting and burning when taken into the mouth, and 
if swallowed, occasions inflammation of the stomach. Poisoning by it 


1594 


APPENDIX. 


should be treated by means of emetics, followed by iced tea and small 
bits of ice. 

Black or Garden Nightshade, and Woody Nightshade, or Bitter-Sweet.— 

Plate XX. The first-named plants produce red berries, and the 
second, black ones, which contain the poisonous principle common to the 
two plants and several others of the same family, known as solania. 
The symptoms of poisoning are great thirst, headache, dimness of 
vision, dizziness, dilated pupils, convulsions, vomiting, and purging. 

Treatment. —Treatment is the same as that recommended for other 
narcotic j>oisons. See page 1442, Method 5. 

Deadly-Nightshade. —This plant is a native of Europe, but has been 
cultivated in this country, and has in some places become naturalized so 
that it grows wild. Its roots, leaves, and berries are poisonous, con¬ 
taining the deadly alkaloid known as atropia. The symptoms of 
poisoning are dryness in the mouth and throat, with great thirst which 
cannot be relieved, nausea, vomiting, and wide dilatation of the pupils, 
vision indistinct and double, dizziness, palpitation, delirium, and stupor. 
The symptoms generally appear one to three hours after the poison is 
taken. 

Treatment. —Secure vomiting as soon as possible by an alum or 
mustard emetic. It is also well to administer a dose of castor-oil. The 
best antidote is powdered charcoal, animal charcoal being the best. It 
may be taken in any quantity, from a teaspoonful to two or three table- 
spoonfuls, without harm. For other treatment see page 1442, Method 5. 

Indian Turnip, Dragon-Boot, Wake Robin, or Jack in the Pulpit.— 

Plate XX. This is a well-known native plant, all parts of which con¬ 
tain an acrid and volatile poison. It produces a severe stinging pain in 
the mouth when chewed, and sometimes considerable soreness and swell¬ 
ing. Great irritation is produced when any portion is swallowed. The 
best remedy is milk, which should be drunk freely. 

Poke, Scoke, or Garget. —This is a poisonous plant which grows chiefly 
in uncultivated fields. When matured, the stalks have a purple color, 
and stand six or eight feet in liight. It produces reddish purple berries, 
which have a sweetish taste. The root and berries are the most active 
parts, though the leaves are also poisonous. The chief symptoms of 
poisoning are severe vomiting, great weakness, tingling of the skin, 
sometimes stupor. If taken in a large dose, the poison will be expelled 
by vomiting and diarrhea. If vomiting occurs, plenty of warm water 
should be taken to encourage it. If it does not, an alum or mustard 
emetic should be administered, to be followed by doses of powdered 
charcoal in strong tea. Copious warm enemas are also serviceable. 


POISONS . 


1595 


Fool’s Parsley. — Plate XIX. This plant closely resembles the poison- 
hemlock. It may be distinguished from it by the fact that the stem is 
not spotted. It also closely resembles parsley. It may be usually dis¬ 
tinguished by its disgusting odor. If the leaves are eaten, in a short 
time vomiting, dizziness, severe pain, often numbness, and, in children, 
convulsions are produced. 

Treatment. —Either a mustard or an alum emetic, copious warm 
drinks, cold to the head, and hot bottles to the limbs. The hot bath, or 
a blanket pack, may be wisely administered. If the heart becomes 
weak, fomentations should be applied over the left side of the chest. 

Aconite, Wolf’s Bane, or Monk’s Hood. — Plate XIX. This plant is 
often mistaken for horse-radish, the roots of the two plants being 
somewhat similar, as may be seen by reference to the plate. They may 
be easily distinguished, however, by the fact that when the root is cut, 
it very soon becomes red on exposure, while horse-radish root remains 
white. The taste is also a means ot distinguishing aconite root, which 
causes a tingling and numbness of the tongue, while horse-radish root 
has a bitter, pungent, and burning taste. This is a very poisonous plant. 
The symptoms of poisoning usually come on within a few minutes, and 
may be described as heat, numbness, and tingling in the head and throat, 
dizziness, great weakness, pain in the bowels, vomiting, purging, some¬ 
times delirium and stupor, pupils dilated, skin cold, pulse feeble, and 
breathing depressed. The patient is numb and paralyzed. 

Treatment. —Give an emetic at once ; then administer powdered 
charcoal and strong tea or coffee. Apply hot fomentations to the spine, 
and hot bottles to the limbs. If the breathing ceases, or is very feeble, 
employ artificial respiration. 

Castor-Oil Seeds. —A single seed is sufficient to produce serious symp¬ 
toms, and three seeds have occasioned death. The symptoms usually 
appear two or three hours after the seeds have been swallowed. The 
first symptom is severe pain in the bowels, which is followed by purging 
and vomiting. In some cases there is hemorrhage from the bowels. 
The patient becomes cold, and perspiration covers the surface. There 
is intense thirst, and very small, almost imperceptible, pulse. 

Treatment. —Excite vomiting as soon as possible by mustard or alum 
emetic, and administer strong tea and powdered charcoal, or bone-black. 

Potato Balls and Sprouts.— The fruit of the potato familiarly known 
as potato-balls, contains a poison which has produced fatal effects. 
Sometimes the leaves and stalks of potatoes are also poisonous. Sprout¬ 
ing potatoes contain the same poison, and it has been found to be present 
in potatoes which have grown with one side not covered by earth, which 


1596 


APPENDIX . 


may be known by their green color. The symptoms of poisoning are 
vomiting, frequent respiration, cold, moist skin, and very feeble pulse. 
In some cases there is delirium, and the symptoms attending cholera 
morbus. Potatoes green on one side, and those which are badly sprouted, 
should never be eaten. 

Treatment. —The treatment consists in emetics, hot drinks, hot appli¬ 
cations to the extremities, fomentations over the stomach and bowels, 
and hot and cold applications to the spine. 

Sheep-Laurel, Mountain-Laurel, or Big-Leaf Ivy. — Plate XXI. This 
plant is said to poison sheep, and was once used by the Indians for mak¬ 
ing a tea which was taken for the purpose of suicide. Poisoning is 
sometimes occasioned by eating the flesh of birds which have fed on 
laurel. The symptoms are nausea, headache, disturbance of vision, cold¬ 
ness of the extremities, and feeble pulse. 

Treatment. —A prompt emetic, fomentations to the spine, hot applica¬ 
tions about the body, and rubbing with dry flannels or bathing with hot 
vinegar. 

Mushroom Poisoning. —There are some varieties of mushrooms which 
are sometimes used for food, though not to be recommended for such 
use; poisoning frequently occurs from eating the poisonous varieties by 
mistake. Sometimes the harmless species become poisonous from grow¬ 
ing in wet places, or from undergoing partial decomposition. The 
usual symptoms of poisoning are dizziness, disturbance of vision, delirium, 
and perhaps stupor, pains in the bowels, with violent purging and vomit¬ 
ing. 

Treatment. Give an alum or mustard emetic as soon as possible, and 
follow it by a dose of castor-oil. Keep the extremities warm with hot 
bricks or bottles or heated sand bags. Make alternate hot and cold 
applications to the spine, and apply hot fomentations over the stomach 
and the region of the heart. 

Oleander. This shrub is very commonly cultivated for ornamental 
purposes, and it is not generally known that every part of it possesses 
poisonous properties. There is no danger of contamination of the air, 
however, as the poisonous element is not volatile, and only injures when 
some portion of the plant is eaten. 

Treatment. The patient should be made to vomit thoroughly and 
rapidly , and other symptoms should be treated as they may arise. 

Henbane. Plate XXI. The root of this plant is sometimes mis¬ 
taken for parsnip. The berries are the most poisonous part, although all 
farts of the plant are poisonous, containing an alkaloid known as 
hyoscyamin, which is used in medicine. The symptoms are dizziness. 


POISONS. 


1597 


dilatation of the pupils, dimness of vision, delirium, and great prostration. 
The treatment is the same as for “ deadly-nightshade.” See Method 
.5, page 1442. 

Yellow Jasmine. — Plate XXII. This is a climbing plant, found most 
abundantly in the South. The flowers and roots are the most poisonous 
portions. The symptoms are great. weakness, dimness of sight, double 
vision, frequent and feeble pulse. Treatment should be the same as that 
recommended for other narcotic poisons. Page 1442, Method 5. 

Spigelia, Pink Root, or Carolina Pink is used in medicine, particu¬ 
larly as a remedy for round-worms. When taken in poisonous doses, 
dizziness, dilatation of the pupils, convulsions, and stupor are produced. 
Treatment according to Method 5, page 1442. 

Virginia Creeper, or American Ivy. —This plant has not been generally 
considered poisonous, but cases have been reported in which poisonous 
symptoms have been produced by chewing the leaves, the symptoms 
occasioned being vomiting and purging, dilatation of the pupils, and very 
great weakness. An emetic should be given. After the stomach has 
been thoroqghly emptied, the patient should be allowed to drink milk 
or hot tea, and hot applications should be made to the extremities, with 
fomentations to the spine and over the stomach and heart. 

Yew. —This is a low bush, bearing red berries, which, with the leaves, 
are poisonous. It is said that sheep are not affected by it. Cases of 
poisoning by it should bo treated as directed for laurel poisoning. 

May-Apple, or Mandrake.— Plate XXII. This plant is so very com¬ 
mon that it need not be described. The fruit is harmless, but the roots 
and leaves are poisonous, producing violent purging, sometimes attended 
by hemorrhage from the bowels. It3 use in medicine is a purgative. 

Treatment.— Rub the patient, give copious hot drinks, administer a 
hot enema, apply hot fomentations over the stomach and bowels. It is 
said that the griping is relieved by drinking buttermilk. If a dose has 
been recently taken, an emetic should bo employed. 

Water-Hemlock, or Spotted Cow-Bane.— The root resembles that of 
parsley. The stem has purplish streaks. It usually grows in wet 
places, and is a very poisonous plant. The symptoms are dizziness, con¬ 
gestion of the face, dilatation of the pupils, and vomiting. Treatment 
same as for poison-hemlock. 

Pulsatilla, or Field Anemone.— The leaves and flowers are poisonous, 
producing, when eaten, nausea, vomiting, diarrhea, increased action of 
the kidneys, dimness of vision, and profuse sweating. 

Treatment.— Emetics, followed by strong tea and charcoal. 


PATENT MEDICINES AND NOSTRUMS. 

- 3 

Quacks and quackish nostrums have flourished in all ages; but at no 
age of the world has the business of manufacturing and selling secret 
remedies and patented nostrums attained such gigantic proportions as at 
the present. Thousands of adventurers, whose love for filthy lucre has 
rendered them oblivious to the rights of their fellow-men and unscrupu¬ 
lous as to the methods by which their ends are to be obtained, have by 
ingenious advertising and shrewd management amassed immense fortunes 
in the manufacture and sale of pernicious, useless, and in some instances, 
wholly inert substances. The two things necessary for the success of any 
new nostrum are an attractive or striking name, and judicious advertis¬ 
ing. The manufacturers nearly always keep the composition of their 
compounds secret, as mystery is one of the essential elements of potency 
in a nostrum. The ignorant public hold tenaciously to the old supersti¬ 
tion which has come down to them from the Dark Ages, that disease is 
cured by some mysterious magical process, and as soon as the nostrum is 
divested of its mystical shroud, and shown to be composed of inert or 
common substances, such as every person is quite familiar with, it loses 
its potency in the minds of the majority of persons at once. It is for the 
purpose of discouraging the use of these unwholesome articles which are 
constantly endangering life and health, and rarely do anything toward 
prolonging it, that we present in this section the composition of a large 
number of patented preparations.* We have omitted stating the pro¬ 
portion of the several ingredients employed in many of them, as their 
character is such as to forbid their use by persons who regard life and 
health as of value. In some instances we have given the proportions in 
which the several ingredients are to be used. In such cases the reader 
may understand that we regard the remedy as harmless in character, 
and of some real value. With the exception of mineral waters and arti¬ 
ficial wines, the proportions of which are given to show their character, 
quite a number of prescriptions for really useful remedies will be found 
in the list. 

* These formulae have been gathered from many different sources, and are believed to be in the 
main correct, most of them having been obtained by careful chemical analysis of the nostrums in 
question, by eminent chemists. 

(1598) 




PATENT MEDICINES AND NOSTRUMS . 


1599 


PILLS. 


Holloway’s Pills. 

Aloes, 

Rhubarb, 

Capsicum, 

Saffron, 

Sulphate of Soda. 

Eclectic Elver Pills. 

Podophyllin, 

Leptandrin, 

Sanguinaria, 

Extract of Dandelion. 

Cook’s Pills. 

Powdered Aloes, Soc., 

Powdered Rhubarb 
Calomel, 

Powdered Soap. 

Lady Webster’s Diuner Pills. 

Powdered Socotrine Aloes, 

Powdered Mastic, 

Red Rose Leaves. 


Hooper’s Pills. 

Powd. Aloes, 

Powd. Sulph. Iron Exsic., 

Powd. Myrrh, 

Powd. Soap, 

Powd. Ginger, Jam, 

Powd. Canella, Alba, 

Ext. Hellebore, Nig. 

Anti-Chill Pills. 

Chinoidine, 

Oil Black Pepper, 

Ferrocyanide of Iron, 

Arsenious Acid. 

Dr. Kryeder’s Ague Pills, 

Quinia Sulph., 

Dover’s Powders, 

Sub. Carb. Iron. 

Dr. Alberty’s Anti-Billons Pills. 

Calomel, 

Powdered Gamboge. 


LINIMENTS. 


Carpenter’s Liniment. 

Chloroform, 

Olive-Oil, 

Aqua Ammonia, 

Sulph. Morphia, 

Alcohol. 

Loomis’s Linimsnt. 

Alcohol, 

Aqua Ammonia, 

Oil Origanum, 

Gum Camphor, 

Opium, 

Gum Mvrrh, 

Common Salt. 


Good Samaritan Liniment. 


Oil Sassafras, 

Oil Hemlock, 

Spts. Turpentine, 

Tinct. Cayenne, 

Tinct. Guaiac, 

Tinct. Opium, 

Tinct. Myrrh, 

Oil Origanum, 

Oil Winter-Green, 

Gum Camphor, 

Chloroform, 

Alcohol, 

Fluid Lightning 

Aconitin, 

Essential Oil of Mustard, 
Glycerine, 

Alcohol, 


of each, 1 ounce. 


4 ounces. 
2 ounces. 
X ounce. 
2 ounces. 
IX ounces. 
X gallon. 

1 grain. 

1 drachm. 
1 ounce. 

4 ounces. 


Magnetic Liniment. 


Tinct. Cantharides, 

2 drachms. 

Oil Origanum, 

1 ounce. 

Mur. Ammonia, 

2 drachms. 

Sulph. Ether, 

1 ounce. 

Alcohol, 

1 pint. 

German Liniment. 

Oil Origanum, 

1 ounce. 

Oil Sassafras, 

Gum Camphor, 

1 ounce. 

X ounce. 

Granville’s Lotion, 

3 drachms. 

Chloroform, 

3X drachms. 

Tinct. Aconite, 

X ounce. 

Tinct. Capsicum, 

X ounce. 

Camp. Soap Liniment, 

1 ounce. 

Alcohol, 

X gallon. 

Chapman’s Liniment. 

Balsam Fir, 

1 ounce. 

Oil Sassafras, 

IX ounces. 

Oil Hemlock, 

X ounce. 

Oil Cedar, 

X ounce. 

Sweet Spts. Nitre, 

1 ounce. 

Tinct. Guaiac, 

1 ounce. 

Sulph. Ether, 

1 ounce. 

Oil Winter-Green, 

2 ounces. 

Gum Camphor, 

X. ounce. 

Chloroform, 

1 ounce. 

Tinct. Capsicum, 

2 ounces. 

Oil Origanum, 

X ounce. 

Oil Turpentine, 

2 drachms. 

Oil Wormwood, 

X ounce. 

FI. Ext. Hydrastis, 

X ounce. 

Alcohol, 

X gallon. 





1600 


APPENDIX. 


Great African Wonder. 


Alcohol, 

4 pints. 

Tinct. Myrrh, 

1 

ounce. 

Oil Sassafras, 

ounces. 

Tinct. Capsicum, 

1 

ounce. 

Oil Origanum, 

3X ounces. 

Sweet Spts. Nitre, 

1 

ounce. 

Spts. Camphor, 

3)^ ounces. 

Sulph. Ether, 

1 

ounce. 

Tinct. Opium, 

2 ounces. 

Chloroform, 

X 

ounce. 

Chloroform, 

2 ounces. 

Tinct. Arnica, 

Oil Spearmint, 

1 

ounce. 

Turpentine, 

2 ounces. 

2 

drachms. 

Vinegar, 

2 ounces. 

Oil Winter-Green, 

2 

drachms.- 


Arnica Liniment. 


Tinct. Arnica, 

Oil of Sassafras, 

Oil of Turpentine, 

Oil of Origanum, 
Alcohol, Q. S. for 1 pint. 


8 ounces. 
% ounce. 

% ounce. 

2 drachms. 


Pain Relief Liniment. 


Oil Cajeput, 

Oil Sassafras, 

Oil Origanum, 

Oil Hemlock, 

Oil Cedar, 

Powdered Capsicum, 
Alcohol, Q. S. for 1 pint. 


2 drachms. 

3^ ounce. 

1 drachm. 
1 drachm. 
1 drachm. 
80 grains. 


Nerve and Rone Liniment. 


Oil Origanum, 
Oil Rosemary, 
Oil Amber, 

Oil Hemlock, 
Turpentine, 
Oil Linseed, 


}■ of each, 4 ounces. 


4 pints. 
6 pints. 


Coolt’s Electro-Magnetic Liniment. 


Alcohol, 

Oil Amber, 

Gum Camphor, 
Castile Soap (fine), 
Beef’s Gall, 

Aqua Ammonia, 


1 gallon. 
8 ounces. 
8 ounces. 

2 ounces. 
4 ounces. 

12 ounces. 


St. Jacobs’ Oil. 


Gum Camphor, 

1 ounce. 

Chloral Hydrate, 

1 ounce. 

Chloroform, 

1 ounce. 

Sulph. Ether, 

1 ounce. 

Tinct. Opium, 

X ounce. 

Oil Origanum, 

% ounce. 

Oil Sassafras, 

3 4 ounce. 

Alcohol, 

X gallon. 


Hamlin’s Wizard Oil. 


Tinct. Camphor, 
Aqua Ammonia, 
Oil Sassafras, 

Oil Cloves, 
Chloroform, 
Turpentine, 
Alcohol, 


1 ounce. 
yi ounce. 

}4 ounce. 

1 drachm. 

2 drachms. 
1 drachm. 
3 % ounces. 


California Liniment. 


Oil Lobelia, 
Aqua Ammonia, 
Alcohol, 


1 drachm. 
K ounce. 

1 quart. 


Favorite Liniment. 


Black Oil, 
Alcohol, 

Tinct. Arnica, 
British Oil, 

Oil of Tar, 


2 ounces. 

3 ounces. 
2 ounces. 
2 ounces. 
1 ounce. 


Rlaek Oil Liniment. 


Sulph. Acid, 

Nitric Acid, 

Quicksilver, 

2 ounces. 
1 ounce. 

% ounce. 

Opodeldoc Liniment. 

Alcohol, 

1 quart. 

Gum Camphor, 

1 ounce. 

Sal. Ammoniac, 

ounce. 

Oil of Wormwood, 

% ounce. 

Oil Origanum, 

3£ ounce. 

Oil Rosemary, 

3£ ounce. 

Soft Soap 

6 ounces. 

Pride of India 

Liniment. 

Oil Lini, 

Gum Camphor, 

)4 gallon. 

4 ounces. 

Oil Sassafras, 

2 ounces. 

Spirits Nitre, 

2 ounces. 

Alcohol, 

1 pint. 

Oil of Spike, 

Petroleum Barbadoes, 

4 ounces. 

Spts. Turpentine, 

4 ounces. 

Oil Linseed, 

1 pint. 


Oil Seneca, 4 ounces. 

Perry Davis’s Pain Killer. 


Spts. Camphor, 
Tinct. Capsicum, 
Tinct. Guaiac, 
Tinct. Myrrh, 
Alcohol, 


2 ounces. 
1 ounce, 
ounce. 
3^ ounce. 
4 ounces. 


Great London Liniment. 

Chloroform, 

Olive Oil, 

Aqua Ammonia, 

Acetate of Morphia. 



FAT ENT MEDICINES AND NOSTRUMS. 


1001 


OINTMENTS. 


Trask’* Magnetic Ointment. 

Lard, ) 

Raisins, . > each, equal parts. 

Fine Cut Tobacco, ) 


Seeley’s Pile Ointment. 


Sulph. Morphia, 
Tannin, 

Pine Tar, 

White Wax, 
Benzoated Lard, 


3 grains. 
48 grains. 
72 grains. 
72 grains, 
766 grains. 


Black Salve. 


Olive-Oil, 

32 

ounces. 

Resin (clear), 

1 

ounce. 

Beeswax, 

1 

ounce. 

Venice Turpentine, 

14 ounce. 

Red Lead, 

6 

ounces. 

Gum Camphor (powdered), 

K ounce. 

Petit’s Eye Salve. 


White Precipitate, 

1}4 ounces. 

Oxide Zinc, 

2 

ounces. 

Benzoic Acid, 

1 

drachm. 

Sulph. Morphia, 

24 

grains. 

Oil Rosemary, 

10 

drops. 

Oil-Olive, 

16 

ounces. 

Spermaceti, 

6 

ounces. 

White Wax, 

2 

ounces. 


Ointment of Iodoform. 

Iodoform, 1 drachm. 

Balsam Peru, 1 drachm. 

Vaseline, I ounce. 


Sanative Ointment. 


Mutton Suet, 

Oil of Sesame, 

Oil of Origanum, 
Camphor, 

Resin, 

Yellow Wax, 
Borax, Powd., 
Glycerine, 


16 ounces. 
5 ounces. 

1 ounce. 

2 ounces. 
2 ounces. 
2 ounces. 

)4 ounce. 
}4 ounce 


Green Mountain Salve. 


Resin, 5 pounds. 

Burgundy Pitch, ) 

Beeswax, > of each, % pound. 

Mutton Tallow, ) 

Oil of Hemlock, 1 

Balsam Fir, 

Oil Origanum, )- of each, 1 ounce. 

Oil Red Cedar, 

Venice Turpentine, J 

Oil Wormwood, % ounce. 

Verdigris (pulverized), 1 ounce. 


Compound Oxygen. —Probably one of the most successful of recent 
fraudulent nostrums is that known as “ Compound Oxygen.” We have 
so often met persons who had spent large sums of money for this worth¬ 
less stuff without being in the slightest degree benefited, that wo have 
felt it to be a duty we owed our fellow-men to investigate the matter 
thoroughly, and publish the results. We accordingly obtained fresh 
samples of “ Compound Oxygen ” and “ Oxygen Aquse ” which had just 
been received from the manufacturers in Philadelphia, and sent them for 
analysis to Prof. A. B. Prescott, M. D., professor of chemistry in the 
University of Michigan, which possesses one of the largest and most 
complete chemical laboratories in the country and probably in the world. 
After subjecting the compound oxygen, so-called, to a careful analysis, 
Prof. Prescott reported to us as follows:— 

“ A solution of nitrate of ammonium and nitrate of lead in water, in 
not far from equal proportions, and together forming just three per cent 
of the liquid.” 

It should be recollected that this solution is to be used by inhalation, 
a teaspoonful being added to a small quantity of warm water through 
which air is drawn by means of a glass tube. Neither of the sub¬ 
stances contained in the solution are volatile at the temperature at Avhich 
the solution is used, so that it is impossible for any medicinal property 

101 




1602 


APPENDIX. 


whatever to bo imparted by this boasted remedy, except what comes 
from the warm water, which is itself very healing when used in this way, 
as we have demonstrated in hundreds of cases. Prof. Prescott also tested 
the vapor given off from the pure solution when it was boiled, but found 
nothing more than the vapor of water. 

The “ Compound Oxygen ” is usually accompanied by what the man¬ 
ufacturers are pleased to call “Oxygen Aquae,” w T hich they recommend 
their patients to take as an aid to digestion. The analysis of this 
showed it to contain nothing but water. The most careful tests re¬ 
vealed nothing else. 

The following description of a number of popular nostrums we quote, 
with the authorities, from The Popular Health Almanac for 1876 and 
1877; as will be seen, many of them are dangerous and unfit for the pur¬ 
poses for which they are recommended :— 

Mrs. Winslow’s Soothing Syrup comes in vials containing 1% fluid ounces; it consists 
of sugar syrup strongly flavored with an alcoholic tincture of fennel—anise—and a little 
caraway-seed, or an alcoholic solution of their essential oils, and with or without an admixt¬ 
ure of solution of sulphate of morphine in various quantities. While recently it has been 
found not always to contain morphine, at times as much as one-half of a grain and more 
has been found contained in each fluid ounce of the syrup, as often reported in the course 
of years in medical and pharmaceutical journals. In regard to the dangers of this nostrifm, 
which conceals morphine under a legitimate designation, and offers it for administration to 
infants, a medical writer in the Pacific Medical and Surgical Journal , April 18, 1872, re¬ 
marks: “ It would be scarcely possible to estimate the number of children which it sends 
to the grave before they reach their second year. Another still graver question is: How 
much of the physical disease, drunkenness, degradation, and vice, and how many of the 
weakened intellects are due to the use of the soothing syrup in infancy? ” 

John Hill’s Pectoral Balsam of Honey. —Each bottle holds 1 fluid ounces of a brown 
liquid consisting of a tincture of 9 parts by weight of balsam Tolu, 2 parts of prepared bal¬ 
sam of storax, and 1 part of opium in 300 fluid parts of strong alcohol, sweetened with 80 
parts of clarified honey.— Hager. 

Halbv’s Carminative. —Each bottle contains 1% fluid ounces of a whitish turbid liquid 
consisting of ^ fluid ounce of strong alcohol, 1 drop oil of anise-seed, 10 drops of tincture 
of asafetida, a few drops of compound tincture of cardamom, and 10 drops of tincture of 
opium; which mixture, when prepared, is added to a solution of 10 grains of bicarbonate 
of potash and 14 ounce of sugar in 1 fluid ounce of peppermint water, or instead of the lat¬ 
ter, in 1 fluid ounce of water intimately mixed with 1 or 2 grains of carbonate of magnesia 
and one drop of oil of peppermint.— Hoffmann. 

Walker’s California Vegetable Vinegar Bitters. —Each bottle contains 19 to 20 fluid 

ounces consisting of a decoction of aloes and a small quantity of gum guaiac, anise-seed, 
and sassafras bark, in water slightly acidulated with acetic acid, or by subsequent fermenta¬ 
tion, or by the use or addition of sour cider; to this are added about 1 ounce of sulphate 
of soda, H ounce of gum arabic, and }4 to 1 fluid ounce of alcohol.— Eberbach. Hoffmann. 
Nichols. 

“This ‘Bitters’ is one of the nastiest nostrums, introduced and largely sold by the 
most extensive and brazen advertising under the false pretense of being free from alcohol. 
It originated with the cook of a party which traveled overland as a mining company to Cal¬ 
ifornia in 1849, he settled in Calaveras county, and having no success as a miner, he 
turned his attention to the bitter qualities of the herbs growing about him, and came to 
San Francisco with the idea of making and vending a nostrum to be called ‘ Indian Vegeta¬ 
ble Bitters.’ He fell in with an enterprising druggist, who saw money in the project, and 
joined him. At the suggestion of the latter, the ‘ Indian ’ was struck out, and as the con¬ 
coction got 60 ur by fermentation, it was concluded to call it ‘ Vinegar Bitters,’ and to iden- 


PATENT MEDICINES AND NOSTRUMS. 


1603 


tify it with the temperance movement. The na ve herbs which became rather troublesome 
to collect, were discarded, and aloes, being a cheap bitter, was substituted. ‘ Nine sick peo¬ 
ple out of ten,’ said the druggist, ‘will be cured by purging.’ Wherefore the aloes and 
Glauber’s-salt. So the cook turned doctor, the decoction became sour and of Californian 
instead of Indian paternity, and ‘Doctor Walker’s Vinegar Bitters’ began their career in 
the newspapers and on the shelves of the drug-stores.” (From Dr. Gibbon’s address before 
the annual meeting of the California State Medical Society. Pacific Medical and Surgical 
Journal , 1874; and “Third Annual Report of the Board of Health of the City of Boston,” 
1875.) 

[At the present time this wretched preparation is said to be made of sour beer and 
aloes. A specimen which we examined some three years ago (1882), we found to contain 
5 <fo of alcohol.] 

Brandrcth’s Pills. —Each box contains 24 or 25 pills, each weighing about 2X grains. 
The 24 pills consist of 10 grains of the root of May-apple, 10 grains of the extract of the 
same, 30 grains of the extract of poke-berries, 10 grains of powdered cloves, 2 to 5 grains 
of gamboge, traces of Spanish saffron, and a few drops of oil of peppermint.— Hager. 

Ayer’s Cathartic Pills. —Each box contains 30 sugar-coated pills, each weighing nearly 
4 grains, and consisting of aloes, compound extract of colocynth, gamboge, Spanish pepper, 
and oil of peppermint.— Hager. Hoffmann. 

Rad way’s Ready Relief. —2X fluid ounces (in a 50 ct. bottle) of a light brown liquif 
consisting of 2 ounces of soap liniment, 2 drachms alcoholic tincture of Spanish pepper, ant 

2 drachms of strong aqua ammonia (hartshorn).— Hager. Peckolk. Hoffmann. 

Radway’s Renovating Resolvant. —About 6 fluid ounces of a vinous tincture of cards 
mom and ginger sweetened with sugar.— Hager. 

Pierce's Golden Medical Discovery. —7 fluid ounces of a dark brown liquid consisting oi 
a solution of 1 drachm extract of lettuce, 1 ounce of honey, % drachm tincture of opium in 

3 ounces of dilute alcohol, and 3 ounces of water.— Hager. 

Pierce’s Favorite Prescription.—10 fluid ounces of a greenish-brown turbid liquid con 
sisting of a solution of X ounce of sugar and 1 drachm of gum arabic in 8 ounces of a de¬ 
coction made from 2 drachms of savine, 2 drachms of white agaric, 1 % drachms of cinna¬ 
mon, and 2 drachms of cinchona bark; to this mixture are added X drachm of tincture of 
opium, and % drachm of tincture of fox-glove, and a solution of 8 drops of oil of anise-seed 
in 1)^ ounces of alcohol.— Hager. 

Sage’s Catarrh Remedy.— Half an ounce of a green powder consisting of 200 grains of 
finely powdered common salt mixed with 8 to 12 grains of powdered camphor, the same 
quantity of carbolic acid, and colored with a mixture of 20 grains finely powdered yellow 
Puccoon root with 2 grains of indigo.— Bowen. 

Hamburg Tea. —Each package, weighing about 2 ounces, consists of 1 ounce of senna 
leaves, % ounce of manna, l /± ounce of bruised coriander fruit, and % ounce of powdered 
cream tartar, or tartaric acid.— Hager. 

Van Bnskirk’s Fragrant Sozodont. —Each vial contains nearly 2 fluid ounces of a red 
liquid consisting of a filtered solution of X drachm white Castile soap in 1 ounce of strong 
alcohol, % ounce of water, and H ounce of glycerine, colored with cochineal and flavored 
with the oils of peppermint, cloves, and winter-green. 

The powder which accompanies each bottle consists of a mixture of precipitated chalk, 
powdered orris-root, and carbonate of magnesia.— Wittstein. Hoffmann. 

Tarrant’s Effervescent Seltzer Aperient consists of a mixture of powdered sugar, Epson 
salt, bicarbonates of soda and potash, and tartaric acid.— W. Schrage. 1875. 

Billing and Clapp’s Cineho-Qninine is an arbitrary mixture of the four principal cinchom 
alkaloids; its therapeutical value is fully represented by mixing 94 parts of sulphate o\ 
cinchonine with about 2 parts each of sulphates of quinine, quinidine, and cinchonidine. 
This nostrum, therefore, is not an alkaloidal representation of cinchona bark.— Ebert. 1874- 
Scheffer. Diehl. 1875. 

R. V. Pierce’s Pleasant Purgative Pellets. —Each little bottle contains 28 to 36 small 
sugar-coated pills of unequal size, and weighing in all 18 to 22 grains. Their cathartic effect 
is solely due to podophyllin, the resin of the root of the May-apple.— Lyons. Hofi'mann. 
Polenske. 1876. 


1604 


APPENDIX. 


Ayer’s Affne Cure.— Each bottie contains six ounces of a dark red syrupy liquid, with a 
slight white sediment, a very bitter taste, and an odor of winter-green oil. It consists of an 
alcoholic tincture of cinchona bark, with the addition of about three grains of quinoidine 
and three grains of sulphate of cinchonine for each fluid ounce, dissolved by the aid of sul¬ 
phuric acid; it is sweetened with sugar and flavored with oil of winter-green. The white 
sediment consists of sulphate of lime.— 0. L. Churchill. 1876. 

Jayne’s Agne Mixtnre. —Each bottle contains 7% fluid ounces of a mixture having the 
odor and taste of rhubarb, dandelion, and common molasses. It contains sulphate of 
quinine and traces of other cinchona alkaloids, but not enough to render the mixture very 
bitter.— 0. L. Churchill. 1876. 

Rhode’s Fever and Agne Core, or Antidote to Malaria. —Each bottle contains 12 fluid 
ounces of a black turbid liquid, having a sweet and astringent taste. The sediment, filling 
about one-third of the bottle after standing, is powdered animal charcoal, while the solution 
is nothing but sweetened water with a little tincture of chloride of iron, with the addition 
of a little sulphate of iron (copperas).— 0. L. Churchill. 1876, 

Wilhoft’s Antiperiodic Fever and Agne Cnre. —Each bottle contains four fluid ounces of 
a thin, dark-red liquid, with the odor of cinchona bark, and a very bitter and acid taste. It 
consists of an infusion of cinchona bark made with water, and the addition of a solution of 
sulphate of quinine in aromatic sulphuric acid. Each fluid ounce contains 3 grains of sul¬ 
phate of quinine.— 0. L. Churchill. 1876. 

Christie’s Ague Mixture. —Each bottle contains 7 fluid ounces of a very dark, syrupy 
liquid, one-fourth filled with sediment, and having a very bitter and peppery taste and the 
odor of common molasses. The sediment is powdered Spanish pepper and a little resinous 
matter. The solution consists of a tincture of cinchona bark with the addition of sulphate 
of cinchonine and common molasses.— 0. L. Churchill. 1876. 

D, C. Frese and Co.’s Imported (?) Hamburg Tea consists of a mixture of broken senna 
leaves and remnants (leaf-stalks, stones, dust, etc.) from fanning and sifting partially infe¬ 
rior grades of commercial senna, coarsely powdered coriander fruits, and manna intimately 
mixed with tartaric acid. The quantities of these ingredients in each package are, approx¬ 
imately: leaves, stalks, and dust of senna, together 10 drachms, coriander fruits 
drachms, manna 1% drachms, tartaric acid 8 to 12 grains.— Hoffmann. 1876. 

Radway’s Regulating Pills. —Each box contains 29 to 31 sugar-coated pills of unequal 
size. They consist of 30 grains of aloes, 15 grains of jalap, 8 grains of gamboge, and of 
some inert substance.— Hager. 1876. 

Morison’s Pills. —Each pill weighs 2% grains; they consist of equal parts of aloes, colo- 
cynth, and cream-of-tartar; those in boxes marked No. 2 contain, besides these ingredients, 
gamboge.— L. Buchner. 

Dehaut’s Purgative Pills (French) consist of scammony resin, powdered rhubarb-root, 
and the extracts of colocynth and dandelion root. They are coated with red-colored sugar. 
—Hager. Jacobsen. 

Blancard’s Pills ( Pilules de Blancard , Paris) consist of iodide of iron, honey, and the 
powders of liquorice roots and marsh mallow roots. They are covered with powdered iron, 
and coated with balsam of Tolu. Each pill contains about grain of iodide of iron.— Lan- 
derer. 

Franc’s Life Pills ( Grains de sante or Crains de vie du docteur Frank). —Each box 
contains about 50 two-grain pills, covered with silver-foil, and consisting of four parts, by 
weight, of aloes, and one part of gamboge.— Witt stein. 

Papier Fayard-Blayn. —A French Paper for Rheumatism, etc., consists of nothing but 
a strip of strong silk paper, 16 by 10% inches, saturated with overheated, dark brown lead 
plaster. — Hager. 

John F. Henry’s Carbolic Healing Salve. —Each tin can cantains about half an ounce of 
a whitish ointment, consisting of about half an ounce of simple cerate, five grains of car¬ 
bolic acid, and 2 drops each of oil of bergamot and lavender.— Hager. Jacobsen. 


PATENT MEDICINES AND NOSTRUMS. 


1005 


Ronrke’s Iodine Liniment and Wm. (die’s Liniment of Iodide of Ammonia —the lat¬ 
ter being an imitation or rather a new edition of the former—consist of a solution of 15 
grains of iodine, 2 drachms of camphor, and 1 drachm each of the oils of lavender and rose¬ 
mary, in half a pint of alcohol and 1 ounce of strong hartshorn (ammonia water).— Drug¬ 
gist's Circular. 1S75. 

Tobias’s Venetian Liniment. —Each bottle contains a little less than two fluid ounces of 
a light-brown liniment, consisting of a mixture of one ounce of spirits of camphor, X ounce 
of weak ammonia water, and 1 drachms of tincture of Spanish pepper.— Scliaedler. 

Medicated Pads. —The sale of the various sorts of liver, lung, stomach, 
and other kinds of pads has been one of the most successful of the nu¬ 
merous frauds perpetrated upon the gullible portion of the people. Car¬ 
loads of these worthless remedies have been sold in some States for “ ab¬ 
sorbing malaria out of the system.” It is scarce! } r conceivable that any 
appreciable medicinal benefit is produced by the wearing of these pre¬ 
cious bags, and we should not by any means wish to have our reference 
to them here construed to mean anything like approval of their use. 
The following are a few of t he most popular:— 


Anti-Constipation Pad. 

Mandrake Root. 

Aloes (powd.), 

Ex. Colocynth Comp, (powd.), 
Croton Oil, 

Oil Sassafras, 

Black Root, 

Lad-y’s-Slipper. 

Day’s Kidney Pad. 
Black Cohosh, 

Gum Benzoin (powd.), 

Gum Guaiacum (powd.), . 

Juniper Berries, 

Queen of the Meadow, 

Digitalis Leaves, 

Oil Juniper. 

French Uterine Pad. 

Blue Cohosh, 

Gum Guaiac (powder), 
Witch-Hazel Bark, 

Ergot, 

Cinchona Bark, 

Angelica Root, 

Oil Tansy, 

Oil Stillingia, 

Oil Lobelia, 

Oil Lavender, 

Oil Eucalyptus. 

Stomach Pad. 

Bayberry, 

Lupuline, 

Wild Ginger, 

Sassafras Bark, 

Gum Myrrh, 

Lady’s-Slipper, 

Capsicum, 

Oil Fennel, 

Oil Cloves. 


Lung Pad. 

Grindelia Robusta, 

Scull Cap Leaves, 

Blueberry Root, 

Blood Root, 

Yerba Santa, 

Gum Ammoniac, 

White Pine Turpentine Gum, 

Oil of Tar, 

Oil of Eucalyptus, 

Oil of Sassafras. 

Head Pad. 

Lupuline, 

Lady’s-Slipper, 

Battle’s Bromidia, 

Fluid Ext. Jamaica Dogwood, 
Angelica Root, 

Oil Eucalyptus. 

Liver Pad. 
Mandrake Root, 

Bayberry Bark, 

Black Root, 

Red Cinchona Bark, 

Gum Guaiac (powder), 

Fenugreek Seed (powder), 

Oil Eucalyptus. 

Catarrh and Croup Pad* 
Lobelia (herb), 

Tartar Emetic, 

Blood Root, 

Blue Cohosh, 

Yellow Peruvian Bark, 

Pleurisy Root, 

Gum Myrrh, 

Oil Stillingia, 

Oil Cajeput, 

Oil Cinnamon, 

Oil Lavender. 



I 


1606 


APPENDIX. 


Artificial Essences and Extracts.— It is not generally known, us it 
should be, that nearly all the essences made are wholly innocent of any 
admixture of the real fruit from which they are named. The following 
is believed to be a correct representation of the composition of some of 
the essences most commonly used with soda-water, etc.:— 


Essence of (Juince. 

Pelargonic Ether, 

Alcohol, 95 per cent, 

Water, 

Color yellow. 

Essence of Apple. 

Acetate of Oxide Amyl, 
Valerianate of Ammonia, 

Cologne Spirits, 

Water. 

Essence of Banana. 

Acetate of Oxide Amyl, 

Alcohol, 

Water. 

Peaeli Extract. 

Alcohol, 

Concentrated Nectarine Ether, 
Concentrated Pine-Apple Ether, 
Oil of Orange (Portugal), 

Warm Water, 

Glycerine. 

Pine-Apple Extract. 

Butyric Ether, 

Ext. Lemon, 

Tinct. Orange Peel (sweet), 
Alcohol, 

Color lightly with Caramel. 


Essence of Pear. 

Acetate Oxide of Amyl, 

Acetic Ether, 

Alcohol, 95 per cent, 

Water. 

Sarsaparilla Extract. 

Alcohol, 

Oil of Sassafras, 

Oil of Winter-Green, 

Warm Water. 

Extract of Vanilla. 

Balsam Peru, 

Oil Orange, 

Extract Orris, 

Tonka Beans (coarse powder), 
Tinct. Castor, 

Cologne Spirits, 

Carb. Magnesia, 

Water. 

Extract of Apricot. 

Glycerine, 

Chloroform, 

Butyrate of Ethyl, 

Valerianate Ethyl, 

Oenanthylate Ethyl, 

Salicylate of Methyl, 

Butyrate of Amyl, 

Alcohol, 

Color lightly with Caramel. 


Mineral Waters. —Most people, in drinking mineral water's, imagine 
that they are imbibing a fluid which in the hidden recesses of the earth 
has acquired some mysterious curative properties, connected with its 
unpleasant flavor, never once suspecting that in all probability the water 
was taken from some well or river in their own town, rather than from 
the distant or foreign spring, to which has been added a few chemicals, 
the nature of w T hich the chemist has discovered by careful analyses of the 
various natural mineral waters. We do not wish to intimate that the 
artificial mineral waters are not equally as good as the original. Since 
they contain all the active ingredients of those which they imitate, we 
can see no reason why they may not be equally as good as the original, 
and, indeed, in some instances they may be even better; but we have 
very little to say in commendation of either one. The following are the 
formulae said to be used by the manufacturers of mineral waters:— 



PATENT MEDICINES AND NOSTRUMS. 


1607 


Hunyadi Janos Water. 


Sulphate of Lime, 
Glauber Salts, 
Epsom Salt, 
Sulphate of Potassa, 
Water, 


1 H ounces, 
24 ounces. 
26 ounces. 

1 drachm. 
10 gallons. 


Seltzer Water. 


Bi Carbonate of Soda, 
Carbonate of Magnesia, 
Marble Dust, 

Muriatic Acid (C. P.), 
Water, 


5^ ounces. 

7 drachms. 
)4 ounce. 
5% ounces. 
10 gallons. 


Kissingen Water. 

Bi-Carbonate of Soda, 1 drachm. 
Carbonate of Lime, 2 drachms-|-2 
Precipitate Carb. Iron, 2 scruples. 


Phosphate Lime, 
Phosphate Soda, 
Sulphate Magnesia, 
Sulphate Soda, 
Muriate Ammonia, 
Common Salt, 


2 drachms-)-2 
13 grains. 

2 ounces. 

2 drachms-|-2 
4 grains. 

8 ounces. 


scru. 

scru. 


scru. 


Vicliy Water. 


Carbonate of Ammonia, 
Bi-Carbonate of Soda, 
Common Salt, 
Phosphate o. Soda, 
Sulphate of Soda, 
Sulphate of Potassa, 


10 grains. 
5% ounces. 

6 drachms. 
25 grains. 

4 scruples. 
2 drachms. 


Carlsbad Water. 


Sulphate of Soda, 100 grains. 

Carbonate of Soda, 25 grains. 

Sulphate of Magnesia, 15 grains. 

Chloride of Sodium, 16 grains. 

Chloride of Calcium, 15 grains. 

Tartrate of Iron and Potassa, 10 grains. 

Water, 10 gallons. 

Congress Water. 


Calcined Magnesia, 
Bi-Carbonate Soda, 
Hydrate of Soda, 
Common Salt, 


1 ounce. 
20 grains. 
23 grains, 
ounces. 


Artificial Wines, Whiskies, Bitters, etc. —Those who make use of these 
unwholesome substances, possess little knowledge of their constituents. 
Nearly all are very largely adulterated in the case of wines and liquors, 
and the bitters are rarely composed of anything which will be at all 
likely to do a person any real good. 


To Neutralize Whisky. 

Whisky, 

Unslacked Lime, 

Alum (powdered), 

Spirits of Nitre. 

Irish or Scotch Wliisky. 

Proof or Neutral Spirits, 

Creosote, dissolved in 1 pint of Alcohol, 
Acetic Acid, 

Loaf Sugar. 

Old Bourbon Whisky. 

Proof Spirits, 

Good Bourbon Whisky, 

Spirits of Nitre, 

Fusel-Oil (from Corn), cut in 1 qt. Alcohol. 

Koclielle, or Bordeaux Whisky. 


Proof Spirits. 

Oil Cognac, 
White Sugar, 
QEnanthic Ether, 
Acetic Ether, 
Tinct. Kino. 


Peach Brandy. 


Proof or Neutral Spirits, 
Peach Brandy (pure), 
Bitter Almonds (crushed), 
Loaf Sugar, Powd., 


40 gallons. 

3 gallons. 
1 pound. 

4 pounds. 


Brandy. 

Neutral, or Pure Spirits, 
Crude Tartar dissolved ) 
in Hot Water, j 

Jamaica Rum, 

Raisins (bruised), 

Tinct. Kino, 

Color with Sugar Coloring. 


40 gallons. 
10 ounces. 

2 gallons. 
4 pounds. 

3 ounces. 


Holland Gin. 


Proof or Neutral Spirits, 40 gallons. 

Spirits Nitre, 2 ounces. 

Loaf Sugar, 4 pounds. 

Oil Juniper, 1 oz., ) opt in Al- 

Oil Caraway, % oz., ) cohol 1 qt. 

Gin. 


Pure Spirits, 

40 gallons. 

Best Gin, 

5 gallons. 

Juniper Berries, 

2 pounds. 

Sweet Fennel Seed, 

% ounce. 

Spirits Nitre, 

2 ounces. 

Loaf Sugar, 

1 pound. 

Alcohol, 

K gallon. 

Prepared 

Cider. 

Pure Cider, Sweet, 

40 gallons. 

Pure Spirits, 

3 gallons. 

Sugar or Syrup, 

3 pounds. 

Crude Tartar, 

% pound. 




1608 


APPENDIX. 


Mad«ria Wine. 


Prepared Cider, 

40 gallons. 

Tartaric Acid, 

pound. 

Alcohol, 

4 gallons. 

Loaf Sugar, 

3 pounds. 

Malaga Wine. 

Prepared Cider, 

40 gallons. 

Water, 

5 gallons. 

N. 0. Sugar 

16 pounds. 

Alcohol, 

4 gallons. 

Sliorry Wine. 

Prepared Cider, 

40 gallons. 

Essence Bitter Almonds, % pint. 

Loaf Sugar, 

4 pounds. 

Cheap Cape Wine, 

8 gallons. 

Tinct. Kino, 

2 ounces. 

Claret Wine. 

Prepared Cider, 

40 gallons. 

Water, 

5 gallons. 

The Juice of 

40 lemons. 

Sugar, 

2 pounds. 

Cream of Tartar, 

4 ounces. 

Pure Spirits, 

3 gallons. 

Port 

Wine. 

Prepared Cider, 

40 gallons. 

Proof Spirits, 

5 gallons. 

Wild Grapes, 

10 quarts. 

Rhatany Bark (bruised), 1 pound. 

Loaf Sugar, 

3 pounds. 

Tinct. Kino, 

4 ounces. 

Stoughton Bitters. 

Orange Peel, 

(ground) 6 ounces. 

Gentian Root, 

“ 8 ounces. 

Virginia Snake Root, 

“ 1)4 ounces. 

American Saffron, 

“ )4 ounce. 

Red Saunders, 

“ X ounce. 

Alcohol, 

4 pints. 

Water, 

4 pints. 


MISCE 

Godfrey’s Cordial. 

Tinct. Opium, 


Molasses, 


Alcohol, 


Water, 


Carb. Potassa, 


Oil Sassafras. 


Mother’s Cordial. 


Partridge-berry (herb), 
Hclonias, 

Blue Cohosh, 

High Cranberry (bark), 
Water, 

Brandy, 

Sugar. 


German Bitters. 

German Chamomile, 

Sweet Flag, 

Orris Root, 

Coriander Seed, 

Centaury, 

Orange Peel, 

Alcohol, 

Water, 

Sugar, 


2 ounces. 

2 ounces. 
4 ounces. 

1^ ounces. 
1 ounce. 

3 ounces. 

4 pints. 

4 pints. 

4 ounces. 

Stomach Bitters. 


Gentian Root, 

(ground) \}4 ounces. 

Cinchona Bark, 

U 

% ounce. 

Orange Peel, 

it 

2)4 ounces. 

Cinnamon Cort., 

u 

)4 ounce. 

Anise Seed, 

u 

ounce. 

Coriander Seed, 

a 

)4 ounce. 

Cardamom Seed, 

’1 “ 

% ounce. 

Gum Kino, 


% ounce. 

Alcohol, 


1 pint. 

Water, 


4 quarts. 

Sugar, 


1 pound. 


Oil Wormwood, 

Oil Melisa, 

Oil Anise, 

Oil Star Anise, 

Oil Fennel, 

Oil Coriander, 
Alcohol, 

Water, 

Hop 

Hops, 

Orange Peel, 

Cardamom, 

Cinnamon. 

Cloves, 

Alcohol, 

Sherry Wine, 
Simple Syrup, 
Water, sufficient. 


French Absinthe. 

1 drachm. 
15 drops. 
2% drachms. 
2j/£ drachms. 
% dracbm. 
3 drops. 

14 pints. 

6 pints. 


Bitters. 

4 ounces. 

2 ounces. 

2 drachms. 

1 drachm. 
% drachm. 

8 ounces. 

2 pints. 

1 pint. 


Elixir of Iafa. 

Powdered Rhubarb, 

Powdered Ginger, 

Powdered Aloes, 

Powdered Gum Myrrh, 

Powdered Cayenne, 

Powdered Saffron, 

Powdered Sassafras Bark, 
Powdered Golden Seal Root, 
Brandy or Whisky. 

Tropic Fruit Laxativa. 

Powd. Senna Leaves, 

Powd. Anise Seed, 

Tamarinds (pulp), 

Molasses. 





PATENT MEDICINES AND NOSTRUMS. 


1609 


Incense Powder. 

Ground Gum Benzoin, % pound. 

Ground Cascarilla Bark, % pound. 

Ground Sandal-wood, % pound. 

Powdered Nitrate of Potassa, 1 ounce. 
Grain Musk, 10 grains. 

English Curry Powder. 

Powdered Coriander Seed, 

Powdered Allspice, 

Powdered Mace, 

Powdered Caraway, 

Powdered Fennel, 

Powdered Celery Seed, 

Powdered Tumeric, 

Ground Capsicum, 

Ground Mustard, 

Ground Ginger, 

Table Salt. 

Butter Color. 

Annatto, of good quality, 

Caustic Soda, or Potassa, 

Borax, powdered, 

Tincture of Tumeric, 

Water. 

Haarlem Oil. 

Balsam of Sulphur, 

Barbadoes Tar, 

Crude Oil of Amber, 

Oil of Turpentine, 

Linseed Oil. 

Smith’s Electric Oil. 

Linseed Oil, 

Olive Oil, 

Sassafras Oil, 

Chloroform. 

Trix, or Jokes. 

Puwd. Extract Liquorice, 

Oil of Cloves, 

Oil of Cinnamon. 

Brown’s Bronchial Troches. 

Pulv. White Sugar, 

Pulv. Extract of Liquorice, 

Pulv. Cubebs, 

Pulv. Acacia, , 

Fluid Extract Conium. 

Chlorodyne. 

Purified Chloroform, 

Stronger Ether, 

Stronger Alcohol, 

Molasses, 

Powdered Ext. Liquorice, 

Muriate of Morphia, 

Oil of Peppermint, 

Simple Syrup, 

Hydrocyanic Acid. 


Jayne’s Expectorant. 

Syrup Squills, 

Tiuct. Tolu, 

Tinct. Camphor, 

Tiuct. Lobelia, 

Tinct. Digitalis, 

Tinct. Opium, 

Wine Ipecac, 

Antimon. Tart. 

Coe’s Dyspepsia Cure. 

Fluid Extract Yellow Root, 

Fluid Extract Wild Cherry, 
Bi-Carbonate Soda, 

Essence Peppermint, 

Simple Syrup. 

August Flower. 

Rhubarb, 

Golden Seal, 

Cape Aloes, 

Peppermint Leaves, 

Carbonate of Potassa, 

Capsicum, 

Sugar, 

Alcohol, 

W ater, 

Ess. Peppermint. 

Piso’s Consumption Cure. 

Tincture of Tolu, 

Fluid Extract Lobelia, 

Fluid Ext. of Cannabis Indica, 
Sulphate of Morphia 
Tartar Emetic, 

Chloroform, 

Ess. Spearmint, 

Hot Water, 

Sugar. 

Bromidia. 

Bromide of Potassa, 

Chloral Hydrate, 

Solid Extract Hyoscyamus, 

Solid Ext. Cannabis Indica, 

Alcohol, 

Soft Water. 

German Syrup. 

Oil of Tar, 

Fluid Extract Ipecac, 

Tincture of Opium, 

Fluid Extract Wild Cherry, 

Water, 

Sugar, 

Carbonate of Magnesia. 

Consumptive Cure. 

Syrup Tolu, 

Syrup Wild Cherry, 

Tinct. Hyoscyamus, 

Syrup Squills, 

Chloric Ether, 

Water. 



1610 


APPENDIX. 



Corn Cure. 

Tannin, 

Tinct. Iodine, 

30 grains. 

) 

Acetic Acid, 
Glycerine, 

>• each, 1 drachm. 


Jackson’s Cough Syrup. 

Syrup of Acacia, 

Syrup of Ipecac, 

Syrup of Senega, 

Oil Sassafras, 

Sulphate Morphia. 

Osgood’s Cliolagogue, or Celebrated 
Ague Cure. 

Sulph. Quinine, 

Fluid Ext. Leptandrin, 

Saturated Tiuct. of Queen’s Root, 

Fluid Ext. Podophyllin, 

Oil Sassafras, 

Oil Winter-Green. 


Thompson’s Eye Water. 

Sulphate of Copper, 10 grains. 

Sulphate of Zinc, 40 grains. 

Rose-Water, 2 pints. 

Tinct. Saffron, 4 drachms. 

Tinct. Camphor, 4 drachms. 

Allen's hung Balsam. 


Tinct. Sanguinaria, 
Tinct. Lobelia, 

Tinct. Opium, 

Tinct. Capsicum, 
Essence Sassafras, 
Essence Anise, 

New Orleans Molasses. 


Tpham’s Pile Ointment. 

Powdered Galls, 

Powdered Sugar Lead, 

Powdered Opium, 

Simple Cerate. 

Loomis’s Tonic. 

Sulph. Quinine, 

Aqua, 

Chloroform 
Tinct Mur. Iron, 

Glycerine. 

Tully Powder. 

Sulphate Morphia, 

Pulverized Camphor, 

Pulverized Liquorice Root, 

Prepared Chalk. 


IJpham’s Asthma Remedy, 

Pulv. Stramonium Leaves, 

Pulv. Skunk-Cabbage, 

Pulv. Lobelia. 

Beach’s Diaphoretic. 

Powd. Opium, 

Powd. Ipecac, 

Powd. Camphor, 

Powd. Cream Tartar. 

Safe Kidney and Liver Cure. 
Fluid Ext. Buchu, 

Fluid Ext. Pareira Brava, 

Fluid Ext. Mandrake, 

Fluid Ext. Leptandrin, 

Spirits Nitre, Dulc., 

Oil Juniper, 

Bi-Carb. Potassa, 

Syrup Orange Peel. 

Worcestershire Sauee. 

Cider Vinegar, 

Sherry Wine, 

Allspice, powdered, 

Cloves powdered, 

Black Pepper, powdered, 

Ginger, powdered, 

Cayenne, 

Mustard, powdered, 

Salt, 

Shallots, 

Sugar, 

Tamarinds, 

Curry Powder. 

Bromo-Chloralum. 

Alum, coarse powder, 1 pound. 

Boiling Water, 2 pints. 

Aqua Ammonia, sufficient. 

Muriatic Acid, sufficient. 

Bromine, % ounce, 

Water, sufficient. 

Wistar’s Cough Lozenges. 

Ext. Liquorice, powdered, 

Gum Arabic, powdered, 

Sugar, powdered, 

Oil Anise, 

Sulph. Morphia, 

Tinct. Tolu, 

Water. 

German Rheumatic Remedy 

Wine Colchicum, 

Tinct. Opium, 

Spirits Nitre, Dulc. 


VV.q- E g! v 






CHOICE PRESCRIPTIONS. 


The following choice prescriptions are such as may be used with 
the confidence that they will accomplish all that can fairly be expected of 
medicines. But it must be borne in mind that medicines are seldom 
curative in their effects; and at best can simply palliate symptoms. 
Diseases are cured by the correction of bad habits, or the removal of 
other causes, and by the efforts of Nature, rather than by any mysteri¬ 
ous potency of drugs. Care has been taken to avoid such prescriptions 
as will be likely to be abused, and result in harm. The prescriptions 
given are selected from among those which we have found most useful 
for the purposes for which they are severally recommended. 


For Dyspepsia. —The various forms of dyspepsia require very different 
remedies. The proper regulation of the diet is the most important measure 
of treatment, but the following prescriptions we have found useful as palliatives of 
various troublesome symptoms, and aids to a more speedy recovery:_ 



Bismuth Subcarb., 

dr. 4. 



Glycerine, 

oz. 1. 



Aquae, 

oz. 2. 

M. 

Dose.- 

—A teaspoonful before each meal. Useful in cases in which 

there is great ten- 

demess of the stomach and pain immediately after eating. 




Extract of Hydrastis, 

dr. 2. 



Glycerine, 

oz. 1. 



Aquae, 

oz. 1. 

M. 

Dose.- 

—A teaspoonful. Use same as the preceding, 

and in cases of ulcer of the 

stomach. 



ft. 

Pure Pepsine, 

dr. 1. 



Sugar of Milk, 

dr. 1. 

M. 


Make into sixteen powders, and take one after each meal. Excellent in cases of flatu¬ 
lent and acid dyspepsia. Such patients should also drink two to four glasses of hot water 
one hour (not less) before each meal. The pepsine must be pure, concentrated, not the 
saccharated pepsine usually sold in drug stores. 


Paptonized Gruel. —To one pint of sweet milk add ten grains of bi-carbonate of soda 
(what will lie on a silver ten-cent piece) and five grains of pure pancreatin. Place in a 
warm place for half an hour. The appearance of a slight bitter flavor is evidence that the 
digestion has proceeded far enough. Eat at once, or boil to prevent further action. This 
is a most excellent food in cases requiring artificial aid to digestion, and for use as a nutri¬ 
tive enema in cases requiring it. 


Charcoal. —Dose, a teaspoonful after each meal. Put the charcoal in a tumbler, add a 
few drops of water, sufficient to make a thick paste, then dilute, stir, and take at once. The 
quantity may be increased somewhat without injury. If bran charcoal cannot be obtained, 
charcoal made from boxwood or cocoanut shells is next best in quality. The charcoal must 
be specially prepared. 

J*. Pure Pepsin, dr. 1. 

Charcoal, dr. 2. M. 


(1611) 



1612 


APPENDIX. 


Divide into thirty-two capsules or powders, and take one after each meal. 

The best mode of taking charcoal is in capsules, as its properties are thus most 
thoroughly preserved. 

For Constipation.— 

B. Brown Sugar, tablespoonful 1. 

Water, pt. 1. M. 

Use when there is want of desire for movement of bowels. 

B. Common Salt, dr. 1. 

Aquae, pt- 1. M. 

Use same as preceding. 

Soap and Water Enema. —Make a pretty strong solution of castile soap in warm, soft 
water. Use one pint to two quarts, as may be necessary to secure a movement of the bowels. 
Useful in obstinate constipation. In very obstinate cases, common soap may be used instead 
of castile soap, being more powerful. 

Camphor Water Enema —To half a glassful of water, add ten to thirty drops of spirits 
of camphor, and inject into the rectum half an hour after breakfast,—a most valuable 
remedy when constipation is the result of want of sensibility of the lower portion of the 
intestines. In severe cases, the same quantity of camphor water should be injected into the 
rectum in the evening, and retained during the night. 

Glycerine Enema. —One to two tablespoonfuls of glycerine should be used, with three 
or four times as much water. It is of service in the same class of cases as the preceding. 

B. Extract of Cascara Segrada, dr. 4. 

Simple Sirup, oz. 3. M. 

Cose.— A teaspoonful after each meal. A very mild vegetable laxative, to be taken in 
cases of constipation, in which correction of diet and the employment of the simple means 
suggested elsewhere in this work are not effective, and to avoid the habitual use of the 
enema. Its use should not be long continued. Hot water drinking, two or three glasses 
being taken before each meal, and at night, should be employed in all cases of constipation 
in connection with the prescription above given, unless contra-indicated by some other con¬ 
dition present. 

For Hemorrhoids, or Piles.— The bowels may be kept regular by the use of 
the following prescription, if care respecting diet and the employment of other 
measures recommended elsewhere in this work are not effective:— 

B- El. Extract Cascara Segrada, fl. dr. 4. 

Simple Sirup, fl. oz. 3. M. 

Dose. —A teaspoonful after each meal. The dose may be doubled without injury in 
obstinate cases; but the quantity taken should be gradually diminished until it can be dis¬ 
continued without injury. When there is much tenderness and pain at stool, use the fol¬ 
lowing by enema before going to stool, retaining it as long as possible, at least ten or fifteen 
minutes:— 

B. Elaxseed (unground), oz. 1. 

Hot Water, pts. 2. M. 

Allow to stand two hours before using. A small quantity of this infusion, half a pint, 
may be taken at night, and retained in cases of the sort mentioned. 

The extract of hamamelis is an excellent remedy for use in these cases, and often 


affords great relief. It may be used in any of the following ways:— 


B. El. Extract Hamamelis, 

fl. oz. 2. 


Glycerine, 

fl. oz. 4. 


Aquae, 

fl. oz. 10. 

M. 

Bathe the parts twice a day. 

B- El. Extract Hamamelis, 

fl. oz. 4. 


Vaseline, 

oz. 3. 

M. 


CHOICE PRESCRIPTIONS. 


1613 


(lav. 


Rub well together. Apply this ointment to the parts, if sore and protruding, twice a 


It. 


FI. Extract Hamamelis, dr. 2. 

Cacao Butter, dr. 6. M. 

Rub well together and make into suppositories, one to be used after the bowels move 
in the morning, and one at night. 

Ft. Ac. Tannic, 

Cacao Butter, sufficient quantity. 

Make into ten suppositories. Use same as preceding. 

It. Ac. Tannic, 

Iodoform, 

Cacao Butter, sufficient quantity. 

Make into sixteen suppositories, and use same as preceding. 

For Colic.— 

Charcoal is a useful remedy in cases in which the colic is due to the decomposition of 
the food in the 6tomach or bowels, both as a curative and as a preventive. Give a table¬ 
spoonful of finely powdered vegetable charcoal in half a glass of hot water. As a preventive, 
use a teaspoonful after each meal. In these, as in other cases where charcoal is required, 
the remedy is much more effective if used in capsules, and in much smaller doses. 


gr. 20. 


gr. 30. 
dr. 1. 


M 


M. 


R. Essence of Peppermint, 

dr. X- 


Laudanum, 

drops 2. 


Hot Water, 

oz. 2. 

M. 

Take at one dose. 

R. Tr. Assafoetida, 

dr. 1. 


Starch Water, 

oz. 2. 

M. 


Useful in cases of hysterical colic. 

dr. X- 


Use by enema, to be retained. 

R. Acid Carbolic, 

Simple Sirup, oz. 4. 

Dose .—A teaspoonful in cases of colic with offensive breath. 


M. 


For Dysentery. —In the acute stage of the disease, the employment of 
large enemata of hot water is generally efficient. If there is much pain and 
constant desire to relieve the bowels, use the following:— 


R. 


drops 10. 
oz. IX- 


M. 


Use one-third or one-half the 


Laudanum, 

Starch Water, 

Introduce into the rectum once in four to sfx hours, 
above dose for a child. 

The application to the rectum of a cloth or sponge wet in very cold water is often more 
effective than the opium mixture just described. 

The following prescriptions are particularly useful in chronic dysentery:— 

R. Lime-water, pt 1. 

Boiled Rain-water, pt 1. M. 

Use by enema, retaining it as long as possible. This is especially serviceable to soften 
the mucus and clean out the ulcers. 

R. Vegetable Charcoal, dr. 1. 

Bis. Subcarb. dr. 1. H. 

Divide into twelve powders, and take one three times a day. Will relieve the dis¬ 
charges of their offensive character. 

R. Potass. Chlorat, dr. X- 

Glycerine, * oz. X- 

Aquae, oz - 3. M. 

Inject two or three times a day, having the patient retain it as long as possible. 


1614 


APPENDIX. 


For Cholera Morbus.— 


I*. Tr. Opii., dr. 1. 

Vini Gallici, oz. 2. M. 

Dose .—A teaspoonful every two hours, to be taken in connection with fomentations 
applied to the abdomen, and hot enemas. 

I*. Bismuth Subnit., dr. 4. 

Glycerine, oz. 1. 

Aquae, oz. 1. M. 

Dose .—One or two teaspoonfuls every hour, with other treatment as above suggested. 

For Cholera Infantum.— 


Ijt. Bismuth Subnitrate, 

Aquae, 

Dose .—A teaspoonful once an hour, 
cedes cholera infantum. 


dr. 1. 
oz. 3. 


M. 


Particularly useful for the diarrhea which pre 


Creasote, drop 1. 

Lime-water, oz. 2. M. 

Dose .—A teaspoonful with an equal quantity of milk, to be given as often as the patient 
vomits in cases of cholera infantum, or the vomiting accompanying intestinal irritation so 
common in summer. 

* Daw Meat prepared by first hashing the meat and then rubbing it through a fine seive, 
is an excellent food remedy in many cases, as it furnishes concentrated nutriment in a form 
which cannot ferment. The little patient may receive one-half an ounce to an ounce the 
first day, and the quantity should be carefully increased from day to day until half a pound 
is taken. It may be given at intervals of one to three hours. The raw meat employed 
should be subject to careful scrutiny to insure against infection with tape-worm, the embryos 
of which when present appear as small white specks. Either beef or mutton may be used, 
but the former is usually preferable. 

Torpid Liver. —Perhaps no purely functional disease is more common in 
this country than inactivity of the liver. This is undoubtedly owing to the bad 
dietetic habits of the American people. The difficulty is curable only by a 
removal of the cause ; yet considerable benefit may be derived by the use of some 
simple remedies like the following:— 

ft. Ammonia Chloridi purificati, oz. 1. 

Peppermint water, oz. 6. M. 

Take two teaspoonfuls three times a day with a pint of hot water. The large quantity 
of water is essential to the success of the remedy. The proper time to take it is one hour 
before breakfast and dinner, and just before retiring at night. 

Taraxacum, or Dandelion Root .—This reined}’ was first used for functional troubles of 
the liver and bowels by Arabian physicians several centuries ago, since which time it has 
come into very general use, and probably possesses some virtue as a remedy in these cases, 
through its action upon the bowels, by which the liver is favorably affected. 

9- FI. Ex. Taraxacum, fl. dr. 1. 

Hot Water, pt. %. M. 

Take at one dose one hour before eating, three times a day. 

H Taraxacum Root (bruised), oz. 1. 

Cold Soft Water, pt. 1. M. 

Bring to a boil in a covered vessel, boii ten minutes, strain, and add to the strainer 
enough water to make a pint of the decoction. Take four to six tablespoonfuls in a half 
pint of hot water before breakfast and dinner, and upon going to bed at night. 

Hot Water .—One of the best of all remedies for a torpid liver is the free use of hot 
water. The water should be taken as hot as it can be swallowed without discomfort, and 


CHOICE PRESCRIPTIONS. 


1615 


should usually be taken in quantities of two to four glasses (half pints) three times a day. 
One hour before breakfast and dinner, and just before going to bed at night, are the best 
hours for taking the fluid, as when thus taken it does not interfere with the meals. We 
have recommended this practice in a very large number of cases, and have invariably found 
good results, the dinginess of the eye, muddiness of the skin, and red sediment in the urine 
disappearing in the course of a very few weeks, often in a few days. 

We would not wish to hide from the reader our conviction that the greatest benefit to 
be derived from the foregoing medicinal prescriptions is due to the large quantities of water 
with which they are taken. 

Bright’s Disease of the Kidneys, —There is probably no disease for which 
less can be done by the use of drugs than this, owing to the fact that the disease 
disables a portion of one or both kidneys, producing such changes as can be 
removed by no remedy which can be administered. Medicines which act upon 
the kidneys are particularly harmful. The following simple remedies, however, 
we are able to commend as useful, and of far greater value than any of the much- 
vaunted and advertised quack nostrums, not excepting “ Safe Liver and Kidney 
Cure,” and other delusive remedies:— 

Lemon Water. —To a pint of boiling water, add half a lemon cut in slices. Let it stand 
until cooled sufficiently to allow it to be sipped. Take three times a day, at least one hour 
before eating. 

Cream of Tartar Whey. —To one pint of milk add a half teaspoonful of cream of tartar. 
Strain through a cloth, and drink the whey. Take this quantity three times a day. If the 
digestion is at all disturbed by the long continuance of the remedy, substitute the preceding. 

Camphor-Vapor Bath. —Arrange the patient as directed elsewhere in this work for a 
hot-air bath. Place over the alcohol lamp a tin plate, and on this place two or three tea- 
spoonfuls of camphor gum. This is an excellent bath for stimulating the skin in Bright’s 
disease, and is also useful in chronic rheumatism. 

It. Acid Carbolic, fl. dr. 1. 

Essence of Cinnamon, fl dr. 3. 

Rain-water, boiled, fl. oz. 6. M. 

An excellent lotion to apply to the legs after puncturing to allow accumulated fluid to 
escape, as is often necessary in cases of Bright’s disease. 

Ague, or Chills and Fever. —This disease should first be treated according 
to the directions given elsewhere in this work. If after a reasonable time the 
chills still continue to recur, the following remedies may be resorted to:— 

J*. Tincture of Camphor, fl. oz. %• 

Hot Water, pt. M. 

Take fifteen minutes before the chill is expected. In many cases the chill may be pre¬ 
vented by this means, especially if the patient takes the additional precaution to be in bed 
surrounded by woolen sheets, and, if necessary, a good supply of hot jugs, bricks, or hot- 
water bags. 

Amyl Nitrite is a remedy of established value for modifying the chill, and sometimes 
even averting it. Five or six drops should be placed upon a handkerchief, and inhaled. 

A half teaspoonful of Chloroform in half a glass of milk, taken just at the time when 
the chill is expected, will often accomplish the same result. 

Peruvian Bark, in one form or another, is the most reliable remedy for interrupting 
the paroxysms of this disease. It may be given in the form of quinine or chinoidine. Of 
the former, two to four grains may be given at intervals of four hours, beginning twenty- 
four hours before the expected chill. The dose of chinoidine must be about twice as great. 
The chinoidine may be made into pills, and 20 taken; the quinine is best taken in the form 
of capsules or sugar-coated pills. 

Eucalyptus, the oil obtained from the tree of that name, has lately acquired a reputa- 


1616 


APPENDIX. 


tioD as an anti-periodic. The dose is half a teaspoonful of the oil to be taken in mucilage 
or milk. 

Aconite, in drop doses of the tincture, may be used hourly for two or three hours dur¬ 
ing the febrile stage in addition to the cool sponging recommended in our description of the 
proper treatment of this malady. When perspiration begins, the remedy should be con¬ 
tinued. It has no curative influence, but shortens the febrile stage. 

For Bladder Difficulties. —The following are a few of the prescriptions 
which we have found of greatest service in the treatment of cases requiring the 
use of the bladder douche. 


It. Common Salt, dr. 1 . 

Aquae, pt. 1. M. 

Excellent for simply cleansing the bladder, or distending it when contracted. 

It, Bi-carbonate of Soda, gr. 16. 

Aquae, pt. 1. M. 

Use when urine is acid, or shows a brick-dust deposit. 

It. Boracic Acid, dr. 1. 

Aquae, pt. 1. M. 

Useful as a cleansing injection, and in cases of acute catarrh of the bladder. 

It. Ex. Hydrastis (aqueous), f. dr. 2. 

Aquae, pt. 1. M. 

Useful in chronic catarrh of the bladder. The strength may be increased by degrees. 

For Mouth and Throat Diseases. —The following prescriptions we have 
tested by experience, and know to be of real value in the treatment of the condi¬ 
tions for which they are recommended:— 

It- Borax, dr. X- 

Glycerine, f. oz. 1. M. 

Apply with camel’s-hair brush or swab in thrush or aphthae. 

It- Chlorate of Potash, dr. 1 . 

Aquae, f. oz. 4. M. 

Use as gargle in sore mouth or sore throat. 

It. Acid, Carbolic, dr. 

Glycerine, f. oz. 1. 

Aquae, f. 0 z. 3. M. 

Apply to throat in severe diphtheria with fetid breath, by means of atomizer or 6 wab. 
It. Chlorinated Soda Solution, oz. 

Aquae, f. oz. 3. M. 

Use as gargle or with atomizer in diphtheria when the breath is foul. 

It- Acid Tannic, gr. 10. 

Glycerine, f. oz. 1 . 

Apply to back of throat with brush or swab in cases of chronic sore throat, with re¬ 
laxed uvulae. 

It. Chloride of Sodium (Common Salt), dr. %. 

Aquae, f. oz. 4 . M. 

Inhale spray with atomizer three times a day for acute hoarseness from a cold. 

It. Acid Tannic, gr. 4. 

Aquae, f. oz. 1 . M. 

Inhale spray daily for chronic sore throat and hoarseness. 

It. Alum, gr. 5 . 

Aquae, f. 0 z. 1 . M. 

Use for same purpose as the preceding. 


CHOICE PRESCRIPTIONS. 


1617 


For Croup. — In treating this disease, the chief reliance must be placed upon 
cold applications to the throat, and other measures elsewhere recommended in 
this work; but the following prescriptions will be found of service in relieving 
the conditions for which they are recommended:— 

I*. Alum, powdered, dr. 4. 

Honey or Molasses, oz. 1. M. 

Dose. —Two t^aspoonfuls once in half an hour until vomiting is produced. To be used 
only where the breathing is greatly obstructed, and the patient gets no relief by coughing. 


It. Acid Carbolic, dr. 1. 

Glycerine, oz. 1. 

Aquae, oz. 5. M. 

Inhale one-half ounce every two hours. Is very useful in allaying the inflammation. 

Bromine, drops 4. 

Potass. Bromid., dr. 1. 

Aquae, oz. 4. M. 

Inhale with steam atomizer to dissolve membrane. Repeat as needed. 

Lime. —This is one of the very best agents for dissolving the false membrane. It may 
be used as lime-water, with a steam atomizer, or by inhaling the vapor arising from slacking 
lime as follows: Put freshly burned lime in a pan. Pour on boiling hot water. Cover the 
pan with a large paper funnel, or a stiff paper bag one corner of which has been cut off, and 
allow the patient to inhale the vapor through the aperture. Care must be taken to avoid 
burning the patient at first, while the vapor is very hot. When properly used, this is un¬ 
doubtedly the best known means of combating the worst feature of this grave disease. It 
is also useful in diphtheria, when there is danger of suffocation from the false membrane. 


For Consumption.— 


Lime-Water. —The use of lime-water and milk, in the proportion of one part of lime- 
water to three parts of milk, two to four pints to be taken in a day, is a very effective 
dietetic remedy in this disease. 

Carbolic Acid has been much extolled as a remedy for consumption. It has been admin¬ 
istered by a variety of methods, chiefly in solution by the mouth, by hypodermic injection, 
and by inhalation. The following is a good formula for inhalation with the atomizer:— 

Ji. Acid Carbolic, drops 2. 

Aquae, oz. 7 M. 

Use two or three times a day. 

The following we have found less irritating and more acceptable in some cases, with 
effects fully as beneficial:— 


I*. Oil of Wintergreen, drops 4. 

Alcohol, dr. %- 

Glycerine, dr. 2. 

Aquas, dr. 5. 


Use with atomizer, one-half ounce, three or four times a day. 


M. 


Benzoate of Soda has enjoyed a great reputation as a curative agent in consumption, 
though larger experience has not confirmed the first enthusiastic accounts of its merits. 

H. Benzoic Acid, gr. 10. 

Carbonate of Soda, gr. 10. 

Aquae, oz. 2. M. 

Use with atomizer, one-half ounce, two or three times daily. 

The Compound Tincture of Benzoin is a very soothing remedy, often relieving a very 
distressing cough. Ten to twenty drops may be used in the steam inhaler several times a 
day, or a half dram of the tincture may be added to a pint of boiling water in an open 
vessel, and the steam inhaled through a paper funnel. The Gum Benzoin has been em- 


1618 


APPENBTX. 


ployed in a somewhat rude though effective manner, a piece of the gum the size of a hazel¬ 
nut being placed on a hot shovel, and the fumes inhaled. 

Iodoform, though not very agreeable, is a useful remedy, especially where there is 
ulceration of the larynx. A dram of iodoform should be mixed with a half ounce of starch, 
and the fumes inhaled from the mixed powder spread upon paper. 

Iodine sometimes relieves a troublesome cough when used as follows:— 

Add a dram of tincture of iodine to an ounce of water. Apply gentle heat, and inhale 
the fumes cautiously. * 

Cod-Liver OH once enjoyed a very great reputation for the cure of consumption; but 
it is now generally admitted that its merits were greatly exaggerated, and no less an 
authority than Prof. Walsh, of the University College Hospital of London, admits that it is 
open to many objections, of which the following are a few: 1. It often disagrees with the 
digestion of the patient, producing nausea, loss of appetite, and diarrhea; 2. It is injurious 
in cases of inflammation of the lung tissues and hemorrhage; 3. Its beneficial effects are 
not marked in incipient cases; 4. Although the patient may seem to be benefited, the 
weight being apparently increased, the disease may be making steady advancement all the 
time; 5. It is injurious in cases in which there is enlargement or fatty degeneration of the 
liver. Experience with a large number of cases of this disease has convinced the author 
that sweet cream and rich milk are quite as beneficial as cod-liver oil, much more easily 
assimilable, and free from the objections urged against the latter. 

Olive-Oil and Cocoa-Nut Oil are very useful as external remedies. They may be used 
interchangeably, care being taken to secure an absolutely pure article, which is difficult as 
regards olive-oil. Cocoanut oil is likely to be slightly rancid. It must be kept in a cool 
place, in a tightly-corked bottle, or covered with lime-water. Apply the oil daily after a 
saline sponge, with considerable friction of the surface. 

Saline Sponge Baths are of great service in checking night sweats and improving the 
circulation. They may be employed either quite hot, 120° F., or tepid, about 92° F. If used 
to relieve night sweats, the bath should be given at bed-time. 

Vinegar Baths are also serviceable for the same purpose. Use one part of good cider 
vinegar to three parts of water. 

Alcohol Baths are still more effective in some cases. One part of alcohol should be 
employed with three of water, and may be applied either hot or tepid. 

For Catarrh.— 


Common Salt, dr. l. 

Aquas, pt. l. M. 

Draw into the nose from the hand or a sponge, or use with nasal or post-nasal douche. 
Useful in cases in which there is a profuse discharge, with or without a tendency to form 
scabs. As a cleansing solution, it is good in most cases of catarrh. 


Sulphate of Zinc, dr. 1. 

Aquae, pt. 1. M. 

To be used in the same way as the preceding, after cleansing the nasal cavities with the 
salt solution. May be still better used by means of the hand atomizer. Useful in cases in 
which there is a profuse discharge and dropping at the back of the throat. 


Sulphate of Iron, 

Aquae, 

Use same as the preceding. 

I*. Ferric Alum, 

Aquae, 

Use same as preceding. A very excellent remedy. 

J*. Tannic Acid, 

Aquae, 

Use same as the preceding. In some cases a vegetable 
results than the mineral. 


dr. 1. 

pt. 1. M. 


dr. 1. 

pt. 1. M. 


dr. 1. 

pt. 1. M. 

astringent produces better 


CHOICE PRESCRIPTIONS. 


1619 


J5- Potass. Permanganate, dr. 

Aquae, pt. 1. M. 

Use same as preceding in cases of catarrh accompanied by an offensive odor. 

J5. Extract of Witch-Hazel (distilled), oz. 2. 

Aquae, oz. 2. M. 

Use in same manner as preceding in cases in which there is dryness of throat and nose 
from insufficient secretion. 

J5. Borax, dr. 1. 

Bi-carbonate of Soda. dr. 1. 

Glycerine, f. oz. 

Aquae, pt. 1. M. 

An excellent cleansing solution, to he used in cases of chronic catarrh as a preparation 
for the application of other remedies. Use with atomizer. 

55. Chlorate of Potash, dr. 1. 

Aquae, pt. 1. M. 

Use with atomizer in cases of catarrh with an irritating discharge. 

15. Oil, Eucalyptus, dr. %. 

Oil, Petrolina, f. oz. 3. M. 

Use daily with atomizer in cases of dry catarrh. 

15. Boracic Acid, dr. 1. 

Powdered Gum Acacia, dr. 2. M. 

Use as a snuff in cases of catarrh with offensive discharges, after cleansing. 

For Pneumonia.— 

15. Tincture Aconite, drops 16. 

Aquae, oz. 2. M. 

Dose .—A teaspoonful every half hour for two hours, then every hour for three hours. 

15. Bicarbonate of Potash, dr. 3. 

Gum Water, oz. 3. M. 

Dose .—A teaspoonful in water every three or four hours. It delays the cough and 
facilitates expectoration. Fomentations should be applied to the chest at the same time 
after the first day. 

For Neuralgia. —Applications of heat in the form of a hot bag or brick, or 
hot fomentations, or in some cases the employment of ice or iced water, are most 
effective means of relieving neuralgia, as a rule. When these fail, however, the 
following may be tried:— 



Atropia Sulph., 

gr. 5. 



Aquae, 

oz. 3. 

M. 

Soak a 

cloth in the solution and apply over the paiuful 

part, covering 

the compress 

with oiled silk or muslin, and changing every hour or two. 




Meuthol, 

dr. 3. 



Oil of Wintergreen, 

dr. 1. 



Oil of Peppermint, 

dr. 1. 



Alcohol, 

oz. 3. 

M. 


Use as a liniment, 
external application. 


One of the most efficient of all remedies for the relief of pain by 


For Lumbago. —Employ the same remedies recommended for neuralgia. 
The following are also very effective remedies:— 


15. Extract Cascara Segrada, 

Aquae, 


dr. 4. 
oz. 2. 


M. 


1620 


APPENDIX. 


Dose .—A teaspoonful three times a day until the bowels are loose. At the same 
time drink ten to twelve glasses of hot water daily. Two or three glasses should be taken 
an hour before each meal, and at night, on going to bed. 


Pi. Bicarbonate of Soda, 

lb. * 


Aquae, 

gals. 2 

* M. 

Heat to boiling, and apply to the loins by means of 

flannel cloths 

wrung out suffi- 

ciently dry to prevent dripping. 



For “ Poison Ivy ” or “ Poison Sumach.”— 



Ji. Ammonia Water, 

oz. 1. 


Glycerine, 

oz. 1. 


Aquae, 

oz. 4. 

M. 

Apply as soon after contact as possible. 



Saleratus or soda, 

oz. X. 


Aquae, 

oz. 8. 

M. 

Soft soap may be employed in the absence of the above. The poisonous principle is an 

acid, which must be neutralized by an alkaline wash of 
prescriptions are the best. 

some kind, of 

which the above 

For Nettle Sting.— 



Use same prescriptions recommended for “ Boison Ivy, 

” and also the following:— 

pi. Acid Carbolic, 

dr. 1. 


Glycerine, 

oz. X- 


Ammonia Water, 

oz. %. 


Aquae, 

oz. 5. 

M. 


Bathe the part affected. 


Palpitation of the Heart. —This affection is often due to indigestion, the 
use of tobacco, tea, or coffee, masturbation, and marital excesses. It is also a 
frequent accompaniment of the general disturbances occurring at the change of 
life. It is very common with nervous invalids, particularly young women. 
When due to organic disease of the heart, a permanent cure cannot be effected; 
but in other cases it disappears on removal of the cause, which should be the 
first matter of attention, after which the following remedies and measures may 
be employed:— 

W Tinct. Aconite, drops 10. 

Water, glassful M. 

Take a teaspoonful every fifteen minutes for an hour or two. 

Camphor is a valuable remedy in these cases. A tablespoonful of Aqua Camphorce , or 
a half teaspoonful of the tincture in a little sweetened water, is the proper dose. 

I*. 01. Eucalyptus, fl. dr. 1. 

Olive or Almond Oil, fl. oz. 2. M. 

A teaspoonful in two tablespoonfuls of milk is very effective in relieving the palpitation 
incident to the change of life. 

A Belladonna Plaster worn over the region of the heart, is often very effective. 

Posture is an excellent means which should always be tried. The patient should bend 
the body forward, allowing the arms to hang down and holding the breath for a few seconds. 

Pressure upon the large vessels of the neck, making firm pressure with the thumbs 
upon both sides at once for a quarter of a minute at a time, is a very effective means of 
relieving nervous palpitation. 

Ice , contained in a rubber bag, should be worn over the region of the heart when the 
palpitation is persistent and does not yield to other treatment. 


CHOICE PRESCRIPTIONS. 


162J 


For Diarrhea.— 


9- Cinnamon Water, oz. 3. 

Subcarbonate of Bismuth, oz. 1. M. 

Dose .—A teaspoonful once in three or four hours. 

This is especially serviceable in diarrheas due to intestinal irritation. Excellent in most 
cases of diarrhea in children, for whom the dose should be one-half to one-third that given 
above. 


it. Tincture of Coto bark, dr. 4. 

Simple Sirup, oz. 2. M. 

Dose.-— One to two teaspoonfuls once in three hours. 

Useful in both acute diarrhea and the diarrhea of consumption. 


14. Tincture Quassia, 

Hot Water, 

Use by enema while hot, the whole quantity twice a day. 
cases of diarrhea due to irritation produced by retained faeces. 


oz. 2. 

qts. 2. M. 

Especially serviceable in 


For Hiccough. —Have the patient He on the left side. If the hiccough does 
not soon cease, give snow or ice-pills freely. Apply a fomentation or a mustard 
plaster over the stomach. A strong current of faradic electricity may be applied 
over the region of the diaphragm with good effect in most cases. Failing in 
these measures, try the following:— 

9- Tinct. Physostigmatis, *fl. dr. 1. 

Potass. Carb. dr. 1. 

Mist. Acaciae, fl. dr. 6. M. 

Dose .—A teaspoonful at intervals of an hour or two if the first is not effective, or three 
times a day in chronic hiccough, for which it is especially useful. 

Five drops of chloroform administered on a lump of sugar is useful when other meas¬ 
ures fail. 

A dyspeptic hiccough may be relieved by two or three glasses of hot water taken 
rapidly, or a little “ mint and soda ” in hot water if the stomach is acid. 

For Sore Nipples. —The following are a few of the most efficient remedies 
for use in cases of sore or cracked nipples :— 

9;. Alum or Borax, gr. 15. 

Whisky, f. oz. 1. M. 

Apply to surface twice a day when tender but not raw, for the purpose of hardening. 


9- Zinc, Sulphas, 

gr. 10. 


Aquae, 

f. oz. 2. 

M. 

Apply daily when slightly abraded or cracked. 

9. Tannic Acid, 

gr. 15. 


Glycerine, 

f. oz. 1. 

M. 

Apply after cleansing the part, twice a day. 

9- Tannic Acid, 

dr. 3. 


Glycerine, 

f. dr. 1. 


Aquae, 

f. dr. 2. 

M. 

Vaginal Lotions for Leucorrhcea. — The following are a 

few of the most 

serviceable prescriptions for use by injection into 

the vagina in 

the treatment of 

vaginal and uterine affections :— 

9. Tannic Acid, 

oz. 2. 


Glycerine, 

f. oz. 1. 

M. 


1622 


APPENDIX. 


Add a teaspoonful to a pint of cold water, and use daily after hot douche in mild cases 
of leucorrhoea. 

9- Boracic Acid, oz. 1. 

Aquae, pts. 2. M. 

Inject one-half pint after hot douche daily, in leucorrhoea, particularly when there is an 
acid or irritating discharge. 

9. Alum, dr. 2. 

Ac. Tannic, dr. 1. 

Aquae, pt. 1. M. 

Use after hot douche daily, in leucorrhoea or chronic congestion of the womb. 


9- Alum, 

Decoction of Oak Bark, 

Use daily after hot vaginal douche in leucorrhoea. 


dr. 1. 
pt. 1. 


M. 


9- Hops, 

Hot Water, 


oz. 1. 

pt. 1. M. 


Let stand over night. Inject after hot douche in cases of leucorrhoea in which there is 
much irritation. 


For Vaginal Pledget.— 

9- Tannic Acid^ oz. 1. 

Glycerine, f. oz. 4. M. 

Dissolve, use daily, or three times a week, alternating with pure glycerine or vaseline. 
Useful in cases of subinvolution of the vagina and womb, enlargement of the womb, and 
profuse leucorrhoeal discharge. It will be necessary to dilute the preparation with an equal 
quantity of glycerine in many cases at first. 

9:. Ac. Carbolic, 

Glycerine, 

Mix thoroughly. 

This is useful as an alternate for the preceding, and in all cases in which glycerine is 
indicated. It may be used instead of the preceding when the vagina is tender, alternating 
with the vaseline pledget until the parts will bear the tannin preparation. It is a very 
healing preparation. 

9- Iodoform, 

Balsam Peru, 

Glycerine, 

Very useful in cases of ulceration or abrasion 
is an irritating or offensive vaginal discharge. 

9- Iodoform, dr. 1. 

Tannic Acid, dr. 2. 

Glycerine, f. oz. 1%. M. 

Of special service in profuse, excoriating leucorrhoea. Apply daily. 

9- Ex. Eucalyptus, f. oz. 2. 

Glycerine, f. oz. 2. M. 

Apply daily. 

This new remedy we have found exceedingly valuable as a means of relieving the 
harassing neuralgic pains so common in cases of chronic disease of the womb and ovaries. 
It is also useful in cases in which there is an offensive leucorrhoeal or menstrual discharge. 


dr. 2. 
f. dr. 1. 

f. oz. 1. M. 

of the neck of the womb, and when there 


dr. 1. 
f. oz. 12. 


CHOICE PRESCRIPTIONS. 


l633 


For Vaginismus.— 


tit. Iodoform, 

dr. 


Vaseline, 

dr. 4X- 

M. 

Useful in cases of painful contraction, or vaginismus. 

The ointment should be applied 

on a little plug of charpie or lint, which should be gradually increased 

in size from day to 

day until the painful contraction is overcome. If the odor is very objectionable, a little Bal- 

earn of Peru may be added. 



J?fc. Ex. Bella., 

dr. 1. 


Vaseline, 

oz. 1. 

M. 

Apply on charpie as directed for the preceding. 



For Irritable Vulva.— 



Borax, 

dr. 1. 


Aquae, 

oz. 4. 

M. 

Apply to the vulva when irritable, using lint or soft linen cloths for the purpose. 

G Acid, Boracic, 

dr. 1. 


Aquae, 

oz. 4. 

M. 

Apply same as preceding, and for same purpose. 



I*. Ac. Carbolic, 

f. dr. 1. 


Glycerine, 

f. oz. 1. 


Aquae, 

f. oz. 15. 

M. 

Apply with lint or soft cloths in cases of inflammation of the vulva. 

• 

For Gonorrhoea and Gleet.— 



The best of all measures is the hot urethral douche. 

This may be taken by the aid of 

a fountain syringe, or by a pail, and a rubber tube six or eight feet long, and an ordinary soft 
rubber catheter. The catheter should be passed into the urethra to a point aq inch or two 
in front of the bladder, so that the canal will be cleansed throughout its entire length. The 
quantity of water should be one or two gallons, and the temperature as hot as can be borne, 

or beginning at 105° F. and gradually increasing to 120' 

0 F., or even 

higher. After this 

treatment, which is equally beneficial and essential in both gleet and acute gonorrhoea, some 

one of the following prescriptions may be employed:— 



It Carbolic Acid, 

dr. 1. 


Gum Water, 

oz. 8. 

M. 

Use with urethral syringe, half an ounce two or three times a day in acute cases in 

which there is much irritation or soreness. 



Jt. Bismuth Subnitrate, 

dr. 4. 


Gum Water, 

oz. 4. 

M. 

Use same as preceding, shaking just before using. 



p. Tannic Acid, 

dr. X. 


Carbolic Acid, 

dr. 1. 


Glycerine, 

oz. 2. 


Aqu;e, 

oz. 12. 

M. 

Use half ounce twice a day in recent cases. 



fy. Hydrastin, 

dr. 1. 


Gum Water, 

oz. 4. 

M. 

Use half ounce twice or three times daily in acute cases. 


Oil Copaibae, 

oz. 


Powdered Gum Acaciae, 

oz. 1. 


Aquae, 

oz. 3. 

M. 


Use hall ounce twice a day in cases of gleet. 


1624 


APPENDIX. 


M. 


9. Cider Vinegar, oz. 2. 

Aquae, oz. 6. M. 

Use same as preceding, gradually increasing the proportion of vinegar until nearly pure 
vinegar can be used. 

For Syphilis.— 

It ought to he stated at the outset that no medicine will absolutely cure this disease. 
Mercury and some other remedies will cause a disappearance of the symptoms, but the 
disease may still be lurking in the system. We can only recommend the following:— 

IJr. Potass. Iodide, dr. 1. 

Syr. Sarsaparilla, oz. 3. M. 

Take a teaspoonful three times a day with a glassful of water. Most efficient in the 
later stages of the disease. 

Tinct. Iodine, 

Tinct. Opii, 

Aquae, 

Use as gargle in painful syphilitic ulceration of the throat. 

I£. Sulphuric Acid (concentrated), 

Powdered Charcoal sufficient to form a paste. 

Useful for destroying a chancre. A little of the paste should be applied and retained 
for a few minutes. Nitric acid may be used for the same purpose without mixing with the 
charcoal. 

Lotions for the Skin.— 

9b Canp. Tr. Benzoin, dr. 4. 

Alcohol, oz . % % 

Glycerine, oz . 1. 

Water, oz. 2. M. 

An excellent lotion to cure and prevent chapping of hands. A small quantity rubbed 
on the hands after washing, morning and night, will keep the skin soft and healthy. Also 
an excellent lotion for the face, clearing the skin, and removing freckles caused by wind and 
6 un. 

9b Zinc Sulphate, 

Rose-Water, 

Apply to face twice daily to remove redness and pimples. 


dr. 1. 
dr. 1. 
oz. 5. 


dr. 1. 


dr. 1. 
pint 1. 


M. 


9- 


dr. 1^. 
dr. 1^. 
dr. 2. 
dr. 4. 
oz. 1. 
oz. 6. 


M. 


Much better than most of the lotions sold 


Borax, 

Carbonate of Soda, 

Carbonate of Ammon, 

Aquae Ammonia, 

^ Glycerine, 

Water to make, 

An excellent lotion for cleansing the hands, 
for this purpose, and less expensive. 

Disinfectant Lotions.— 

fy. Copperas, lb . 2 . 

Water, gal. 1. M. 

wher"^* S * n ^ CC ^ an ^ ^° r U8e scar let fever and diphtheria patients, as directed else- 

I*. Sulphate of Zinc, lb. 

. Aquae, gal. ^ 

Disinfectant lotion for cleansing cloths used in connection with diphtheria and scarlet 
fever patients. * 

9b Potassium Permanganate, oz 2 

. . Ac l u *> gal. i. M. 

the diseb^rffe« U nf ° r v as * bo ^ e ' A teacupful should be placed in the vessel which receives 
the discharges of a diphtheritic or scarlet fever patient. 


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